Huge PSA spike

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Oncas
Regular Member


Date Joined Jan 2009
Total Posts : 390
   Posted 6/13/2011 4:48 PM (GMT -6)   
My post surg pathology on 3/25/09 was dismal. Gleason 9, sem vesicles involved and 2 of 9 nodes positive, PSA .6. Finished SRT 3/10. PSA continued to slowly rise. On 4/3/11 I was at 2.28 and the rise was slowing even further. All of a sudden two months later my test results were 3.65.
I am astonished and shaken. Because of the very slow rise I have deferred on starting any ADT up until now. My doubling time was well over eighteen months and within eight weeks it has dipped to below six months. Is this possible? Should I abandon my wait and see plan and immediatedly jump into ADT or wait for another test? My oncologists are pretty much leaving it up to me. Has anyone else ever had such a dramatic acceleration in PSA?
Thanks for any input.
 
Jim

Age 61
Northeastern Penna.
11/08/08 annual checkup (3 yrs late) PSA 8.04 from previously 2.7 in 11/05
1/23/09 biopsy 12 cores positive, 10 cores Gleason 7, 2 cores Gleason 8 70% tumor
2/06/09 cat +bone scans clean ..
3/26/09 RRP surgery Post op path .. upgraded to Gleason 9 (5+4), seminal vesicles involved, several positive margins, 2 of 9 lymph nodes positive.

livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 6/13/2011 5:54 PM (GMT -6)   
thanks for writing Jim I can somewhat understand your thinking. I went through ADT3 and radiation. Now my PSA is back up to .8 however it has steadily increased over the last six months. My doctor advised me to wait a little longer which trust me I have no problem with because I am not looking forward to ADT3 again. I go back June 30th and I have decided that I will do something if it is over 1.
I wish I could tell you what to do but I can't all I know is I am going to wait as long as I can before doing anything.
keep me posted

peace to you
Dale
I was 45 at diagnosis with PSA of 16.3
http://www.caringbridge.org/visit/dalechildress

My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's. Scheduled to have a radical on July 11th, 2007, surgery was aborted when it was discovered it had spread to the lymph nodes.
I was on Lupron, Casodex, and Avodart for two years with my last shot March 2009.
My Oncology hospital is The Cancer Treatment Center of America in Zion IL
PSA July of 2007 was 16.4
PSA May of 2008 was.11
PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11
PSA Jan 15th 2010 is .13
PSA April 16th of 2010 is .16
PSA July 22nd of 2010 is .71
PSA Sept of 2010 is .71
cancer in 4 of 6 cores
92%
80%
37%
28%

dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 6/13/2011 8:16 PM (GMT -6)   
Oncas:  I believe you have to decide how you want to fight the cancer, do you want to be proactive or lay back and allow the cancer to get stronger and stronger.  I'ts obvious that at some point you're going to have start HT, now or later is the only decision left.
 
If you haven't read Dr. Myer's book on HT now is the time to do so, it gives guys hope where a lot of other Docs. seem to think we're just running out the clock.  He lays his position out for all to see. He has one other thing going that most other Docs don't he was on HT for an extended period of time so he knows the SE's first hand.
 
His position is to attack the cancer early and when its at its weakest point. 2+2 has always equaled 4 to me so it makes sense.
 
Please give the book a read, you'll feel much better about your situation.
 
Good luck
 
David

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 6/13/2011 8:30 PM (GMT -6)   
Jim, why don't you get another PSA in 30 days. Get another data point to judge the velocity. I agree with Dave, however, your headed for HT. if I was at 3.65 I would be on HT now. You may be able to hold off longer if your last PSA is a abberation. Best of luck. BB
Dx Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4)
Robotic RP March 2009
Path Report: T2c, G8, organ confined, neg margins, lymph nodes - tumor vol 9%
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT/SRT .01, < .01
End ADT3 5/11 PSA < .01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/13/2011 9:10 PM (GMT -6)   
Oncas,

So sorry to hear about your news and your big spike in PSA. While I am not a Gleason 9, take a look at my signature, and you can see that I am having the same problem with very large PSA increases, particuarlly since my SRT has failed. I am current seeing a new medical oncologist that is affiliated with MD Andersen, and we are working on my situation.

I wish you the very best, as you contemplate your next course of action.

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, 6/11 5.8
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 : 3738
   Posted 6/13/2011 10:45 PM (GMT -6)   
Was it ever discussed, right after your post-surgery pathology report was discussed, that you might want to consider adjunct radiation treatment combined with hormone treatment as soon as possible after surgery??

What treatment path did your doctors recommend to you when that G-9 and positive nodes finding became known?

You and I have very similar stats..Because of my high-risk, high-grade disease, my doctors all agreed that the most aggressive course of treatment was advised, and that's what I'm doing...I'm not a doctor and this is just my opinion, but I would be pulling out all the stops, finding the best medical oncologist I could, one who specializes in PC and thinks outside the envelope..There are trials going on right now where they combine aggressive ADT with chemotherapy and that seems to be very effective...Also, are you aware of the proven benefits of pomegranate juice? Two good clinical trials have shown it can cut the PSA doubling time in half...Us Gleason 9 guys can not afford to leave any stones unturned...Best of luck to you...
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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