So scarred ????

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melange123
New Member


Date Joined Jan 2010
Total Posts : 13
   Posted 4/13/2011 5:20 PM (GMT -6)   

I posted here quite a while ago but now I really need help...

We went yesterday to my husband’s radiation oncologist for results of PSA. It’s been almost 1 year since SRT was completed. We had both gone in feeling very optimistic because the PSA had gone down from the 1st PSA since SRT and the Dr. felt very good that the SRT was a success. We both about dropped out of our chairs when he told us that there was a rise from 0.04 to 0.10, it felt the same as being told for the first time that he had Pca. The Dr feels this rise is not from the prostate bed but from distant mets. I am now so scarred and feeling like we are running out of options to kick this cancer in the ass. I know about HT but have read so many conflicting opinions about when and if to start?? They will run another PSA and bone scan in 30 days but suggested we see the oncologist now. I want to stop the madness and stop thinking and living life around PSA. I hate this disease and I am now so scarred that we are entering the real effects of this disease. Do you start HT now or do you wait until they see something on your xray,MRI or whatever. WHAT TO DO??


May 08 Dx age 57 my husband
PSA 4.7
June 08 DaVinci Robotic Surgery @ COH
Biopsiy: Gleason 8 4+4 1 positive margin T3b
PSA
10/08 .01
12/08 .01
03/09 .02
03/09 .03
July 09 Clinical trial after rising PSA
11/08 .05
1/10 .06
02/10 .07
April 10 SRT
PSA
6/10 0.10
01/11 0.04
04/13 0.09
All of this is the best of my memory

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/13/2011 5:28 PM (GMT -6)   
I believe a determination of the doubling rate is a good move then start the HT. It appears to be three months but docs like to see the trend in three successive PSA assays.

But this is your husbands call. If he wants to start then he should. If he wants to wait it isn't a bad strategy for the short term. But it will eventually require some sort ofintervention.

One thing for sure. Stay positive. There is still much to do...

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

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/13/2011 5:38 PM (GMT -6)   
mel,
I also used CoH. Did your husband use them for radiation as well?

Tony

melange123
New Member


Date Joined Jan 2010
Total Posts : 13
   Posted 4/13/2011 5:40 PM (GMT -6)   
Tony,

Yes, he's been treated at City of Hope from the beginning. I love the place and all the doctors just hate that we need to go there.

Melissa
May 08 Dx age 57 my husband
PSA 4.7
June 08 DaVinci Robotic Surgery @ COH
Biopsiy: Gleason 8 4+4 1 positive margin T3b
PSA
10/08 .01
12/08 .01
03/09 .02
03/09 .03
July 09 Clinical trial after rising PSA
11/08 .05
1/10 .06
02/10 .07
April 10 SRT
PSA
6/10 0.10
01/11 0.04
04/13 0.09
All of this is the best of my memory

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 4/13/2011 6:11 PM (GMT -6)   
Recurrent cancer is very scarry. I am a G8 and was in near panic mode when PCa recurred. I got a lot of comfort from reading Dr Myers book on HT and Diet. You have another weapon available to you that can be effective for a long period of time. Now you need a good medical oncologist to help you with the best way to use it.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 4/13/2011 6:15 PM (GMT -6)   
Melissa, I am in a similar situation to your hubby, but have not had SRT.

At the current low levels, the PSA number will jump around a bit so you shouldn't read too much into a rise from 0.04 to 0.09. However, it seems that whatever the doubling time, the PSA is rising so you will be faced with HT at some time in the future.

Opinions are divided at just when that should be -- my uro suggested waiting until my PSA is 10, but also there is a school of thought that suggests hit it early and hard.

Statistics indicate we have a 13-year life expectancy after recurrence -- see John T's post in this thread www.healingwell.com/community/default.aspx?f=35&m=2072465

As for the scared side of things -- I take this view: I have always been going to die of something, someday. All that has happened is that I now have some inkling of what and when, and still by no means certain. But in the meantime, I will enjoy my remaining 10 years or whatever.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4/12 cores
Non-nerve-sparing RRP 7 March 2008 age 63
Organ confined, neg margins. Gleason downgrade 4+4=8
Fully continent
Bimix worked well; now using just VED
PSA undetectable at first but now 0.4, doubling time 7 months
No radiation but ADT coming unless I can slow down the rise...

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3893
   Posted 4/13/2011 6:53 PM (GMT -6)   
The choice with HT is pretty simple..Now or later....

If you start it now, you get to endure the side effects NOW..
If you wait until PSA 10.0, you maintain quality of life and postpone the side effects for a considerable period of time..

Dr. Walsh points out in his book that the mortality figures are the same either way...Life expectancy stays the same for either treatment protocol...

A recent, good, clinical trial has proven that Pomegranate juice can greatly slow the PSA doubling time in cases like your husbands. If he is carrying any extra weight, now might be a good time to get rid of it..It's hard to maintain your weight when on HT..

Also, the best medical oncologists who specialize in PC seem to be able to manipulate the ADT in such a way as to postpone the day when hubby becomes hormone refractory. Every man responds differently and a good doctor realizes that and will respond to it by adjusting the hormone therapy to keep it working as long as possible...These people are VERY well paid. Make them earn it...

When Hubby began his SRT, did anyone mention adding HT to the radiation treatment as a way of increasing its effectiveness?

Best of luck on your journey...
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

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6087
   Posted 4/13/2011 6:58 PM (GMT -6)   
Hang in there, there is a lot there is to do and a lot that can be determined. Looking at the stats, I do not see " that high a psa to determine srt failure or quite frankly to definitivly call BCR in the first place, but Im not a doctor. You are here for support and you got it. You are also here for advice. Here's mine, at the minimum, wait till you get to at least the std BCR 2 consecutive .2 3 mos apart, before you use the HT card. I personally would wait longer, and will not get into that now. Help me guys is this just me, but this man has had a clinical trial, a " BCR " and now " failed SRT, all this, with out even hitting the .2 mark and just hitting the .1. Melissa, love that name, have your husband, read walshes book and scardino's book regarding rising psa after surgery and get involved in the decsion making , if he isn't already. the bone scan and psa are just what is needed as next step. My bet is no bone mets. When the RO says he thinks its distant mets, where's the evidence, whats the evidence , just because you had srt. Ok having said all this, I am a believer in having faith in your doctors , but it should be educated faith. Listen this not the begginig of the "real effects. Slow your mind down, keep your hope and faith. COH is top notch, Im baffled on this one, tho...
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

melange123
New Member


Date Joined Jan 2010
Total Posts : 13
   Posted 4/13/2011 11:02 PM (GMT -6)   
Thanks everyone for all your info!! I have read and read Dr Walshe's book, and feel that's the best read for questions for the doctors. I'm not sure why the doctor feels this was a failed SRT but he said "there is no bounce in PSA after the prostate is gone". When they retest in 30 days if it stay the same he thinks he can just wait it out again. I have kind of thought he should have started HT with or before SRT but it wasn't suggested? It just seems like there are so many choices of what to do and when to do it... Again thank for all the info and just for knowing how this makes one feel.

Melissa
May 08 Dx age 57 my husband
PSA 4.7
June 08 DaVinci Robotic Surgery @ COH
Biopsiy: Gleason 8 4+4 1 positive margin T3b
PSA
10/08 .01
12/08 .01
03/09 .02
03/09 .03
July 09 Clinical trial after rising PSA
11/08 .05
1/10 .06
02/10 .07
April 10 SRT
PSA
6/10 0.10
01/11 0.04
04/13 0.09
All of this is the best of my memory

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/13/2011 11:10 PM (GMT -6)   
melissa, my radiation oncologist made it clear, as well as 2 of her partners, that there is no psa bounce after srt, it should never rise. after radiation as a primary treatment, there is normally a bounce, as the patient still has a prostate, even if badly damaged by the radiation.

after my srt, had 2 small drops, been nothing but rises ever since its been declared a failure.

good luck

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,

Newporter
Regular Member


Date Joined Sep 2010
Total Posts : 225
   Posted 4/14/2011 12:57 AM (GMT -6)   
Don't give up. A dear friend had open RP 8-9 years ago and BCR within a year. He then did SRT. Failed SRT and PSA kept rising until it hit ~1.0. However, PSA then stayed at ~1.0 for the past 6 years. His doctor had no idea why but told him to just enjoy his good fortune. I saw him recently and he told me his PSA was still at ~1.0. Also, Fairwind suggested pomegranate juice, no harm trying that to see if it helps.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 4/14/2011 1:36 AM (GMT -6)   
Sorry you've got to deal with this, and so soon after SRT.
The bone scan will almost certainly show absolutely nothing, but that's sort of the reason for doing it now in order to have a base line against which to spot any changes that may show up later.

I can't remember whom it is but there is someone here whose PSA went up a bit after SRT to something like 1.0, but then stayed there for years without him having any additional treament. Everyone seems to have a slightly different journey.

I think the key now is to accumulate information (once again) but take it slowly when it comes to making the next decision about treatment.

Alf
Age dx 48
Apr 09 PSA 8.6
DRE neg
Biop 2/12 pos
Gleason 3+3
Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
Nov 09 PSA 0.1
Mar 10 PSA 0.4 sent to RT
13 Apr CT
RT 66Gy ends 11 Jun 10
Tired + weird BMs
Sep 10 PSA <0.1
Jan 11 PSA <0.1
Apr 11 PSA <0.1
Erection OK
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