Some advice needed please

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Missyj
Regular Member


Date Joined Sep 2007
Total Posts : 87
   Posted 10/25/2007 5:34 AM (GMT -7)   
Hi everyone
 
I think the two questions I am about to ask will be pretty unanswerable really but if anyone could offer any insight I would be really grateful
 
Firstly, Rick finds out in under two weeks his PSA numbers after being on HT (Zolodex) for three months. Given that it started off at 17, does anyone have any idea what might be seen as a positive decrease? I know any decrease is positive but we're trying to work out if his PSA drops to, say 12 or 10 or 8 or whatever how encouraged the doctor will be with this. Rick says he wants to know, whether it's an encouraging result or not
 
Secondly, over the last few days, he has had a problem peeing naturally and has had to use self-catheterising again (he had been able to do without them and pee naturally up until now) We are concerned that this might mean that the tumour on his prostate is growing and that it what's stopping his natural flow
 
I should point out that this whole thing was brought to a head with Rick experiencing an acute urinary retention episode some months ago and he was given anti-inflammatory tablets to reduce the swelling. The cancer was found incidentally at the time.
 
We don't know whether to contact the oncology nurse about this new development
 
I know that particularly for the first question, there is likely to be no definitive answer but any input on either question would be much appreciated
 
Hoping all is well with everyone
 
Julia
Age - 59
Dianosed - July 07
Gleason 8 (4+4)
PSA - 17
Bone Scan - August 07 revealed mets to spine, neck, rib, shoulder and pelvis
MRI - August 07 revealed seminal vesicle involvement
Treatment - Zolodex started on August 10th
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8122
   Posted 10/25/2007 11:53 AM (GMT -7)   
Hi Julia,
Any drop is positive. It is possible that he can acheive a full remission as well. but take the baby steps. You want to see a drop, then another, then another. Call the nurse. And talk to the doctor. There are things that he can do get the continary issues back to normal. You also may want a visit with a radiation oncologist. I know the rule of thumb is at stage IV you can't be cured. But you know, they are not 100% sure about the effects of radiation at this stage. Salvage therapy is effective at relieving pain and lowering the PSA. I have explored this as I am a tick below stage IV, and would consider anything that would reduce the size of a targetable tumour.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
STAY POSITIVE!


Missyj
Regular Member


Date Joined Sep 2007
Total Posts : 87
   Posted 10/26/2007 1:36 AM (GMT -7)   

Thanks Tony, we will be contacting his nurse today to get some advice re the continence.

His doctor didn't seem to think radiation therapy would benefit Rick but it seems in the US it is used more often (we are in the UK) This actually worries me as I believe survival rates are much better in the US so am concerned that here in the UK we are lagging behind.

I read somewhere that the quicker the PSA goes down in the first seven months of treatment, the better the longterm outcome. Has anyone heard this?

Julia


Age - 59
Dianosed - July 07
Gleason 8 (4+4)
PSA - 17
Bone Scan - August 07 revealed mets to spine, neck, rib, shoulder and pelvis
MRI - August 07 revealed seminal vesicle involvement
Treatment - Zolodex started on August 10th
 


War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 10/26/2007 4:31 AM (GMT -7)   

Good morning Julia,

Sorry to hear about the problems. The nurse should be able to take care of the incontinence problem. Have you had any discussions with the doctor about infusions of Zometa the increase bone strength? Also, radiation can help to relieve bone pain when it is targeted at the specific mets.

Tony is right about any drop in PSA being great news. It is all about trends. Is the PSA trending down or up. Our Oncologist tells us to forget the number and look at rate of change. A bad trend would be a doubling of the PSA over a short time. The same can be said for decreasing numbers. As long as it is going down, that's good.

Have you discussed HT with your doctor? A combination of the Zolodex (Casodex) and Eligard or Lupron is common here.

Keeping you and Rick in our prayers.

Love, hope, and a big War Eagle

Walt


Age: 54
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005 (Eligard every 6 months)
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007
Casodex 4/2007
Spread to Spine (L4 & T5), rib, and pelvis
Zometa infusions 4/2007
PSA 4.8 8/2007
PSA 4.9 9/2007
PSA 5.4 10/07
 
"I will persist without exception - I will find a way where there is no way"


Missyj
Regular Member


Date Joined Sep 2007
Total Posts : 87
   Posted 10/26/2007 9:18 AM (GMT -7)   

Hi Walt, thanks for your reply

It makes total sense what you say about watching for trends rather than individual numbers. I think this first PSA reading wont really tell us much (providing it has gone down, which I am sure will be the case!) It will be future readings which make up the bigger picture.

I have made a note of the drugs you mentioned and will enquire when Rick has his appointment in November.

Rick called the oncology nurse and I'm sorry to say she was really short with him. Kind of indicated "Well this sort of thing is what your appointment is for - we'll discuss it then"!! His appointment isn't until the 7th Nov - quite a while to wait when you're having this kind of problem.

Thank goodness for this forum. I am going to suggest to Rick that he registers so he can experience the warmth and support of people who pretty much know exactly what he is going through

Hope you have a lovely day :)

Julia


Age - 59
Dianosed - July 07
Gleason 8 (4+4)
PSA - 17
Bone Scan - August 07 revealed mets to spine, neck, rib, shoulder and pelvis
MRI - August 07 revealed seminal vesicle involvement
Treatment - Zolodex started on August 10th
 

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