Posted 9/26/2017 10:29 PM (GMT -7)
Just got my ultra PSA test results back from LabCorp which shows 0.01% and 0.009% post RP after 22 months (i tested twice on subsequent days to rule out a false positive).
Prior PSA blood levels after 16 months were less than 0.015%. Most recently I was below 0.006% on 6/2017. I am getting tested again in a month just to determine the rate of PSA rise which will help determine the time frame / urgency. LabCorp claims to test 0.006% and higher ...
The question is how to proceed from here to optimize longevity ?
I would ideally like to undergo some treatments such a T cells or similar that have only have upsides with minimal or no downsides. I want to avoid or defer radiation as long as possible.
Immunotherapy for prostate cancer
New technology for prostate-cancer imaging
The Perineural infiltration and very small margins have always bothered me for BCR risk.
Perineural Invasion Linked With Prostate Cancer Bone Metastasis | Cancer Network | The Oncology Journal
58 years old
1/14/15 5/4/16 8/29/16 12/1/16 3/3/17 6/5/17 9/15/17 9/16/17
<0.02 <0.015 <0.015 <0.015 <0.015 <0.006 0.010 0.009
Radical Prostatectomy UCSF 11/19/2015 Dr Peter Carroll da Vinci robotic surgery
Synoptic Comment for Prostate Tumors
- Type of tumor: Small acinar adenocarcinoma.
- location of tumor: Single tumor. Left posterolateral midgland and base (1.2 cc; slides B10-12).
- Estimated volume of tumor: 1.2 cc.
- Gleason score: 3+4=7; primary pattern 3, secondary pattern 4.
- Estimated volume > Gleason pattern 3: 10%.
- Involvement of capsule: Tumor invades capsule: left posterior midgland (slides B10, B11).
- Extraprostatic extension: None.
- Margin status for tumor: No tumor at ink, but tumor into capsule is less than 0.1 mm from ink; slide B11.
- Margin status for benign prostate glands: No benign glands present at inked excision margins.
- High-grade prostatic intraepithelial neoplasia (HGPIN): Present, extensive.
- Tumor involvement of seminal vesicle: No tumor.
- Perineural infiltration: Present.
- Lymphovascular invasion: None.
- Lymph node status: Negative; total number of nodes examined: 1.
- AJCC/UICC stage: pT2aN0.
Johns Hopkins (Epstein) pathology 10/13/2015
Gleason Score: 3+4=7
2 cores (60% + 20%) (30% Gleason pattern 4)
Kaiser pathology, 9/1/2015
Gleason Score: 3+4=7
NUMBER CORES INVOLVED/TOTAL NUMBER CORES: 2 / 14
TOTAL CARCINOMA LENGTH: 10 mm
PSA 3.2 6/10/2014
PSA 4.8 6/8/2015
PSA 4.4 8/10/2015 (free PSA 7%)
PSA 5.0 9/28/2015 (free PSA 8%)
A) PROSTATE, RIGHT APEX, NEEDLE BIOPSY
-- ATYPICAL SMALL ACINAR PROLIFERATION
-- TOTAL SPECIMEN LENGTH, 44 MM
B) PROSTATE, RIGHT MID, NEEDLE BIOPSY
-- FOCAL HIGH GRADE PROSTATIC INTRAEPITHELIAL
-- TOTAL SPECIMEN LENGTH, 30 MM
C) PROSTATE, RIGHT BASE, NEEDLE BIOPSY
-- FOCAL HIGH GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA
-- TOTAL SPECIMEN LENGTH, 23 MM
D) PROSTATE, LEFT APEX, NEEDLE BIOPSY
-- BENIGN PROSTATIC GLANDS AND STROMA, 43 MM
E) PROSTATE, LEFT MID, NEEDLE BIOPSY
-- BENIGN PROSTATIC GLANDS AND STROMA, 22 MM
F) PROSTATE, LEFT BASE
ADENOCARCINOMA, GLEASON GRADE 3+4 = 7
ADENOCARCINOMA INVOLVES 2 OF 2 CORES AND 10 MM OF 30 MM
The first involved core from the left base contains 3 mm of Gleason grade 3+3=6 adenocarcinoma and the adenocarcinoma is located 6 mm from the presumed peripheral edge (see note).
The total core length is 17 mm.
The second involved core from the left base contains 7 mm of adenocarcinoma. Greater than 6 mm of the adenocarcinoma is Gleason grade 3 and less than 1 mm is Gleason grade 4. The Gleason grade 4
adenocarcinoma is located approximately 2 mm from the presumed peripheral edge (see note).
The total core length is 13 mm.
NO PERINEURAL INVASION IDENTIFIED