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Eight Years after Surgery PSA up DANG

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56pontiac
Regular Member
Joined : Sep 2006
Posts : 240
Posted 12/19/2014 3:25 PM (GMT -8)
I was hoping I could just pop back on here for my annual PSA report and it would be all good. This forum was a wonderful place to be when I got this in 2006. Most of the guys I got to know here have moved on and didn't report back as to how things went. I was feeling pretty good in the fact that I reported back each year and it was a good report with low PSA and all bodily functions working well. So, now here I go again.
10/2006 DaVinci Surgery PSA 0.01
10/2007 PSA 0.02
10/2008 PSA 0.04
10/2009 PSA 0.06
10/2010 PSA 0.06
10/2011 PSA 0.085
10/2012 PSA 0.15
05/2013 PSA 0.13
10/2013 PSA 0.13
06/2014 PSA 0.14
12/2014 PSA 0.20
06/2015 PSA 0.17

Dang just got back from the doctor he said we would just get another PSA in six months and watch and see. Other than the stinking increase in my PSA everything has been going very well health wise. I feel great have all my bodily functions without any problems. This forum was a real blessing to me and a wealth of information when I got this in 2006. At what point does one consider the salvage radiation?

Added 12/20/14
I have no idea what this stuff means except it was supposed to be "good news" at the time
pre surgery 2006 The words "positive a margins" was never mentioned. Was told after surgery it was all good if there is such a thing with PC.
PSA was 4.3
Lat Mid Gleason 6 Grades 3+3
Lat Base Gleason 7 Grades 3+4
Stage was T1

Post Edited (56pontiac) : 6/14/2015 12:48:20 PM (GMT-6)

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proscapt
Veteran Member
Joined : Aug 2010
Posts : 644
Posted 12/19/2014 4:24 PM (GMT -8)
The point to consider salvage would be the next PSA. Once you get a second rising value above 0.2, that is the official definition of recurrence.
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InTheShop
Elite Member
Joined : Jan 2012
Posts : 11468
Posted 12/19/2014 4:51 PM (GMT -8)
Not the news you wanted.

You're almost at that point. Another rise and you'll need to make the rounds of the doctors again.

Hard to say if SRT is the next step for you, but sadly you might be talking to an RO in six or seven months.

Sucks actually.
Andrew
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PSA3DOT7
Veteran Member
Joined : Dec 2013
Posts : 720
Posted 12/19/2014 4:52 PM (GMT -8)
56,

Sorry to hear of the rise in PSA. At the time of surgery what were your stats: PSA, Gleason and stage?
.
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logoslidat
Veteran Member
Joined : Sep 2009
Posts : 7585
Posted 12/19/2014 6:11 PM (GMT -8)
I agree with proscapt advice , but with a a change. It would be time to consider additional treatment.Consider being the operative word. SRT would be one of the options for treatment, not the only one. And based on the trend{moving slowly, still hasn't doubled since 10/2012} Doing nothing, at this juncture would also be as viable an option as the others. There are studies out there that would support any of the 3 options. Your Doctor is no dummy on this. I like the 6 mos psa test, rather than than 3 mos even. He seems steady to me. So carry on my friend...
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Tim G
Veteran Member
Joined : Jul 2006
Posts : 3054
Posted 12/19/2014 6:28 PM (GMT -8)
I'm sorry to read that your PSA is rising. Sounds as though it's time to consider salvage radiation. There's a guy here, Allen, who will doubtless pop his head in to give you some good advice on some options. I remember you from former days, and hope that, despite this setback, all is well with you. All but a few of the guys who go back as far as you--most having found better ways to spend their time than on a prostate cancer forum--have disappeared into deep cyberspace.
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56pontiac
Regular Member
Joined : Sep 2006
Posts : 240
Posted 12/20/2014 5:08 AM (GMT -8)
Hey there Tim G! I remember you as well. We both are about the same age we got this disease about the same time. We both are in the Pacific Northwest. Most all of our "classmates" have moved on ( a good thing for them I hope) and I only see a few of the familiar names here from "back in the day". Anyway looks like I will be studying SRT and seeing what it is all about. Any recommended reading or material to consider about it in my investigation?
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Cajun Jeff
Veteran Member
Joined : Mar 2009
Posts : 4175
Posted 12/20/2014 5:50 AM (GMT -8)
56, sorry to hear this news. Nth at sucks for sure. That being said it has been a long time. Yep I'm still hanging around and check the site every couple of days.

I hope all goes well with you.

Cajun Jeff ( former name corvetteman3)
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Patrick M
Regular Member
Joined : Nov 2013
Posts : 450
Posted 12/20/2014 6:08 AM (GMT -8)
Hey 56
Uhgg, that's not the news your were looking for. Would you mind posting information about what your pre-surgery stats were? Did you have any positive margins?

Best of luck and hopefully the next test result is down and this was just a glitch

Pat
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56pontiac
Regular Member
Joined : Sep 2006
Posts : 240
Posted 12/20/2014 6:50 AM (GMT -8)
I have no idea what this stuff means except it was supposed to be "good news" at the time
pre surgery 2006 The words "positive a margins" was never mentioned. Was told after surgery it was all good if there is such a thing with PC.
PSA was 4.3
Lat Mid Gleason 6 Grades 3+3
Lat Base Gleason 7 Grades 3+4
Stage was T1

This latest PSA really have me bothered some what about the possibility of facing RADIATION (nasty word it is) and potential side effects and down grading my quality of life. I have been so blessed since I got this disease no leaking and full sexual recovery without any drugs (used the pump off and on for the first three years) then full sail. So my life has been pretty darn good after getting PC, and it is right now. However, this has me concerned about my future quality of life. So, now I will try to focus on the great quality of life I have right now today and try not to stress over this bump in my life's road. I also feel kind of guilty complaining with my numbers especially when I have read some of you other guys very heavy struggles with this disease.
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biker90
Veteran Member
Joined : Nov 2006
Posts : 1465
Posted 12/21/2014 7:36 PM (GMT -8)
Hey 56,

Sorry to hear that you have to concern yourself with this garbage again. You and I came on hear about the same time. Hang in my friend....

Jim
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Tall Allen
Elite Member
Joined : Jul 2012
Posts : 10645
Posted 12/21/2014 11:26 PM (GMT -8)
Hi 56-

What you've got going for you is the slow PSADT. I'm afraid that negative margins are not really a good thing in your case because your PSA is detectable. The reasoning is that if there were positive margins, then they would know exactly what was causing the PSA and that it is localized and treatable. Recent studies have shown that it is better to treat sooner rather than waiting. You should be talking to an RO about salvage already. He will probably just want to treat the prostate bed for now. Your PSA is too low for any mets to be detectable. Some excellent radiologists have claimed some success in finding tumors in the prostate bed with an mpMRI, but that is far from assured. Your PSA is too low and the PSADT is too slow for a PET scan to be useful, and you wouldn't want to wait for it to rise.

What was your pathology Gleason Grade and stage? If the Grade was no higher than 3+4 on pathology too, ADT may not be useful. Was 56 the year you were born? I'm sorry you have to go through yet another treatment.

- Allen
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Bohemond
Veteran Member
Joined : Apr 2012
Posts : 1438
Posted 12/22/2014 8:13 AM (GMT -8)
56,
Your PSA history is very similar to mine -- see my signature below. Like you, I also stayed at 0.1 for several years. But when it started moving upward again the pace increased greatly. It jumped from 0.1 to 0.2 and then hit 0.4 just four months later. So If I were you, I'd be consulting with an RO now and not waiting too long between PSA tests. The good news is that my SRT has been successful for 4 1/2 years so far, though there may be a looming disturbance in the force. Best of luck.

Jim
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56pontiac
Regular Member
Joined : Sep 2006
Posts : 240
Posted 12/22/2014 4:58 PM (GMT -8)
You asked "What was your pathology Gleason Grade and stage? If the Grade was no higher than 3+4 on pathology too, ADT may not be useful. Was 56 the year you were born? I'm sorry you have to go through yet another treatment."


My Gleason was 3+3 before surgery the 3+4 after surgery the stage was T1 I was born in 1949 the 56 is the year of my classic car 56Pontiac. I thought PSA only came from the prostate can it come from somewhere else?

Post Edited (56pontiac) : 12/22/2014 6:03:51 PM (GMT-7)

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Tall Allen
Elite Member
Joined : Jul 2012
Posts : 10645
Posted 12/22/2014 5:08 PM (GMT -8)
There is no pathological (after surgery) stage pT1. I asked about age because if you were, say 90 y.o., you might not want to do SRT. PSA is almost entirely from prostatic cells, both healthy and cancerous - that's why it's called Prostate Specific Antigen.

- Allen
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56pontiac
Regular Member
Joined : Sep 2006
Posts : 240
Posted 12/22/2014 5:14 PM (GMT -8)
Thanks Allen I dug out my paper work here is what it said pre-surgery. I know there isn't a Gleason after surgery don't know what I was thinking.

Lat Mid Gleason 6 Grades 3+3
Lat Base Gleason 7 Grades 3+4
Stage was T1
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Tall Allen
Elite Member
Joined : Jul 2012
Posts : 10645
Posted 12/22/2014 7:17 PM (GMT -8)
There is both a Gleason and a stage post-surgery and pre-surgery. It would be on your path report from the full pathology of the prostate done after the surgery.
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56pontiac
Regular Member
Joined : Sep 2006
Posts : 240
Posted 12/23/2014 4:29 PM (GMT -8)
Thanks Allen, I don't find a final path report after surgery. I don't think I ever received one, if I had it would be in the pile in the file as I save everything. Is it something I should get and have? If so, exactly what do I tell the doctors office I want a copy of? Would it make any difference at this point 8 years down the road?

Post Edited (56pontiac) : 12/23/2014 5:35:05 PM (GMT-7)

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Tall Allen
Elite Member
Joined : Jul 2012
Posts : 10645
Posted 12/23/2014 6:18 PM (GMT -8)
Yes, it's important to have. Ask your surgeon for your post-surgery path report. Your RO will want it anyway. It has critical info on Gleason score, stage, LNs, margins, etc.
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Tony Crispino
Veteran Member
Joined : Dec 2006
Posts : 8160
Posted 12/23/2014 6:37 PM (GMT -8)
56,
Always nice to hear from you. You have a very slow doubling rate, That's good news. I hope it stays that way.

I think about you every time the Rockabilly show pops up here at the Orleans. You still gigging?
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Jmon
Regular Member
Joined : Feb 2006
Posts : 84
Posted 12/23/2014 8:31 PM (GMT -8)
Hello 56,

Your post is very interesting to me since we are progressing much the same. My DaVinci was in August 2005 and PSA was undetectable for several years. It has progressed very slowly, was 0.15 six months ago and actually went down to 0.13 most recently. Plugging my numbers into one of the programs shows a doubling time of about 8 years. I did have positive margins.

Like you I am very reluctant to risk the potential side effects of salvage radiation. I am currently 67 and otherwise very healthy. A couple years ago my uro was pushing me to interview radiation oncologists. When I balked at that he agreed that we would just keep a close watch and now agrees that that was the proper path. If my doubling time doesn't shorten my PSA will be 0.5 or 0.6 when I am 83 years old and in my 90's before it goes over 1.0.

I will follow your situation with strong interest. One thing to consider is advancements in prostate cancer treatment. Every year that we are able to avoid being zapped is another year that might produce an effective treatment with fewer, less dramatic side effects.

Good luck with your journey and, while prostate cancer is certainly not a blessing, you and I are far better off than many of the good men on this forum.
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56pontiac
Regular Member
Joined : Sep 2006
Posts : 240
Posted 12/26/2014 1:39 PM (GMT -8)
Jmon, I will update on this thread as things play out hope you will let me know what is going on with you as well. Our numbers are spooky close to the same and we are a year apart in age. I just ordered my medical records since I didn't get the final path results. I want them so I can tell the docs assistant what is in there. :) The last visit was really a waste as I knew we would wait for another six month PSA anyway. It bothered me that the Physicians Assistant sat there and looked at my records trying to figure out what he was looking at then muttered something and then I saw the doc for about 1 1/2 minutes with my usual answers of "yes I feel fine, yes my sex life is fine, no I am not incontinent." I also want to get them so I can post them here and get opinions. Some of the people here I think are as knowledgeable and maybe even more so than the docs about the latest studies etc. You are right that so many others on this forum have had to undergo a much more stressful and challenging scenario than we have. God bless each and everyone of them the new ones I will meet, and the old ones still here and the ones who I don't see here anymore.
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Tim G
Veteran Member
Joined : Jul 2006
Posts : 3054
Posted 12/27/2014 5:28 PM (GMT -8)
56Pontiac,

Yes, please keep us updated on your situation. In my case, the only time I've been undetectable is with the standard PSA test, which measures to the nearest tenth nanogram. With the change to ultrasensitive, I've never had an undetectable PSA. I'm still confident that I'm done with prostate cancer and will not need further treatment in the future.
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Squirm
Veteran Member
Joined : Sep 2008
Posts : 744
Posted 12/27/2014 7:47 PM (GMT -8)
Would proton be an option? Perhaps less side effects.
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56pontiac
Regular Member
Joined : Sep 2006
Posts : 240
Posted 12/29/2014 2:16 PM (GMT -8)
I got my medical records. Here is what it says on the Pathology Report after surgery dated 10/12/2006 Anybody know what it means in simple language?
VIEW IMAGE

Post Edited (56pontiac) : 12/29/2014 3:19:35 PM (GMT-7)

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