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for guys who had salvage radiation after prostatectomy and which then failed

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Prostate Cancer
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teddy9
Regular Member
Joined : Sep 2015
Posts : 183
Posted 11/12/2016 4:45 PM (GMT -8)
I am wondering about those of us who had gleason 7 (4+3 or 3+4) who had good pathology (all cancer confined to prostate), and who had salvage radiation at some point afterward their prostatectomy.

How did it take for your psa to start going back up? and did you have hormone therapy (ADT) at about the same time as your radiation? I am not referring to hormone therapy that might start months or years after salvage radiation.

I have finished radiation in May this year and my psa is back to normal about 4 months after ADT stopped.

Wondering about when I might see a recurrence if at all.

Teddy
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Fairwind
Veteran Member
Joined : Jul 2010
Posts : 4107
Posted 11/12/2016 6:34 PM (GMT -8)
If you can stay in the zero club for two ears, that's a good sign...If you stay in the club for five years, you can stop worrying..Ten years and you are home free...Every case is different and there are exceptions to every rule..

Best of luck to you....
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Chask
Veteran Member
Joined : Jun 2014
Posts : 545
Posted 11/12/2016 11:26 PM (GMT -8)
I had Gl 7 (4+3) but with tertiary 5's, and I lasted 12 months with a <.01 before it started rising. That was after Surgery and adjuvant ADT and RT, but here I am nearly 12 months after that before I go back on to ADT.

So almost a 2 year break. Expect to restart intermittent ADT after my next PSA read in a couple of weeks assuming it continues to rise.

Hope it goes better for you

Chas
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trailguy
Veteran Member
Joined : Jul 2015
Posts : 872
Posted 11/13/2016 2:44 AM (GMT -8)
I went on Pituitary Deprivation Therapy 2 weeks after my RP when my first blood test for PSA came back at .2. sad First Firmagon for 3 months, then Lupron for a year, then Eligard for a bit more than a year. In total, my testosterone was no higher than 2.2 ng/dL and my PSA < 0.03 for more than 3 years.

3 months after the RP and starting hormonal therapy I got ~80 Gy over 2 months at 5 sessions a week.

Now it is almost 4 years since the RP. My testosterone has screamed back up to a whopping 204 ng/dL and my PSA is back up to 0.08. Looks like that stuff didn't work and I will most likely go back on intermittent Eligard for the duration. sad

Best of luck to you.
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Howard3569
Veteran Member
Joined : Nov 2014
Posts : 625
Posted 11/13/2016 6:39 AM (GMT -8)
I am in the same boat as you. My PSA for several months after surgery was undetected but then it started to go back up. Its now at .10 so I will consult my oncologist in January after testing it in December. I would not worry about it now. Wait until it starts to rise because it may never rise.
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Break60
Veteran Member
Joined : Jun 2013
Posts : 1870
Posted 11/13/2016 9:00 AM (GMT -8)
No sense in worrying about it but I know it's hard not to. Like has been said, everyone is different but clearly the longer you stay at zero the better and if you do have bcr the longer it takes to double the better. Gleason 7 is on the bubble in terms of aggressiveness and curability whereas 8 or higher usually is not curable.
Bob
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lifeguyd
Veteran Member
Joined : Jul 2006
Posts : 691
Posted 11/13/2016 9:13 AM (GMT -8)
Surgery January 2007. PSA.01/.02 for years. started rising after five years. 2015 psa up to .2, IMRT one year ago Oct 2015. Waiting to see what psa does now. No HT
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Octorobo
Regular Member
Joined : May 2009
Posts : 437
Posted 11/13/2016 9:58 AM (GMT -8)
Surgery 2007
GS 3+4=7 PSA at time of surgery 4.1
Path report T3a, EPE+, Margins-, Post surgery PSA .005
PSA rose to .06 by January 2015
April-May 2015 - SRT 35 sessions 70g's, No HT, no side effects
Nov. 2015 - PSA <.006
May 2016- PSA <.006
Blood draw Nov. 15, 2016-
Praying that it has not changed
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NewspaperLover
Regular Member
Joined : Sep 2009
Posts : 453
Posted 11/13/2016 11:13 AM (GMT -8)
Surgery Nov '09; high Gleason 7, upgraded to an 8. PSA undetected for 18 months, then emerged again.

SRT + 6 month Lupron/Casodex winter 2011-12. PSA undetected in 5 consecutive 6 month tests. A nice break.

PSA emerged again in December '14 test at .06. Steady rise since. Last PSA and scans May/June '16. No mets or bone disease detected yet. PSA .30.

Next PSA and oncology appointment scheduled at the end of this month. Receiving no treatment yet. Feel great and energetic. Best wishes!

NewspaperLover
Age 73
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Galileo
Veteran Member
Joined : Nov 2008
Posts : 701
Posted 11/13/2016 7:29 PM (GMT -8)
My PSA was less than 0.1 at one month after prostatectomy. At the next check, 90 days later, it was 0.2.
The day before I started SRT it was 0.7.

I did not have ADT.

My PSA never went back up after SRT. It was detectable after radiation (0.1) but on the next check it was undetectable and has remained so ever since. That was over 9 years ago. (Hey, I'm getting close to 10 years, Fairwind!)

I would not assume that you will see a recurrence.
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Melg
Regular Member
Joined : Mar 2012
Posts : 93
Posted 11/14/2016 6:01 AM (GMT -8)
My husband did not do ADT with salvage radiation so this doesn't exactly address your question. But he was < .1 for a year and half after salvage radiation before PSA started moving up. It may have started moving up immediately but the hospital didn't believe in using the ultrasensitive results. It is now 3 years after that (5 years after prostatectomy and 4.5 years after radiation) and PSA has been fairly stable .22 - .32 so nothing else has been done. Still no ADT. (He didn't do ADT with salvage because radiologist recommended against because it initial pathology looked like it was gleason 6 but second opinion said 3+4)
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Bohemond
Veteran Member
Joined : Apr 2012
Posts : 1438
Posted 11/14/2016 8:42 AM (GMT -8)
I remained undetectable (0.00) for 4 1/2 years after SRT, then had detectable but pretty stable PSA of 0.02 to 0.05 over the next two years. I've now had a jump from 0.04 to 0.23 in 6 months and am waiting until after Thanksgiving to schedule an appointment with a medical oncologist. I had ADT during my SRT but just Casodex for 3 months, not Lupron. At the time of my surgery I was Gleason 7 (3+4) but about 70 percent cancer load in one lobe, a smaller amount of cancer in the other lobe, plus seminal vessicle invasion. So I was at high risk of recurrence from the get-go. If anything I beat the odds by progressing as slowly as I did. I credit my SRT for buying me a few additional years ADT-free.

Jim
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NewspaperLover
Regular Member
Joined : Sep 2009
Posts : 453
Posted 11/14/2016 8:21 PM (GMT -8)
Bohemond, That's how I see it. SRT bought me a nice reprieve from going to ADT, which I figure will be pretty much forever (in one form or another, and for whatever length of time). Hope to get a little more time before that final leg starts. Best wishes.

NewspaperLover
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teddy9
Regular Member
Joined : Sep 2015
Posts : 183
Posted 11/15/2016 6:58 AM (GMT -8)
all very helpful, thanks. Hopefully my psa at the 5 month mark post Lupron will still be undetectable.
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Bohemond
Veteran Member
Joined : Apr 2012
Posts : 1438
Posted 11/15/2016 12:49 PM (GMT -8)
Newspaperlover -
Thanks, and best wishes for an extended reprieve for you. BTW I love you screen name. I still get the actual newsprint edition of the Boston Globe every day and the New York Times on Sunday. And my English wife has an online subscription to the Guardian and Observer.
Jim
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NewspaperLover
Regular Member
Joined : Sep 2009
Posts : 453
Posted 11/15/2016 4:28 PM (GMT -8)
Bohemond, Yeah I get the print NY Times on Sundays, electronic rest of week. Local paper print edition daily. Best wishes.

NewspaperLover
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