A bunch of questions

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Veteran Member

Date Joined Nov 2009
Total Posts : 7269
   Posted 5/12/2011 11:06 AM (GMT -6)   
Here's a quick synopsis of my situation:
PSA-- 3/08--2.90;
 11/09--4.19 (Free PSA: 24%),
11/09--PCA3 =75 (bad news!)
Biopsy 11/30/09. Gleason 4+3. Stage: T1C.
Current Age: 64 . Robotic Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm.
100% continent by 3/10. ED- Yes..
PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. PSA on 9/21/10--0.06; 
PSA on 1/4/11-0.13
PSA on 3/1/11--0.27—clearly the beast is BACK. Time for:
SRT— started 3/22/11 for 38 sessions—68.4 total GY.
OK, I know I've asked these questions before. These are certainly questions worth asking Dr. Scholz or some other expert.
So I will be done with the SRT tomorrow. I would like to try some supplements. But when I do some research, it seems that these substances go in and out of favor. For example, flaxseed oil quite a few years ago was good. Now it's not. I read pros and cons about ground flaxseed. Even pomegran. seems to be questionable (also, I don't mind the juice but is it better to take the pills or better not to take any of it). Also, during SRT I've been advised to minimize anti-oxidents and vitamins, but in 2 weeks I can go back to that. But go back to what? Is fish oil good? It does seem that vitamin D3 is good. I am hesitant to even read books on this subject as books get old and things keep changing. I am confused!!
I don't want to start the old debates and flaming wars. I'm just wondering if there are generally accepted supplements. Incidentally, what about aspirin? I've read good things about that (RE: PC) but maybe that was as a preventative. I'm beyond that stage!
I also have some other questions:
1) My latest PSA was on 3/1 and it was 0.27 with the latest PSADT being about 2 months. That's scary! I started SRT 3 weeks later, so I figure my PSA was probably in the 0.35-0.40 area. My next PSA will be in about 3 months I think (isn't that typically when one does the first post-SRT PSA). My question is: what would be a good result? Suppose it is 0.31? Can one then conclude that SRT failed?
2) I know that a PSADT of 2 months is bad. But does that also imply that HT will fail quicker? I have heard that, but never read that. It would seem the success or failure of HT is dependent on the proportion of cancer cells (refractory vs. sensitive) and that may have nothing to do with the PSADT unless refractory cells by their nature double faster. I'm not sure if that's true.
3) Finally, if SRT fails, then I would guess Casodex followed by Lupron or something similar is the standard tx. But Casodex can cause severe breast pain. I've heard radiation can help. If so, how many tx., are there any SE to those tx., and do you do the tx. before starting Casodex or wait until you have breast pain/enlargement before starting the radiatoion.

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4268
   Posted 5/12/2011 11:30 AM (GMT -6)   
You will find a huge difference in what doctors and patients recommend for supplements. After all my readings I take pomegranite extract pills, asprin and 1000 units of Vit D3 because I feel these have the most evidence behind them. I also take a satin as anything that will reduce cholestrol is good for PC.
Re Casodex: you can take Femera which will stop any breast growth or pain or have 4 sessions of radiation to the breasts before taking Casodex.
I took Femera and had no problems.
Re psa after SRT: I would never do anything based on one psa test. The criteria for failure is three consecutive rises in psa.

Veteran Member

Date Joined Feb 2010
Total Posts : 3987
   Posted 5/12/2011 11:31 AM (GMT -6)   
Mel -- relax and take a leap of faith with supplements.  we're not in control but we may be able to effect the outcome.  i take pomx and and opc xtra, as well as d3, calcium and a multivitamin.  it may do me no good physically but being proactive helps me mentally and emotionally, and those are the only areas where i have even the tiniest bit of control.
age: 56
PSA on 12/09: 6.8
gleason 3+4 = 7
received 3rd and last lupron shot 9/14/10
2/8/11 PSA <.1, T= 6 ng/dl

Veteran Member

Date Joined Jan 2011
Total Posts : 735
   Posted 5/12/2011 12:56 PM (GMT -6)   
Hold off adding any anti-oxidant supplements (vit C, E. pomegranate, curcumin, quercetin etc) until you get your first PSA after SRT. A PSA after 2 to 3 months will give a notion if the cancer at the prostate bed was affected or not by the RT. Do supplement with vit D3 if your blood level is under 50 ng/ml. Aspirin and other NSAIDS such as Celebrex have been shown to reduce the incidence of colon cancer and slow down PCa. These can affect the stomach lining and cause bleeding. Use with caution.

As far as response to HT , I think there is no information about response in relation to PSADT for earlier stages of advanced disease when the disease is potentially more androgen dependent.

Superficial radiation to breast tissue to avoid enlargement needs to be done before or at the start of HT with an antiandrogen. Others prefer to use an antiestrogen instead of radiation. Enlargement is caused by the generation of estradiol and it is not immediate after the start of therapy. Many men claim sensitivity rather than high pain with enlargement.

Phoenix, Arizona
Surviving prostate cancer since 1992. RP; Orchiectomy;
GS (4 + 2); bilateral seminal vesicle invasion; tumor attached to rectal wall. Last PSA September, 2010: <0.1 ng/ml
Laughter is the best medicine!

Veteran Member

Date Joined Aug 2009
Total Posts : 2448
   Posted 5/12/2011 12:58 PM (GMT -6)   
Mel, although as I stated in a previous post I have been trying a few things differently, the jury is still out on the effectiveness. My next PSA test is next Thursday.

However, my wife has always been looking into those things that might be beneficial in fighting cancer or allowing the body to live in a healthier state while dealing with cancer.

A few days ago a book that she had ordered arrived. I read through quite a bit of it and skimmed through the whole book before she got up and found it to be very interesting. The principles of it are definitely diet, exercise and some supplements.

The book is "The PH Miracle" by Robert O. Young and Shelley Redford Young. To say it would require somewhat drastic changes in the way Lynn and I eat is an understatement. However, I find a lot of good information and backup to the changes proposed. It is all about bringing the body into a more alkaline and less acidic state and the effects it has on health and cancer fighting.

This is just absolutely for What It's Worth and not meant to start anther Point-Counter Point scenario.

60 years old - PSA 11/07 3.0 PSA 5/09 6.4
da Vinci 9/17/09 Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5% positive margin, extra-prostatic extension
PSA .6 IMRT completed 1/15/10 35 treatments- 70Gy
2/23/10 Post IMRT PSA 1.0
3/22/10 PSA 1.5
4/19/10 PSA 1.2
5/22/10 PSA 1.3
8/9/10 Radiation for MET
9/7/10 PSA 2.2
1/5/11 PSA 3.9
3/7/11 PSA 4.2
4/10/11 PSA 3.8

Veteran Member

Date Joined Nov 2009
Total Posts : 7269
   Posted 5/12/2011 1:54 PM (GMT -6)   
Thanks for all the information.
Hmmm... one confusing answer is the idea that I should NOT resume anti-oxidents until my next PSA tests. I'm not sure about that.
Anyway, I am getting close to finalizing arrangements to see Dr. Scholz. It looks like July 11th will be the day. Things to ask!!

Veteran Member

Date Joined Jul 2010
Total Posts : 3887
   Posted 5/12/2011 2:19 PM (GMT -6)   
Mel, you are going to WORRY yourself to death!! You are trying to play hands that won't be dealt to you for months or years..A lot of needless worry! Finish up the radiation and take a nice, long cruise somewhere, maybe on a cargo ship, something like that..Leave the laptop at home..Just turn it off...This is The Good Time. Enjoy it while you have it..
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

Forum Moderator

Date Joined Jan 2010
Total Posts : 7080
   Posted 5/12/2011 2:41 PM (GMT -6)   
Fairwind seemed to give the best answer in a nutshell.
Ralph's comment is also well-considered. Let's say there is a supplement that kicks down PSA, and you accidentally find and start it now. The PSA test you take to see what the radiation did could become very clouded, or at worst a false negative.
Take some time off PCa, and let the three months pass. Just my opinion, but since I've been there, I guess I earned it smilewinkgrin

Veteran Member

Date Joined Sep 2009
Total Posts : 6067
   Posted 5/12/2011 4:58 PM (GMT -6)   
Hey, thats Mel. Good advice, but we all do what we do and its tough to change. I like to stay 4 to 5 steps ahead myself,, working airplanes for 42 years will do that to you, drives my wife nuts, but I wont change at this point, doubt Mel will either. Plus I would call it concern, not nessasarily worry. I was here when Mel joined and he has been consistent in his approach to the PCA situation. Cruises are fun though, yeh?
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

Regular Member

Date Joined Jun 2008
Total Posts : 91
   Posted 5/12/2011 5:10 PM (GMT -6)   
I had my first post-SRT PSA last Tuesday. The RO told me anything below the PSA just before SRT is good, but the number should not be higher. I was a nervous wreck in the days leading up to the PSA, and a MAJOR nervous wreck between the time the blood was drawn and the call with results. However, I was very, very relieved to have the results be <.01.

I also kept taking a Lycopom capsule and drinking pomegranate juice during the time between SRT and the PSA. When I had my SRT "de-briefing" by the nurse, she actually told me I could keep taking it and didn't seem at all concerned about the supplement messing with the coming PSA score.

Enjoy the next 90 days, which really is a long time. There is absolutely nothing you can do right now and it won't be August until...August!!
Diagnosed at 47 (currently 50). Pre-surgery PSA: 13.7 Pre-surgery Gleason: 4+3=7. CT Scan, Bone Scan, PET Scan: Clear. LRP 5/28/08. Left nerve bundle removed. POST-SURGERY: Gleason: 4+3=7; 10% of prostate all quadrants involved; EPE left base & apex; extensive PNI present. Bladder neck, lymphvasular space, seminal vesicles, 17 examined lymph nodes, and all surgical margins FREE of tumor. T3a. Four-week post-surgical PSA = 0.1; Seven-week = .01; 10/08 – 4/10 PSA= 0.0; 4/10=0.1; 5/10 & 8/10 = 0.1; 9/10=.15; Prostiscint = negative; 12/10=0.3. 12/15/10 began 70.2 grays SRT and finished 2/10/11. Post-SRT PSA 5/10/11 = <0.1.

Veteran Member

Date Joined Jul 2010
Total Posts : 3887
   Posted 5/12/2011 5:28 PM (GMT -6)   
There are cargo ships that also accommodate a small number of passengers..They usually have around 10 passenger cabins. You eat in the mess with the crew...Some head off into the South Seas, some cruise down the west coast of South America, through the Panama canal.. Shorter trips just stay in the Caribbean, stoping at most of the Islands..Completely different than a "tourist" cruise line trip..

John R
Regular Member

Date Joined Sep 2010
Total Posts : 59
   Posted 5/12/2011 5:42 PM (GMT -6)   
Yes, sounds great, then all your worries will be pirates lol!

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 5/12/2011 6:02 PM (GMT -6)   
fairwind - i always wanted to take a long voyage on a tramp steamer. i crossed the ocean 3x by ocean liners in the "old days", these modern cruise ships are no substitute for the Queen Mary, or the S.S. United States, etc.

mel - you really should take 3 months off before the first post SRT test, seriously. there is nothing you can do in between, and you have no reason to think at this point, that it won't be effective, and it will take a good 3 readings before you would know in any event even if you had quick recurrance. i don't know where the line is, it's subjective, but there is a thing line between being prepared and knowledgable or being a worry wart.

if there is a problem post-srt, i kind of think you will be the first person to know. but for now, a great time to put the srt behind you, heal from that, deal with any lingering side effects, give your mind and body a break, you just put it through radioactive hell.

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

Regular Member

Date Joined Feb 2010
Total Posts : 267
   Posted 5/12/2011 8:51 PM (GMT -6)   
When my PSA started slowing at .16, I had just started on Trilipix (I had been taking Lipitor), I started the pom extract, and green tea extract. I had already been taking fish oil and lecithin prior to my cancer diagnosis. I added D3 and cayenne after my PSA dropped. I have stopped antioxident supplements during radiation, but I will resume the pom extract and green tea extract, as well as iced green tea as my preferred beverage after the radiation is done. I don't think it is a cure, but I can't argue with how it slowed my PSADT.
Age 47
PSA 10/09=4.60
Biopsy 12/09
Left side benign
Rt side 3of 4 cores positive, 70%
Initial Gleason 3+4
2nd Opinion Gleason 3+3
DaVinci surgery 2/16/10
Catheter removed 2/27/10
Gleason 4+3
Tumor quantitation=10%
Positive margins right side
Staging T2C PNX PMX
Post surgery PSA 5/10 <.05, 8/10 .12, 9/10 .12, 12/3/10 .16, 1/27/11 .15,
02/28/11 .17
03/28/11 .19
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