Update on my neighbor with new PC DX

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Purgatory
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Date Joined Oct 2008
Total Posts : 25393
   Posted 4/4/2011 8:32 PM (GMT -6)   
Sat and talked with my next door neighbor, I posted a week ago or so, that he had been recently dx with PC.  He met with his uro today and we had aa good talk for about an hour.
 
He is a Gleason 7 (4+3), had 4/7 positive cores - not sure of percentages but thought they were high, staged T2x at this point.  PSA was just over the 4 mark.
 
His will be a complicated case.  He has had previous radiation in the abnomen from a stomach cancer, so they have ruled out any radiation - conventional or seeds as a primary treatment.  And because he had previous cancer in the same area, the doctor does not want to do surgery.
 
They are talking about the Freezing method, lost the name for the moment, along with HT as his best hope.
 
He is calm about it, as like me, he has dealt with many surgeries and other cancers previous to us.  His wife did go with him today, and they asked a lot of questions.  The doctor gave him a lot of info to read.  He wants me to talk to him again soon.  I invited him to HW, either to join or lurk.
 
He is not going to rush into any possible treatment at this point.  We had a good talk about that.  His treatments will be much more limited than most people, so it may be a challenge to find a solution.
 
David in SC

davidg
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Date Joined Feb 2011
Total Posts : 4093
   Posted 4/4/2011 8:35 PM (GMT -6)   
some surgeons that consider themselves highly skilled are now saying they can operate even after radiation.

Purgatory
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Date Joined Oct 2008
Total Posts : 25393
   Posted 4/4/2011 8:53 PM (GMT -6)   
davidg:

the rule of thumb, is that most surgeons will not do salvage surgery after failed radiation for prostate cancer. in this case, since my neighbor had previous radiation in the general area, his uro/surgeon made it clear that he wouldn't do it. my own surgeon participated in 2 salvage surgeries while in medical schooll, and he said he would never do one, and hasn't in nearly 30 years.

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,

Fairwind
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Date Joined Jul 2010
Total Posts : 3895
   Posted 4/4/2011 9:18 PM (GMT -6)   
Ones prostate is a long ways from ones stomach..There may be issues involved I don't understand, but I would certainly be getting some second opinions..
Age 68.
PSA age 55: 3.5, DRE normal.
age 58: 4.5
61: 5.2
64: 7.5, DRE "Abnormal"
65: 8.5, " normal", biopsy, 12 core, negative...
66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
67 4.5 DRE "normal"
68 7.0 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0

Purgatory
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Date Joined Oct 2008
Total Posts : 25393
   Posted 4/4/2011 9:41 PM (GMT -6)   
fairwind, his doctor said he has extensive scarring from the previous ops and radiation.
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,

proscapt
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Date Joined Aug 2010
Total Posts : 644
   Posted 4/4/2011 11:58 PM (GMT -6)   
a potential second opinion: I'm told Peter Carroll head of urinary oncology at UCSF does salvage surgery after radiation. Your neighbor might want to consult with him.
DX age 54 12/2009
PSA 5.6, DRE-, high pre-op PSAV. Clinical stage T1c
Biopsy: Gleason 3+4 with PNI / 6 of 14 cores + / 10% of total length + / worst 45% +
DaVinci RP 2/2010
pT2cNx / Gleason 3+4 / PNI+ / SM- / SV- / EPE- / Tumor vol 3cc / vol 40cc / 63 gm
PSA - 4/10 <0.01, 8/10 0.01, 12/10 0.01, 3/11 0.01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/5/2011 8:46 AM (GMT -6)   
He will be sitting down with his long-term medical oncologist for a second opinion for starters.
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
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Date Joined Sep 2010
Total Posts : 709
   Posted 4/5/2011 9:52 AM (GMT -6)   
A friend of mine had extensive scarring after being involved in a fire during his youth. As a result surgery was pretty much out of the question.  He traveled from Pennsylvania to Loma Linda and MD Anderson, and is now undergoing proton therapy in Florida.  I have not talked to him in awhile, however he felt confident with the treatment he was about to receive.  It may be worth a phone call.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/5/2011 10:31 AM (GMT -6)   
mr bill, the neighbor mentioned proton to me in passing, his dr wasnt keen on it, and not sure my neighbor would be in a postion to travel for it, time wise or money wise. good idea though
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,

medved
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Date Joined Nov 2009
Total Posts : 1100
   Posted 4/5/2011 11:22 AM (GMT -6)   
MSKCC has done, and published, some recent work in the salvage surgery area -- and of course is a highly regarded prostate cancer center. If I were your neighbor, and could manage the travel/expense, I would be up there for some advice.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/5/2011 11:58 AM (GMT -6)   
med - your advice sounds good, but we are dealing with a fixed income retired person with very limited means, but i would certainly mention it
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,
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