New PSA results, even more troubling

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Purgatory
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Date Joined Oct 2008
Total Posts : 25380
   Posted 4/4/2011 3:25 PM (GMT -6)   
I was going to wait until my next 3 month reading in May for the PSA,  but considering that my PSA rose from .06 to 1.24 in 6 months time, I decided last week to have a new reading  (same doctor, same lab).  My last reading was in February, and this one was done 6 weeks later  (approx).  It came back at 3.81.  This was the last ultra sensitive test done, as there is no point.  So its hard to believe, this is my 3rd rise since the SRT has failed, that my PSA tripled as a whole number, not a .xx number, in six weeks time.  My own opinion, I have a total runaway situation on my hands, with both surgery and SRT failing.  It must be a very aggressive strand, and at this rate of acceleration, I could easily be in met stage before the end of the year.  Don't you just love this disease?
 
Now back to the think tank, still in shock.  I thought mabe a doubling at the 3 months mark in May, but not a tripling in just 6 weeks.  Almost like I am racing for the finish line.  Next PSA will still be the original May date.
 
David in SC

clocknut
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Date Joined Sep 2010
Total Posts : 2666
   Posted 4/4/2011 3:43 PM (GMT -6)   
Sorry to hear that, David.  You're right.  This disease really sucks. 

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2842
   Posted 4/4/2011 3:56 PM (GMT -6)   
David:
So sorry to hear the higher numbers in such a short time - there have been postings about looking at the biopsy samples and poorly formed cell structures that point to odd strains of PCa - can your doctors re-examine the original slides or new bloodwork to see what the cells are up to and possible create a scenario to slow the progress down - sorta like the BONKHOFF link that was on HW showing different cell slides?
-I went to one PSA doubling site - nomogram - and punched in your numbers and it looked like it was leveling off instead of just exponential - and the other site - the sloan kettering PSA doubling chart does not allow your original numbers which were less than <.10
www.mskcc.org/APPLICATIONS/NOMOGRAMS/Prostate/PsaDoublingTime.aspx
-hope I am making sense - just want the best for you.
-gentle hugs, BRONSON

Post Edited (tatt2man) : 4/4/2011 4:23:41 PM (GMT-6)


James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 4/4/2011 4:10 PM (GMT -6)   
David..... cry shakehead
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RP, Path: pT2c, 110 gms., clear except:
Probable microscopic involvement-left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09, 12/10-.09, 02/11-.08
ED-total-Bimix 30cc

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 4/4/2011 4:20 PM (GMT -6)   
Sorry to hear that news David. Not much I can say except some of us are not far behind you. I told someone that I needed to look at the Michael Milliken book about his PCa. Keep us posted.
Michael
 

Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 697
   Posted 4/4/2011 4:20 PM (GMT -6)   
Keeping you in my thoughts, David.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) Jan-Mar 2007
PSA 9/2007 and thereafter <0.1
pcabefore50.blogspot.com

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 4/4/2011 4:28 PM (GMT -6)   
That sucks David, I'll keep you in my thoughts and hope for the best.
Dave in Durango CO

RayPat
Regular Member


Date Joined Apr 2010
Total Posts : 104
   Posted 4/4/2011 4:41 PM (GMT -6)   
David, so sorry to hear of the PSA rise. I don't know enough about this darned disease to offer anything other than to say I'll keep you in my thoughts and prayers.

Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 4/4/2011 5:02 PM (GMT -6)   
Hi David. So sorry to read about the less than stellar test result mad
You are in my thoughts. And yes, this disease sucks big time.
One of your many friends here, Mag
Born 1936
PSA 7.9, Gleason Score 3+4=7, 2 of 8 positive
open RP Nov 06, T3a, Gleasons 3+4=7, Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; at SRT Start=0.1,
Salvage RT completed (33 days-66Gy) 19 Dec 08
PSA: in Jan 09 =.05, all tests to date (Jan 11) <.04

duke68
Regular Member


Date Joined Mar 2007
Total Posts : 242
   Posted 4/4/2011 5:03 PM (GMT -6)   
Hi David

Sorry about the lousy psa report.

My psa started rising in march 2010.
Last psa before starting treatment was a quadruple (4*) in 3 months. :( :(

I know you have an aversion to hormone therapy but you need to seriously consider it now.
I was in the right place when mine went aggressive and went on a clinical trial.

My psa is undetectable now. Oncologist says he does not think the Avastin is doing it.

My thoughts are with you.

Best Wishes
Gerry
age 72 diag 68 Oct 2006 G8 T2b psa 11.7
4 of 8 cores 20% 30% 60% 100%
rrp Dec 2006 G9 4+5 m+ sv+ ece after 6 weeks psa 0.6 second opinion Dana-Farber pT3b 4+4 + T5 = G9
3/2007 ADT2 6 months lupron + casodex
4/2007 SRt 35 sessions to lymph nodes and prostrate. Psa <0.1 from June 2007 to March 2010
Psa 6/10 0.3 9/10 0.6 12/10 2.5 :(
Dana- Farber Phase 2 trial Avastin ADT2
3/11 psa 0.02

Jakester
Regular Member


Date Joined Aug 2009
Total Posts : 285
   Posted 4/4/2011 5:07 PM (GMT -6)   
Can't offer much except support, and wishes for a next reduction or leveling off. For what it is worth, I'm taking a short list of supplements.. Fish oil, D3 and pomegranate pills... just in case it helps.

No matter what stage we are in, we are all walking together in support of each other.

Only the best for you and the rest of the gang,
Jake
Dx 8/08 Pre-op psa 4.2, Age 60, 7 of 12 biopsies positive 3+3
DaVinci LRP 11/08, - margins, - EPE, vascular or perineural. Gleason 3+4=7, 5-10% of 4.
3 mo psa .1 2/09, 6 mo .1 5/09, 9 mo .2 8/09
broke ankle bones 6/09, 9/21/09 Bone scan clear, psa still .2
01/05/10 psa .3, SRT 01/19/10 start 39 sessions 70.2gy, psa @ 6 wks into IMRT .4; Post SRT psa @ 10 wks (5/10) .2, @20 wks .1, @8 mo still .1

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 4/4/2011 5:14 PM (GMT -6)   
Oh David...what awful news!! What's your plan of action-have you met with an oncologist yet? Waiting til May seems awfully risky at this point, especially if you believe you'll have mets by the end of the year. Maybe you should plan your trip to NYC sooner rather than later and line up some appointments here?

Keep us posted. And, as always, you'll be in our prayers.

Sephie & John

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/4/2011 5:16 PM (GMT -6)   
David,
I am sorry you are going to have to make a tough decision. I know that you know what the doctors will likely suggest as the next direction. And unfortunately the decision will need to come fairly quickly.

Alternatives to hormonal therapies are few but there are some variations that you can consider. None are without side effects but some are more manageable than others. It's way too early for chemotherapies so that would probably wait. Another option is to look at clinical trials. At this point you need someone well versed in the available options, too.

Good luck in the coming weeks. You know we'll be here for you.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 4/4/2011 5:38 PM (GMT -6)   
David,

I wish it were possible for me to say something positive, but your increase in PSA is very troubling. The velocity is more than disturbing, it is quite startling, and I am very concerned for you.

In the past I have had no comment re: local doctors versus nationally recognized experts. But if I were you at this time I would make it a priority to seek treatment with one of the national experts in the field of medical oncologist, and best one that specializes in PCa. Perhaps that Meyers guy up the road in Virginia, really not so far from us. Your condition in terms of PSA velocity seems off the wall and I really believe you deserve more than ordinary local care can provide.

Sancarlos
Age 66, PC diagnosed 7/2009 at age 65
Stage: T2c, Gleason: 9 (4 + 5), 6 of 6 cores positive
Bone, CAT and MIR scans negative

Treatment: brachytherapy (103 palladium), 100 gy, 11/2009 + IMRT on Novalis, 45 gy, 3/2010 + ADT3 (Lupron + Casodex+Avodart)

PSA: 7/2009, At time of diagnosis -- 11.9
10/2009 -- 5.0 ; 12/2009 -- 0.56 ; 5/2010 -- 0.15
8/9/2010 -- 0.06 ; 11/2010 -- 0.013; 3/25/2011-- 0.005

Gleason 6
Veteran Member


Date Joined Mar 2011
Total Posts : 876
   Posted 4/4/2011 5:44 PM (GMT -6)   
David,

I know I haven't known you all that long, but I appreciate the input
you have given me and we all have this lousy cancer in common. I'm sorry to hear the news.
Age 61
PSA 4.3 9/10
PSA 5.5 2/11
PSA 7.1 3/11
Template Biopsy 6 pos out of 40 3/25/11 GS 6

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3800
   Posted 4/4/2011 5:47 PM (GMT -6)   
David -- i'm speechless.  you've got to slow this thing down, my friend.
 
ed
 
 
age: 56
PSA on 12/09: 6.8
gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 4/4/2011 5:51 PM (GMT -6)   
Sorry bout the news, David.

My boss had HT treatment and once he finished it, got back to normal pretty quickly. His PSA is 0 now. I'm positive yours will be too.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7200
   Posted 4/4/2011 5:54 PM (GMT -6)   
David:
 
This is shocking news. I am so sorry to read this.
 
Please try and see someone who knows a lot about treating advanced cancer. Your doubling time is increasing (like mine). You can't just sit around in a state of torpor and ignore it all.
 
There may be non-HT things for you to try. But you won't know until you meet face-to-face with an expert. I know it's the same old tune and you don't like to hear it from me.
 
Did you get any leads on who to see? It is time to make some telephone calls and make an appointment. Doesn't your local urologist have any recommendations?
 
This disease and these test results just shake one to the core. You did have recent scans, correct?They were fine except for the hip problem. Correct?
 
Please don't just sit around. You still do not have a very large tumor load (probably). You have reached that bridge. It is not the HT bridge. It is the bridge to go consult.
 
Good luck
 
Mel
 
 

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 4/4/2011 6:01 PM (GMT -6)   
So very sorry to here this news!!!  Cooper

Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 208
   Posted 4/4/2011 6:19 PM (GMT -6)   

David, very disappointed about your rise in psa.  Mine also did this but not quite as fast.  I said we have to do what we have to do so I started the HT (lupron) and so far except for loss of libibo (which I pretty much had after the RRP) and the hot flushes (which Effexor has significantly reduced) I can honestly say the HT has caused few problems - and my psa did come down from 1.0 to 0.11.  If your psa is 3.81 (I would get it checked again) I really recommend you consider HT because the Old Sailor would not give you "bum" information.

I will ask Padre Pio to watch over you - remember he said "worry is useless"

The Old Sailor


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/4/2011 6:24 PM (GMT -6)   
Thanks for the replies thus far. I was almost, for once, just going to keep this to myself. I hope now, that for some here that haven't bought into the danger of High PSA Velocity in the year prior to dx, my case will make a believer out of them now. My readings told me from the start, that with my initial pre-dx velocity issues, I was anywhere from 5 to 10 times more likely to die from PC, regardless of any treatments. So far, my case has been textbook perfect on that viewpoint. Trust me, it doesn't make me feel any better being right.

My uro's original suspicions on my case have held true, and his worry and concern has been dead on accurate.

He did say, and there's no way of proving this accurately, that with massive a rise in this short a time, again, that the PSA is being produced in any number of locations away from the prostate bed, anyone of the areas too small to show up on a scan at this point (remember, I just had a clear bone scan a month ago), but collectively, these multiple micro-metatisis are mutilplying quickly and producing these amazing fast rises in the PSA. Makes sense to me.

Yes, still shopping for a good medical oncologist, been following mutiple leads.

Just had a thought, what I have going on is like a nuclear weapon with multiple warheads. If so, this may be very difficult to slow down at best.

Part of me, and no, not in particular a death wish, but almost content just to let its run it course, it may just be my ultimate fate. Nothing has worked so far, and at the local level, the docs aren't putting much hope on HT lasting for long with a case like mine. They may or may not be wrong.

As we all say, it is what it is. This has been a journey from hell right from the start. I am not saying a deserve a break, just another smuck with PC, but I certainly haven't had any breaks with my treatments and side effects. Oh year, I forgot that I still have no evidence of ED. But right now, I don't even care about that.

Meanwhile, I will continue to help as many people as I can, for as long as I can. PC is a vicious, mean-hearted disease. No one has it easy, some just have it harder. I know there are brothers here much worse off than me, I am very aware of that.

Thanks for the support.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

Bob & Wife
Regular Member


Date Joined Apr 2008
Total Posts : 100
   Posted 4/4/2011 6:30 PM (GMT -6)   
So sorry to hear the news and Keeping you in our thoughts.
Age at diagnosis 58 Biopsy 4+4 Surgery 2006, clear nodes and margins
2007 PSA's .14 .16.14.32 2008 Radiation complete post PSA .05 .06.18.14
2009 PSA's .06 .05 .18.14
201 PSA's .18 .19 5 wks later .34 .38
2011 PSA's .59

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/4/2011 6:33 PM (GMT -6)   
"the docs aren't putting much hope on HT lasting for long with a case like mine. They may or may not be wrong."

Whether they are right or wrong does not properly compensate them for being idiots. You're going to need better doctors that that. Pardon my harsh wording but to doctors that say " You have so long to live", or the like, they can kiss the derriere's of many long living patients well past their predictions...

There is no doctor, repeat, no doctor that can predict the efficacy of HT on an individual case. And no doctor should make such comments. Doctors should "Do no harm"... and taking away hope is doing exactly that.

Tony
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
Da Vinci Surgery ~ 2/16/2007
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.
Undetectable PSA.

Blog: www.caringbridge.org/visit/tonycrispino

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/4/2011 6:36 PM (GMT -6)   
Tony, for the record, its not my uro making those remarks.

And, have you seen a case work like mine before, with all your work in the PC support field?

David
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 2/11 1.24
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10,

mr bill
Veteran Member


Date Joined Sep 2010
Total Posts : 688
   Posted 4/4/2011 6:45 PM (GMT -6)   
David,
I, as well as all others here, put a great deal of stock in what you have to say regarding the numerous issues brought to this table.  You have helped many. I feel certain that there will be many more that you will help in the future.
 
My prayers and best wishes are with you.
 
Bill 
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