Summary of today's Oncologist Meeting

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Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/25/2011 6:18 PM (GMT -6)   
Was a good meeting today, I really like this doctor and his attitude about cancer and health issues in general. He has never been a surgeon, or a radiation doctor, only an oncologist.  His big thing is "treating the whole patient, not the numbers".  He said a lot of bad advice and treatments are done on just a PSA number by itself.  Probably in his early 40s, I am not a good judge of age.
 
The entire visit was 2 1/2 hours, but I timed it, we spent a full 90 minutes one on one, and not once did he fool around with his cell phone or get interupted by staff.
 
Some of his general views, and please, let's not shoot the messenger (me) or start trashing the doctor, I am just repeating:
 
AS -  He thinks that most all low positive cover, low percent Gleason 6 cases should be made to do AS, until there is evidence of the cancer becoming aggressive. If someone has like 1 core, 5-10% cancer, that treatment is overkill in most cases.
 
RT as primary treatment - best served by Gleason 6 cases, but not in favor at Gleason 7 or above.  Same with 'seeds'
 
Recurrance - any 3 rises above .10 from surgery, any consecutive rise at all post-SRT
 
Surgery - feels its best treatment for most Gleason 7 cases.  While he is not anti-robotic, he respects the quality of a good open surgery with the tactile quality to it.  Among his patients, he has seen a rise in incontinence issues and ED issues, despite nerve sparing operations, among men that went Robotic.  He said the best robotic surgeons, are the doctors that have a lot of experience with open Surgery, that switch to Robotic.  The surgeons that start with Robotic, have a long learning curve.
 
HT - He doesn't like mixing treatments.  Like doing HT before surgery, or during ART or SRT, likes to see each treatment stand on its own.  He's not in favor of using HT too soon after a secondary treatment failure, as its best to save the HT for when you really need it, and since its not curative, you have to time the use of  the HT card to the needs of the patient.  If you go refractory too soon, you are screwed sooner.
 
Diet - He's big on dietary issues in a balanced way, not the excess that some express here.  Doesn't believe in the elimination of entire food groups, i.e dairy, meat.  He is very anti-excessive sugar consumption.  Big on Mederteranian Diet or any sensible Heart Healthy Diet.  The subject of POM got a good snickle out of him.  If you are thirsty and like the taste, drink it.
 
Supplements - Not for people mega dosing or self-dosing without doctor's approval.  Big on Vit D levels, again under doctor's supervision.  Most people don't even need multi-vitamins.
 
He's big into the science of PC, not just the treatment.  Most of his patients are PC guys, and with women, of course, BC.
 
If you love studies and research, you would love this guy, he's on top of every possible study past, present, and future.
 
As far as my situation goes, this is his current thinking:
 
He does not reccomend HT at this time, despite a climbing post-SRT psa.  Doesn't want me to jump the gun at this time.
 
Wants to change my PSA tests from 3 months apart, after this next reading, to 6 months apart.
 
Wants to talk some dietary tweeking with me on the next visit.
 
Wants to deal with my major faituge and pain issues, and has actually increased my pain management program, to include more regular doses, instead of me waiting all day for the pain to build up to higher levels.
 
Wants to get x-rays of my hips, to see if he can see anything.  With the bone scan, only going to show mets once they are larger.
 
Doesn't feel there are any other tests that can be run right now, that would show anything about where the cancer may or may not need.  Did feel that PNI is a good escape mechinism for cancer cells to leave the barn even way before dx.
 
I need to stay in the Oncology Rehab that I am in, best way for me to get safely conducted exercise.
 
Wants to see me in 4 weeks, to see if I can get a handle on the pain, and if so, it may reduce some of the fatigue. Kind of the chicken and the egg syndrome.
 
Very sharp guy, he knows my former Oncologist very well, but understands with the litigation in place, I can't see him.
 
Said I was a very intelligent and informed patient, loved that I gave him some a detailed chronology on my PC and previous cancer episodes in such precise detail.  He asked about support groups, and I gave a huge plug for HW, so I won't be surprised if he doesnt lurk.
 
All in all, he had a very balanced view, on me as a person, not a number, and no generic fix with HT, without a reason or a purpose.  Wants to preserve as much quality of life for me as possible.
 
David in SC
 
I will add more comments as I remember, this is all from memory, don't have my notes nearby
 
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/25/2011 6:50 PM (GMT -6)   
Since no reply yet, let me add an addition.

This guy is a very deep and serious oncologist, very welll trained, educated and experience. I did find it a bit puzzling, not in a bad way, that he had never even heard of my former cancers, the porocarinoma. It was a first for him. But when I told him that I am now one of only six known cases in the world of having it on my scalp, actually 2 times, it made more sense. Still less than 300 known world wide cases of this cancer type. He looked at the top of my head and remarked that whoever did the surgery did an excellent job. Even the American Cancer Society is unaware of this particular cancer.

On the ED front, he was a stunned as any of my other doctors that I have never experienced ED. He said the surgery I had should have left me with ED, and then to be coming on 18 months post radiation, just amazed that I have no issues. Told him that was my only silver lining in what has proven to be a horrid PC journey.

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 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

Cajun Jeff
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Date Joined Mar 2009
Total Posts : 4119
   Posted 5/25/2011 6:54 PM (GMT -6)   
David: So pleased that you seem to have found a Dr that is working with you so closely. Sounds like a good match between you and the Dr. I know you are breathing a bit easier.

Stay well my friend.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
2 year PSA <0.1
Only issue at this time is ED but getting better

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 5/25/2011 6:54 PM (GMT -6)   
David:
 
Thanks for the resport. Last night I listened to a radio interview with Dr. Scholz (discovered it on the internet; I think the date of the actual interview was about a year ago).
 
Scholz is also a great believer in AS. He believes a HUGE % of PC cases will never come to much, so why put patients through that. Needless to say, we are passed that.
 
Did you ask about PSADT and if that implies HT may not work for long?
 
I think Scholz will consider my cancer very aggressive and will push for earlier HT, but of course I don't know that.
 
Scholz also mentioned vegan and Mediteranean diets and he is stringly for that as well as Vit D3. He tests for the level. He mentioned a few other supplements that might be good (fish oil and something else), but like your guy he was quite specific about Vit. D3 being helpful. He also mentioned some studies showing the benefits of exercise regarding PC.
 
Thanks for the report. I do like the idea of doing one tx. at a time so you can see if it worked (and who wants the additional SE). But I think the latest science differs here with regards to HT (ie: before SRT).
 
Did he mention when to start HT (ie: if PSA goes above a certain figure?).
 
Mel 

BB_Fan
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Date Joined Jan 2010
Total Posts : 1011
   Posted 5/25/2011 7:05 PM (GMT -6)   
I don't know Dave. You have a rapid PSADT, taking a wait and see approach on HT, and he wants you to have 6 month PSA test. I would think that if you are not going to HT right away, with your PSADT you would be monitoring PSA like a hawk. 
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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/25/2011 7:13 PM (GMT -6)   
Mel:

On starting HT, no magic number with him, depends if my velocity continues, was talking more like a PSA of 10 to 20.

Real big on each treatment standing on its on, even with the minor changes with me, he only wants to try one thing at a time and see how my body reacts

Yes, he brought up doubling time, and all but said a fast doubling time is troubling with all levels of treating PC. He wants to calculate mine after my next reading, and then we will tak about it next time.

He doesn't consider doubling times when the PSA is below 1.x as accurate enough gauge to base treatments on though, wants to see them when they are single digit or higher above 1.x

Jeff:

I was calm before todays visit, and after, just took it all in stride, never felt stressed. My only concern in advance, was having a doc that would do the old "one size fits all" approach. This doc is all about each patient and each case on its own merits
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

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3984
   Posted 5/25/2011 7:18 PM (GMT -6)   
did he really say that he would go to six-month PSA testing without seeing your next PSA results, which i think is due in a few days? 
 
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

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6051
   Posted 5/25/2011 7:23 PM (GMT -6)   
Sound likes a good match to me, the 90 minutes plus wearing only one hat is arguably a plus. So where do you use that sailboat, it sounds like alot of fun. I met 2 young ladies at my paddle board surfing spot yesterday, gave them some tips as they were really struggling with it. They were from South Carolina, didn't ask where. wouldn't know where. I'm orignally a " rebel " , born Newport News, Virginia, raised a yankee. Didn,t you do the reverse?
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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/25/2011 7:25 PM (GMT -6)   
no ed, he will make that decision based on my next reading in a few days, and only with my uro's agreement

bb, that's how we guys would look at it, will have to see how much spike i get on this next one
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

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 789
   Posted 5/25/2011 7:25 PM (GMT -6)   
Hey David, sounds encouraging, the doc seems to be switched on with your situation, interesting that he changed your PSA to 6 months, they did the same with me, don't have my next one till end of July. Was interested in his endorsement of the Mediteranean diet, I have been on it for 48 years, my wife is Greek....lol

All the best mate, when is your next PSA?

Mal.
age 67 PSA 5.8 DRE firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept 07 Totally dry
PSA 23rd Oct.0.5
Started SRT on 5th Dec.
Finished 24 Feb 08
PSA from 30th April 08, until now range- 0.5 to 0.7

BillyMac
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Date Joined Feb 2008
Total Posts : 1858
   Posted 5/25/2011 8:20 PM (GMT -6)   
David, that sounds like a pretty good consultation you have had there. It is great that you have such a good rapport with the new guy. What a difference it makes when a doc is prepared to sit and go through the details and pros and cons, with a patient that has a fairly good understanding of Pca, rather than being on the receiving end of the usual monotone dialogue about how you will be treated. His views on the treatments on diagnosis are interesting.
Bill

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/25/2011 8:37 PM (GMT -6)   
mal, thanks my friend, my next one is in a few days. gotta love those greeks

billy, he took so much time with me, and never pressured me to end the appt. it didnt stop until everything was talked about. i mostly listened, and he answered most of my questions on his own, then i hit him up with questions we didnt discuss. thats my kind of doctor. and trust me, his waiting room was busy.
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

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 5/25/2011 8:42 PM (GMT -6)   
Purg; glad to see you've found a Doc you are happy with,and I'm happy for ya!
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 32 grams
Biopsy 12 cores with 7 positive
Gleason score of 7
1st PSA 38.7 10/05/2010
2nd PSA 49.9 11/23/2010
CT neg.
BS Negative
RRP on 01/25/2011
PT3a -40% involved
margin involved-Left anterior
lymph nodes -clear
1st post op PSA-0.26-03/16/11
2nd PSA-05/09/11-0.08

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 5/25/2011 9:16 PM (GMT -6)   
DAVID
- so glad you have found a doctor on the same page with you - having their support and knowledge should help take some of the burden off you - hugs to the future,
BRONSON
Age:55 -gay with spouse of 14 years, Steve -Peterborough, Ontario, Canada
PSA:10/06/09 3.86
Biopsy:10/16/09- 2 of 12 cancerous, 5% involvement -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

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/25/2011 9:33 PM (GMT -6)   
daslink, with the exception of the sea hag RO that fried my bladder needlessly, i am happy with my entire medical team

thanks bronson, and best wishes to you and steve
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

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/25/2011 9:41 PM (GMT -6)   
David, as always a well written, well thought out report --- plus this time some good news!

When it comes to medical stuff, generally, as you know, I don't know, but what this guy had to say makes sense to me and I can understand why you're happy with his approach.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

MrsGFM
Regular Member


Date Joined Feb 2010
Total Posts : 115
   Posted 5/25/2011 9:54 PM (GMT -6)   
So glad you found someone you trust and can communicate well with. I lurk a lot, don't usually post much, but I think of you often and wish you well. You are always so supportive to the rest of us.
Mr GFM's statistics:
Age 50 at diagnosis
PSA History: 10-05 1.3, 01-07 2.09
8-07 - PSA at Biopsy: 2.26
2 of 12 positive
Gleason Score 3+3 6
11-07 - Robotic surgery hospitalized overnight.
Path Report:
Prostatic adenocardinoma, Gleasons 3+3+6, moderately differentiated
Percent of Prostate involved by tumor 5%
Staging pT2c pNx pMx
Margins free of tumor - no further invasion or extension
Catheter out in about 9 days. No incontinence.
Back to work in 2 weeks
ED - resolved. No meds needed at this time.
Post Op PSA: 03-08 0.01, 10-08 0.02, 7-09 0.04, 1-10 0.04, 7-10 0.04

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 5/25/2011 10:29 PM (GMT -6)   
David,
I'm glad that you found an Oncologist who is willing to listen and spend time explaining things. It is comforting to know that there are good doctors out there who value the patient and tailor the treatment to the individual. Good luck with the pain management.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
Davinci surgery 2/9/09 Gleason 4+4 EPE,
Margins clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
all PSA tests since (2, 5, 8, 11, 15, 18, 21, 2 years <.008? ) undetectable
27 months: .005

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/25/2011 10:42 PM (GMT -6)   
Sheldon,neither am I one of the on board technocrats, I listen and learn. The doctor's words were more important to me to hear, then anything I had to say. Thanks as usual, my friend.

thanks mrsgfm, feeling is mutual

thank you EdC, after that terrible year of misery (2010), when it seemed so hopeless at times, it's nice to see another caring doctor out there that is looking out for my best interest. thats all i can ask for at this juncture
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

Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1211
   Posted 5/25/2011 11:04 PM (GMT -6)   
Hi David,
Sounds like you've hit the jackpot with your new Dr.. Glad that you've found one that seems to be on the same wavelength with you. From your report it appears that he really knows his stuff and doesn't mind spending a fair bit of time with you. Thanks for your report btw. I found it quite informative.
Hoping for good things to come your way.
Mag

Born 1936
PSA 7.9, Gleason Score 3+4=7, 2 of 8 positive
open RP Nov 06, T3a, Gleasons 3+4=7, Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; at SRT Start=0.1,
Salvage RT completed (33 days-66Gy) 19 Dec 08
PSA: in Jan 09 =.05, all tests to date (Jan 11) <.04

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/25/2011 11:11 PM (GMT -6)   
thanks mag, i will post some additional comments from him, in 90 mins, we discussed a wide range of topics. between him, my uro, and my long term GP, i feel like i got a really solid team together again.
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

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 5/25/2011 11:17 PM (GMT -6)   
It is good that you have rolled up your sleeves and started with a new doc. With all that's happened so far you must be pretty worn down and your new doc appartently saw that as job one. He sounds practical of the diet issues and it should be easy for both of you to be on the same page.
Ron
ps I agree with all his talking points, but Coffee.

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 5/25/2011 11:18 PM (GMT -6)   
Hi David,

Sounds like you got the right guy for the job.
I am so pleased for you.

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone. T2C.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03|Dec10 – 0.03|Feb11 – 0.03
Lab 2: Nov 10 - 0.01|Dec10 – 0.01|Feb11 – 0.01|Apr11 – 0.01

Sonny3
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Date Joined Aug 2009
Total Posts : 2448
   Posted 5/25/2011 11:40 PM (GMT -6)   
Nicely done David. Found yourself a keeper, I think. I know the feeling that you have when you find the doc that takes the time to discuss it through, explaining each item to it's fullest and giving you the rationale for it.

Seems like a really good fit for you. Real happy to see that you have added another to a fine team to treat you and your Pca as an individual.

Best to you,

Sonny
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
5/19/11 PSA 4.9

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/26/2011 12:51 AM (GMT -6)   
thanks, knot and an

thanks bro sonny, i didnt know what to expect today, was geared to be disapointed, but in the end, he seems top notch. i see him again in 4 weeks, and i will see if that visit is equally as useful. his thinking and your doctors thinking seem to match on some key points.

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 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
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