HT with Radiation study

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dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 363
   Posted 5/24/2011 7:56 AM (GMT -7)   
Here's a study released that shows six months of HT with Radiation is very beneficial.  What I found really interesting was the comment by Dr. DeWeese from John Hopkins who said"benefits of HT used in combo with radiation have been known for sometime".
 
 
You may have to paste this address into your browser, the link doesn't seem to work.
 
David

JNF
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Date Joined Dec 2010
Total Posts : 3414
   Posted 5/24/2011 12:17 PM (GMT -7)   
My Uro and Onco both recommended HT from the start. Both said it greatly improves the radiation effectiveness. Uro wanted me on for one month before the IMRT started and Onco agreed.

They somewhat disagree on how long I should stay on the LHRH agonist (Eligard). Uro is saying 24-30 months and Onco is saying 12-18 months. Next October will be 12 months so we will have some conversations. Snuffy Meyers has changed his view and is more often using shorter term intermitent therapy, usually using HT for 12 months then taking a LHRH holiday. However, he keeps men on Proscar/Avodart during the time off the LHRH agonist (Lupron, Eligard, etc.)
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010
HDR Brachytherapy December 6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.
PSA <.1 on 4-7-2011
Second Eligard shot on 4-7-2011

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 363
   Posted 5/24/2011 1:44 PM (GMT -7)   
JNF:  I believe if you read Dr. Meyer's book you get a whole new understanding of HT, I kind of laugh when I hear some of these guys talk about the SE's when they have never even been on the treatment.  There really is no argument against trying HT but if it causes SE's you can't deal with you can stop at anytime. 
 
You and I are still trying for a cure so I do believe it is easier for us because there's still the possibility that we may never have to go back to HT.  The 2 years I have been on HT, I look at as money in the bank.
 
I almost went with HDR followed by IMRT but a surgeon that I really liked got hold of me and lead me that direction.
 
My Dr. sat down with me and went over the stats relating to how long to stay on HT, I'm the one who said 24 months, he felt 12- 24  was correct but leaned towards the lower number because my PSA immediately became undetectable after my first injection.  I just felt like I had taken it that far I might as well do the full monty.  I don't want to revisit this PCa sh@! for a long long time.
 
Good luck!!!!!!!!
 
David
54 y.o.
Diagnosed 4/10/08

DRE Normal

PSA-5.5

Biopsy- 12 cores, 4 positive highest 4+4=8

Bone scan, CT scan and Chest X-ray clear 4/16/08

Urologist suggested surgery 4/16/08

MRI on 4/24/08 clear no suggestion of lymph node involvement.

4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July. This treatment will not preclude me from surgery if

Sancarlos
Regular Member


Date Joined Feb 2010
Total Posts : 242
   Posted 5/24/2011 1:51 PM (GMT -7)   
Does anyone know if the actual study compared the effectiveness of six months on HT with RT compared to two or three years on HT with RT?

I have been on HT for nearly two years in conjunction with RT. Would be a real downer if 2+ years turn out to be no more effective than six months.

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

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 363
   Posted 5/24/2011 2:43 PM (GMT -7)   
Sancarlos:  I believe this particular study said that the effectiveness was better the longer you stayed on HT but it was substantially diminished as time went on.  I just feel every percentage point you can get on your side is a pecentage point better than if you hadn't done it.
 
David
 

F8
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Date Joined Feb 2010
Total Posts : 3764
   Posted 5/24/2011 3:07 PM (GMT -7)   
David -- i'm with you.  my urologist said i had a good shot at a cure but we'd have to be aggressive.
 
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

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3562
   Posted 5/24/2011 3:37 PM (GMT -7)   
Here is something that puzzles me..While there is general agreement that the combination of ADT and beam radiation greatly improves survival in high-risk men, studies that have combined Hormone therapy with Brachytherapy show no benefit at all and as you might expect it's not used in conjunction with brachytherapy...

I wonder what is going on there...

Like many, I take great interest in these studies that show 6 months is enough..I must make the decision to take another 6 month Eligard shot or not in a couple of weeks...I sure wish these learned men could come to an agreement on how long is long enough...
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

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 363
   Posted 5/24/2011 4:04 PM (GMT -7)   
Fairwind:  I think a lot depends on how you are holding up so far, also does it have to be a six month shot couldn't you go three at a time and if you're having issues it wouldn't lock you in as long.  You and I are trying something a little different than the RT/HT guys we're dealing with SRT, I just believe the longer I go with the HT even if the PCa comes back I'll probably have a longer break before it does.
 
I had a three month shot of Lupron before I had surgery because I was going to do HDR and IMRT so they were setting up for that originally.  I then met with a surgeon that I really liked and opted to go that direction.  The reason I tell you this is that when my pathology report was sent to me after surgery it said that it was obvious that the amount of cancer had been shrunk dramatically by the Lupron before surgery. I saw first hand that HT weakens or actually kills some PCa cells, this is why I have continued on the HT for 2 years.
 
I've been pretty lucky with the SE's also, hot flashes and about 5 lbs. gained over 2 years.
 
Good Luck
 
David
 
 
 
54 y.o.
Diagnosed 4/10/08

DRE Normal

PSA-5.5

Biopsy- 12 cores, 4 positive highest 4+4=8

DaVinci surgery University of Washington June 08

PSA undetectable until 5/09

HT started 8/09 SRT 10/09

Last Lupron shot 5/11 2 years

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 5/24/2011 4:43 PM (GMT -7)   
When I was going into SRT I got 3 different recommendations for HT (all docs recommended HT with SRT). medical onco and uro recommened one 3 month shot of lupron. A second medical onco and radition onco recommended 24 -36 months HT, lupron. I saw Dr Myer and he recommended 12 months ADT3. I am finishing up my 12 months of HT next month. I have my annual appt to see Dr Myer on Thursday. I assume that he will keep me on avodart.
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 RP March 2009
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes - tumor volume 9%, nerves spared, no negitive side effects.
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT .01, < .01

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 363
   Posted 5/24/2011 5:13 PM (GMT -7)   
BB: Let us know what he says, its great you can see him. 
 
David

John T
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Date Joined Nov 2008
Total Posts : 4155
   Posted 5/24/2011 5:48 PM (GMT -7)   
Fairwind,
Most patients that have mono Brachy have low or intermediate risk PC and HT is only recommended to reduce the size of the prostate to make seeding more effective. I had Casodex 3 months before treatment and stayed on it for 3 months after, a total of 7 months. My radiologist wanted to do 1 year of Lupron and my oncologist said 6 months of Casodex was sufficient. I went with the PC expert and did 7 months.
JohnT
66 years old, rising psa for 10 years from 4 to 40; 12 biopsies and MRIS all negative. Oct 2009 DXed with G6 <5%. Color Doppler biopsy found 2.5 cm G4+3. Combidex clear. Seeds and IMRT, 4 weeks of urinary frequency and urgency; no side affects since then. 2 years of psa's all at 0.1.

BB_Fan
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Date Joined Jan 2010
Total Posts : 1011
   Posted 5/24/2011 5:50 PM (GMT -7)   
Will do. Dr Myer is expensive, and only partially covered by my insurance, Also the flight to Virginia and back makes it a real long day. But facing a decision of 3 months or 3 years of HT, I felt that I needed to start seeing a real expert. After reading his book I was sold on his approach.
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 RP March 2009
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes - tumor volume 9%, nerves spared, no negitive side effects.
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT .01, < .01

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3562
   Posted 5/24/2011 9:30 PM (GMT -7)   
Seems to me, that a short run of HT might be beneficial right after diagnosis, shrinking the cancer, while the patient makes his choice about a primary treatment..I mean, what's the downside?? Pre surgery, it might result in fewer positive margins..
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

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 483
   Posted 5/25/2011 4:30 AM (GMT -7)   
Fairwind,  my situation was similar to David's.  I had a three month shot of Eligard after dx thinking I was going to have a combo treatment of seeds and IMRT.  Like David, i got a seond opinion from a surgeon and had surgery instead.  Ironically, the radiologist that performed my SRT was the same doc that would have done the seeds and IMRT.  I suppose the Eligard could have been a factor in delaying my PSA relapse.  So now I'm trying to learn all I can about IHT.
 
Carlos
Dx 2/2008, at age 71, PSA 9.1, G8, T1c
daVinci surgery 5/2008, G8(5+3), pT2c
BCR 2 1/2 yrs after surgery
IMRT, 68.4 Gy, 12/2010 - 2/2011
PSA 0.07 three months after IMRT

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 5/25/2011 4:32 AM (GMT -7)   
I agree on the AHT fairwind. Hindsight is 20/20, but I took 3.5 months after Dx to have surgery and now I wish that I had taken HT at halt the advance of the desease while waiting. Also, I think that as a matter of course they should hit the pelvic lyphnodes when doing SRT. I didn't realize until after the fact that mine were not.
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 RP March 2009
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes - tumor volume 9%, nerves spared, no negitive side effects.
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT .01, < .01

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 363
   Posted 5/25/2011 5:57 AM (GMT -7)   
I had full pelvic done and it doesn't seem to have caused any problems yet, I had a CT of the pelvis done about a month after the SRT was completed for a reason unrelated to the PCa and the report stated that the pelvic lymph nodes were atrophic (sp) so it must have done its job.
 
I did have one issue related to the HT before surgery, my path report couldn't give a Gleason grade because the cancer was so beat up form the HT., there was one other guy who had the same issue on this board.  Also my surgeon said that my prostate was a little harder to remove because it was sticky, he said the HT caused it. 
 
The really upside was I didn't worry one bit what the cancer was doing whle I was waiting for surgery.
 
I feel pretty good about things because I believe I've been as aggressive as possible, if it comes back I'll jump all over it again.
 
David
54 y.o.
Diagnosed 4/10/08

DRE Normal

PSA-5.5

Biopsy- 12 cores, 4 positive highest 4+4=8

DaVinci surgery University of Washington June 08

PSA undetectable until 5/09

HT started 8/09 SRT 10/09

Last Lupron shot 5/11 2 years

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 5/25/2011 6:22 AM (GMT -7)   
Many surgeons do not want patients to have HT prior to surgery, as it makes the surgery much more difficult in general, and can lead to higher incidences of positive margins.

As far as HT added to SRT, still not convinced, Snuffy or no Snuffy. I met with 3 RO's before my decision, 2 strongly opposed mixing HT with SRT, the one day that did think you should, when pushed, he told me he couldn't prove I needed it, and he couldn't prove that it would help.

As far as some of guys that you mock about HT side effects that haven't had HT yet, I know what the side effects of getting bit by a Cobra are, but I don't have to experience it to get the general idea. From being on this board for going on 3 years, I have read more negative comments about the side effects of HT, then I have positive ones, and that's just among our small group.

Quality of life issues are very personal and very subjective. HT can be very effective in slowing down cancer, but it comes with a price. Not all of us are willing to jump on the wagon unless proven beyond a shadow of a doubt, when and if needed.

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

JNF
Veteran Member


Date Joined Dec 2010
Total Posts : 3414
   Posted 5/25/2011 7:15 AM (GMT -7)   
David, I agree with your agressive approach. That is basically what I told my docs....hit me as hard as you think I can take so we get as much, and hopefully all, of it we can right now. I think my signatures shows pretty aggressive treatment so far.

David in SC, regarding HT side effects. I am on Eligard now for a bit over seven months. From the start I have had hot flashes but they have changed and are less bothersome now. They used to come on suddenly and be intense. Now it is like a gradual warm glow that lasts a few minutes and then leaves. Doesn't even draw a sweat, but I know I am warm. They occur more at night then they did. I have just started taking a drug for the flashes so we will see how it will work. I have reduced, but not absent, libido and errections work well. I don't think I have any energy issues. Work, sleep and play is pretty much as it has always been.

My main current concern is that I have gained back the weight (15 pounds) that I lost in anticipation of HT and it is really concentrated around my middle. Befoore treatment I adopted the modified mediteranean diet and supplements by Meyers, but find the HT really has an effect on metabolisim. Thus my exercise regimen has increased greatly and I am adding swimming to the mix for no-impact cardio.

Overall, the se have been far less than what my wife has experienced from her two bouts with breast cancer so they seem minimal to me. My wife is on a five year course of HT for breast cancer control. She started on Arimidex for two months and was switched to Femara last month due to the se of Arimidex. I am concerned about bone health and that is the next avenue I will expolre. No problems so far, but I want to be preventative especially if I am on the HT for an extended period of time.

I am on six month Eligard so I have fewer injections. Eligard comes in less frequent doses also. Lupron is in monthly doses and can go from one to three months, or so. If you have to go on HT you can easily start month to month and monitor the se. Don't go the six month route at first.

I am also on Jalyn (Avodart and Flomax) daily. This manages the DHT and provides urinary assistance as my prostate and cancer rots away from the HT and RT. I am not aware of any se and I expect to be on it indefinately. With the good information about Avodart I would think that it would be used as a long term maintenance by most everyone. It sounds like Meyers uses it (and Proscar) that way.
PSA 59 on 8-26-2010 age 60. Biopsy 9-8-2010 12/12 positive, 20-80% involved, PNI in 3 cores, G 3+3,3+4,and 4+3=G7, T2b.
Eligard shot and daily Jalyn started on 10-7-2010.
IMRT to prostate and lymph nodes 25 fractions started on 11-8-2010
HDR Brachytherapy December 6 and 13-2010.
PSA <.1 and T 23 on 2-3-2011.
PSA <.1 on 4-7-2011
Second Eligard shot on 4-7-2011

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 363
   Posted 5/25/2011 8:34 AM (GMT -7)   
David in SC:
 
Lets agree to disagree.
 
This thread was not started to attempt to change your mind in any way, its obvious from past posts that won't happen.  This thread was started to give some of the newer guys a different side from the one that is presented by you and a few others that its the end of the world if you have to start HT.
 
We all react differently, would I rather not have done 2 years of HT, Hell yeah but I also would rather have a prostate than not and not had PCa at all but hey that's the breaks.
 
It's all about attitude in my opinion.
 
It's obvious that evidence is mounting all of the time that HT improves response in RT its just a fact of life.
 
You have experiences that I don't and I would always defer to the guy who has been down the road, I find in my line of work experience counts.
 
It's a great thread with great info. from a rather large group of HT users with different experiences. I can appreciate your time on the board I've been here just as long as you.
 
Good luck
 
David

Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 483
   Posted 5/25/2011 10:04 AM (GMT -7)   
David (dkob), You, JNF and BB Fan all seem to have good insight with regards to HT and IHT.  What would be a good source of info on IHT?  There seems to be such a wide range of opinions from Walsh at one extreme to Myers at the other.  Is any kind of consensus developing?  I absolutely cant't take any chances and waste any time if I have a PSA relapse.  My wife is pretty sick and fully dependent on me for her care and support.   I have had some discussions about IHT with my local uro/onc but need to be as informed as I possibly can.  Any suggestions would be appreciated.
 
Carlos
Dx 2/2008, at age 71, PSA 9.1, G8, T1c
daVinci surgery 5/2008, G8(5+3), pT2c
BCR 2 1/2 yrs after surgery
IMRT, 68.4 Gy, 12/2010 - 2/2011
PSA 0.07 three months after IMRT

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7184
   Posted 5/25/2011 12:42 PM (GMT -7)   
DK:
 
You said:
 
>>>>>>>>>>>>>
 I kind of laugh when I hear some of these guys talk about the SE's when they have never even been on the treatment. 
>>>>>>>>>>>>>>
Why do I not think that is funny? Arrogant, yes. Funny, no
 
I've never had chemo. I think I can talk about the SE!
 
Mel

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3764
   Posted 5/25/2011 1:21 PM (GMT -7)   
Mel -- i think there's a difference between occasionally rendering an uninformed opinion and protesting too much.  you and David both have strong opinions against HT that are largely fear based ... fear of the unknown.  that's all right.  one of my greatest fears is i'll have to go back on lupron and end my life that way.  but if i had to do it of course i would.
 
right now i am stronger in the gym then when i started lupron, but that's a recent development.  i attribute the extra stength to weight gain and of course consistent exercise.  my sex drive is back but i still get fatigued in the day.  i also think i have gotten lazy and used to feeling bad.  my point is i really can tell NOW what the treatment did to me ....especially the lupron and my fear is i'll have to go back on it someday.
 
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

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7184
   Posted 5/25/2011 4:42 PM (GMT -7)   
F8:
 
Actually, in my case, I am pretty sure that I WILL be going on HT. I have never said that I would NOT or even leaning that way.
 
But, yes, I do greatly fear the SE, just as I did about SRT (but more so, since I am guaranteed to have a number of SE and only the DEGREE is uncertain).
 
I felt with SRT I had no choice if I am looking for a cure. With HT, I suspect I will feel I have no choice if I am looking for some remission
 
I stand by my comment regarding DK's remark.
 
Mel

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25343
   Posted 5/25/2011 4:46 PM (GMT -7)   
F8:

You dead wrong in assuming my reservations about HT are feared based, after all the physical hell I have been through, my feelings have nothing to do with fear. Read my new thread about my new oncologist visit today, still yet another doctor that is advising not to rush in HT. He doesnt buy into this line of thinking of "throwing everything into it" at one time.

Each of our cases are so different, so different fix for each person.

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

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3562
   Posted 5/25/2011 5:53 PM (GMT -7)   
Study after study has demonstrated that in high-risk patients, when salvage radiation is combined with short term hormone therapy, (6-24 months) the time before reoccurrence and survival is increased substantially..

In the high-risk group, this has become the standard treatment...

Seems to me, if you need salvage radiation, you automatically become "high risk" regardless of your Gleason score..

It is also pretty obvious (and natural) that everyone on this board strongly believes that the treatment THEY are receiving is the best possible treatment for THEM....Amazing, considering the minefield we must all navigate, playing musical chairs with the Grim Reaper...
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
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