Artist Mark said...
... I'm a rare bird around here (wish I wasn't). In reality there are very few G9 with the volume of 5's that have (what I consider) a low initial PSA 3.42 . At least I haven't encountered many. I also have PIN .02 mm from mature adipocytes which raises concern for EPE. Not having RP, I don't know for sure what is going on in there. ..
Yeah, you and me my fellow warrior; it's not your imagination, there truly are few like us here (or anywhere for that matter). My PSA was a little higher (5.2), 2 less positive cores. But similar % in the cores. Mine's all G9, some 5+4, some 4+5. Equivocal about
stage 3, mpMRI says indicative anyway. Those type 5 cells don't make a lot of PSA. I figure my "true" PSA would have been about
4 times higher if I had the same situation with a G7.
My PSA path now is maybe ok, maybe concerning. March's PSA check will be a pretty key indicator for me. I definitely lost my "0" last summer, though it wasn't completely unexpected. If it stabilizes around 0.5 then cool, but if it continues trending up at some rate, then that will be less than optimum.
The chemo series is a bit daunting, but at this point if it had been suggested to do so after my RT was done, I definitely would have done it. Now I'm in a different phase of the process, so we wait to see if it's recurring, PSA doubling time, all that sort of thing before any such treatment would be considered.
In my humble opinion, though the chemo side effects and risks are potentially troubling, you may want to have the assurance you did everything that has a chance of helping prevent recurrence. With G9, recurrence is all too likely anyway, but perhaps you don't want to leave any stone unturned. It's very natural to be concerned about
the side effects, the unknown.
This disease causes us to face a lot of fearsome things....
Bx: 6/12 pos, G9=5+4 (80%, 60%), 4+5 (2@100%, 80%, 10%), PNI+
cT3a (3TMRI: Bilateral EPE, NVB+, SV-, LN-)
Date PSA fPSA
9/12 4.1 15%
3/13 5.2 12% PCA3=31
IGRT by IMRT, 44 done 8/28/13: 50.4 Gy pelvic nodes, 79.2 Gy prostate
ADT2 3 yrs: Lupron/Casodex, ended 3/16
Post: (age now 59)
PSA <0.1 : 8/13 - 5/16.
PSA 0.2-8/16, 0.5-12/16, TBD-3/17