Hi, it's been a few years since I have been on a message board (I used to frequent Health Message Boards) and entering this one I recognize you, Tall Allen. It's great you are here and I am comforted by your consistent presence.
I'd love yours or anybody else's assessment of where I am now at. I have not really been focusing on prostate cancer or new practices, letting myself enjoy a period of hope and blissful ignorance.
I have had a couple years believing that I was likely cured. After a couple years of nothing to challenge my belief otherwise, I am now bodyslammed (just like I was after initial diagnosis) with the understanding that my cancer has likely return.
It's different with recurrence, isn't it? Before there was the challenge of working towards a victory of defeating your enemy. Now it's acceptance of a likely life long relationship with eternal treatment. Unless I am wrong, this is how I feel.
I'm 55. At 50 I had a PSA of 65, 8 of 12 cores positive, a Gleason score of 4+3=7 and seminal vesicle involvement. I had brachytherapy and IMRT along with 18 months of ADT. After treatment my PSA went to .1. I was left osteoporotic with a t score of -3.2 (I had osteoporosis prior to treatment but didn't really understand it like I do now. I did do forteo injections for 8 months and my t score is now down to -2.7).
For two years my PSA rose from .1 to .4 and bounced around a bit. As I produce a small amount of ejaculate after orgasm I assumed there was some healthy tissue left in my prostate and felt the .4 was normal.
Between January of this year and now seven months later my PSA rose from .38 to .95. I guess that's a doubling of less than 6 months.o
1. Is this period an accurate indicator? I'm not sure what the standard procedure is in extracting doubling times. Any doubling at any time?
In January I lost my mother (and a wonderful friend). She lived next door to me with my father and I have been tending to them for a couple years. After she passed I have been experiencing intense grief and stress and I can't help but find it suspicious that right after my mother died my PSA shot up. My mother made me promise I would not be sad and feel pain after she died. I have failed miserably but in light of my apparent recurrence I am going to obey her desire as much as possible in the interest of trying to save her son's life.
2. Any thought on that? Stress, grief and PSA progression?
My oncologist here at Hollings Cancer Center, in Charleston, SC. agrees with waiting for another 3 months to confirm further progression. I know 2 plus nadir is standard for recurrence with radiation, but in light of this recent strong bounce neither of us are really expecting a drop.
He is mentioning getting on a clinical trial of ProstVac for non castrate resistant, recurrent PCA.
3. ProstVac? What I have read isn't extremely compelling but I don't know anything about
it. Any thoughts?
this novel length post but one last question.
Using my doubling time and using a model posted on The Journal Of Clinical Oncology I am seeing a very sobering mortality rate of 70% at fifteen years with my parameters.
4. Has there been enough radical improvements in treatment since the data was collected for these kind of studies that skews rates of mortality in now more favorable direction?
Ok, two more.
5. It seems like there has been some advancement over the last few years. Is back on hormone therapy still my best option right now? Any new suggested practices following recurrence?
6. If I am scanned and I have residual local disease what's the most preferred treatment these days? Cryo ablation? HIFU?
Many thanks for anybody that read through all this.
Post Edited (Yarbo3) : 8/27/2016 7:11:53 AM (GMT-6)