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Thread: Elevated and rising PSA, what should I do?

  1. #61
    Senior User garyi's Avatar
    Join Date
    Apr 2017
    Location
    SoFL
    Posts
    383
    How you objectively measure the "best" RALP surgeon at JH is beyond me. They are all top notch. I sure wouldn't wait until November. I'd go with the fastest appointment available.

    Good luck on your journey.
    70 @ Dx
    PSA's over past 17 years - gradual increase from 1.0 to 3.0
    TURP 2/16, 24 g removed, 35 g remaining
    G3+4 discovered
    3T MRI 5/16
    PI-RADS 5 Lesion in Right Apical Posterior
    MRI fusion guided biopsy 6/16
    14 cores; four G 3+3, one G3+4, Grade T1b
    CIPRO antibiotic = C. Diff infection 7/16
    Cured with Vanco for 14 days
    Second 3T MRI 1/17
    Worsened bulging of posterior capsule
    Oncotype DX GPS 3/17, LFP risk 63%, Likelihood of Low
    Grade Disease 81%, Likelihood of Organ Confined 80%
    RALP 7/13/17 Dr. Gonzaglo @ Univ of Miami
    G3+4 Confirmed, Organ confined
    pT2c pNO pMn/a Grade 2
    Dry for first 8 weeks, 95+% now, ED very minimal
    PSA 0.32 on 9/13/2017
    PSA 0.40 on 10/5/2017
    PSA 0.42 on 10/20/2017
    It's called Persistent PSA, Decipher + DCFPyl & MRI Scans - 11/17

  2. #62
    Top User
    Join Date
    Aug 2016
    Location
    St. Louis, MO
    Posts
    554
    Gerard, well done. I am moved, touched, and inspired with the work you have done!

  3. #63
    Top User
    Join Date
    Jan 2014
    Location
    Greater Atlanta
    Posts
    2,451
    Congrats Gerard! Good job thoroughly doing your PC research & homework!

    The option of doing nothing and getting through the next 10 years symptomless is one that you ought to toss into the trash - unless you know for certain that other circumstances will terminate your existence shortly thereafter. If you opt for demise by PC, there will be regret.

    Forum Brother trinity3 had robotic prostatectomy at JH. Reach out to him for his recommendations and impressions.

    When there are multiple treatment options to achieve a cure, you are in a good position! In addition you have ample time to arrive at the best decision for you and get it scheduled.

    Continued best wishes to get this crossed off of your "To Do" list!

    MF
    PSA: Oct '09 = 1.91, Oct '11 = 2.79, Dec '11 = 2.98 (PSA, Free = 0.39ng/ml, % PSA Free = 13%)
    Jan '12: DRE = Positive: "Left induration"
    Jan '12: Biopsy = 6 of 12 Cores were Positive: 1 = Gleason 7 (3+4) and 5 = Gleason 6
    March '12: Robotic RP: Left Positive Margins + EPEs. MD waited in surgery for preliminary Path Report then excised substantial left adjacent tissue(s) down to negative margins and placed 2 Ti clips for SR guidance, if needed in future.
    Pathology: Gleason (3+4) pT3A pNO pMX pRO / Prostate Size = 32 grams; Tumor = Bilateral; 20% / Perineural invasion: present
    3 month Post Op standard PSA = <0.1 ng/ml
    1st uPSA at 7 months Post Op = 0.018 ng/ml uPSA remains stable: = 0.020 ng/ml "Mean (+/-) STD" = 0.002 at 66 Months Post Op: (16 uPSAs: Range 0.017 - 0.024) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

 

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