First post-IMRT PSA results....

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Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 4/14/2011 12:15 PM (GMT -6)   
We received the news this morning. Carter's PSA, three months after IMRT with gold markers, is 1.4. His stats are as follows: Gleason 7, stage T1C, pre-treatment PSA 6.7, small prostate, cancer present in 10-20% of one core (depending on which pathologist to believe), and some PIN. No perinueral invasion.

Treatment choice was nine weeks of IMRT. The reason he chose straight IMRT over a combination of seeds and IMRT was the hope of avoiding any bladder issues at all. That decision to go with what was ultimately fewer gys (although enough to radiate the margins since he was a Gleason 7) seemed reasonable in view of his small prostate and low percentage. His job as a university administrator requires him to be all over a very large campus without easy ways to deal with bladder challenges.

He has been incredibly lucky. He has had no side effects to date, beyond a red rash across his backside which began shortly after the treatments ended and disappeared quickly. It never even hurt. He had no bladder or bowel issues, no fatigue and no ED. We are hoping that continues. All in all, the nine weeks of treatment went quickly and only caused him to miss 30 to 45 minutes of each workday morning. His main memories of the nine weeks of daily appts involve friendly people and lots of freshly baked cookies. He still says the worst part of the whole ordeal was the two biopsies.

Because I have read different things regarding what to expect next (including that a slower decrease in PSA portends a better outcome, which makes no sense to me), I'd love to hear from the experts here. Is 1.4 good? Can we be cautiously optimistic?

Thanks!

Juliet

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/14/2011 1:56 PM (GMT -6)   
Juliet, that sounds like an outstanding first reading for his treatment method. That's great that he hasn't been having any serious side effects. Of course, with any radiation, some side effects can occur and develop after the fact, but he's off to a good start, and that is great news.

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,

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2229
   Posted 4/14/2011 4:43 PM (GMT -6)   
Ditto David and hopefully that trend will continue. Keep us posted.
Michael

Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 4/14/2011 9:07 PM (GMT -6)   
Thank you David and Michael. It seems like yesterday that I first posted here and was so scared and ignorant. I learned so much of what we used to help make our treatment decision on this site and through the links provided here. Since we were not able to tell other people aside from our immediate family and two friends, it is just nice to be able to come here and share a result.

I know that the future can still hold BCR and ugly side effects. I hope for better answers for all of us.

Juliet

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 4/14/2011 9:13 PM (GMT -6)   
I hope you get that wish, Juliet, you and your husband have been through all this too. Keep on posting and updating your husband's journey

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 margin
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, 4/11 3.81
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

Paralleli
Regular Member


Date Joined Jul 2008
Total Posts : 123
   Posted 4/14/2011 9:39 PM (GMT -6)   
Juilet,

I've also read that a long, slow decent to nadir is a good thing. You understand, I hope, that odds are there will no "ugly" side effects. I'd guess they will check PSA in 6 months or so. Is that correct? Best advice I can give is try and take a six month vacation from the whole PCa thing. It can be done!

Best to you and your husband.
IMRT 1/07 - Doing well.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 4/15/2011 12:44 AM (GMT -6)   
You should be optimistic and happy with the early results...

And smiling, overjoyed, kewl...etc...

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

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 4/15/2011 5:04 AM (GMT -6)   
Juliet and Carter -
congrats on the good news - wishing you both all the best.
hugs,
BRONSON
Age:55 -gay with spouse of 14 years, Steve -Peterborough, Ontario, Canada
PSA:10/06/09 3.86
Biopsy:10/16/09- 5 of 12 cancerous samples, Gleason 7 (3+4)
Radical Prostatectomy:11/18/09
Pathology:pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA:04/08/10 -0.05 -Zero Club
PSA:09/23/10 -0.05 -Zero Club
PSA:03/24/11 -0.02 -Zero Club
PSA:03/24/12- TBA

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4183
   Posted 4/15/2011 6:42 AM (GMT -6)   
Juliet, that reading sounds great to me and you should be happy.  I'm glad that recovery is going so well and I trust it will continue.
 
Tudpock (Jim)
Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 12/8/10. PSA: 6 mo 1.4, 1 yr. 1.0, 2 yr. .8. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1305643

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2216
   Posted 4/15/2011 10:31 AM (GMT -6)   
J & C
Glad to hear your news.
Hope things are even better next time.
Alf

6thCC
New Member


Date Joined Apr 2011
Total Posts : 9
   Posted 4/15/2011 7:10 PM (GMT -6)   
Juliet... very good news indeed.  That was a significant PSA drop and the fact that there was/is minimal SE is frosting on the cake.  I also had IMRT/IGRT as the primary treatment.  I did not have as much of a drop as your husband but like you, I have read that a long and gradual decrease in the PSA increases the odds of a cure.  Also, like you I really don't understand the medical reasoning behind that but am sure more than willing to accept it.  Keep us all posted on the progress of your journey.
 
Tom

PSA 1.4 12/2004 to 3.8 7/2010; biopsy 8/2010: 2 of 12 samples positve, Gleason 3+4 (5%) and 3+3 (40%); margins clear, no EPE, no PNI; confirmed with 2nd opinion; 43 sessions of IMRT/IGRT/Rapic Arc completed 12/2010; usual SE's: urinary urgency/frequency, mild fatigue, moderate ED; initial 3 month PSA: March 2011 was 1.7; all SE's are now very minor and not an issue; current age is 64.

Julietinthewoods
Regular Member


Date Joined Sep 2010
Total Posts : 309
   Posted 4/15/2011 8:47 PM (GMT -6)   
Thanks so much to all of you for the well wishes! Carter has an appt. with the radiation oncologist next week to discuss the results. I think I'll tag along and ask about the slow decline issue. If I learn anything, I'll report back!

Juliet
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