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Thread: RP done, post op PSA concern - urgent advise needed

  1. #51
    Experienced User
    Join Date
    Jul 2018
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    83
    As you seem to be following an excellent protocol (my uro says 25 to 50 percent of all surgery at some point requires radiation) it sounds like you are on-track to finish off this challenge. For those of us waiting for surgical treatment to begin, personal stories like this are inspiring.

    Thumbs up.
    Treatment Summary
    Cancer Type: Prostate cancer
    Diagnosis Date: 8/2/18
    PSA at Diagnosis: 10.4
    Gleason Score: 4+4

    Clinical Stage:
    T2a - <1/2 of 1 lobe
    Size (mm) 15mm

    Pathologic Stage, radical prostatectomy performed:
    T2c - bilat
    No regional lymph node metastasis (24 lymph nodes examined)
    SEMINAL VESICLE AND SURGICAL MARGINS NEGATIVE FOR TUMOR
    Gleason Score: 4+3 (4 is 90%)
    Perineural Invasion on one side.
    Organ Contained

    Treatment Completed, one nerve saved.

    Robot assisted laparoscopic prostatectomy surgery date: 10/9/18

  2. #52
    Regular User
    Join Date
    Jul 2018
    Posts
    24
    Quote Originally Posted by Mark H. View Post
    As you seem to be following an excellent protocol (my uro says 25 to 50 percent of all surgery at some point requires radiation) it sounds like you are on-track to finish off this challenge. For those of us waiting for surgical treatment to begin, personal stories like this are inspiring.

    Thumbs up.
    hey Mark, tks for the well wishes. do take care too, and hope you will make your treatment choice soon. All the best!
    Age at diagnosis: 58 in 2018

    Pre op PSA: Total PSA 7.52 ug/L, Free PSA 1.42 ug/L, p2PSA 29.64 ng/L, phi 57

    Biopsy: 5 of 13 cores, G7 (4+3)
    No perineural or lymphovascular invasion seen

    Tc-99m HDP whole body bone scan: Jan 2018
    No definite scan evidence of bone metastases

    MRI of pelvis and prostate: Jan 2018
    Prostatic capsule remains intact, No pelvic lymphadenopathy seen, no suspicious bony lesions identified.

    Da Vinci RP: Feb 2018
    Surgical Pathological Exam
    G(3+4) = 7 grade group 2, tumor 10% of total volume
    Positive margin: Right Posterior Mid, Focal, 2mm, Highest grade at margin G(3+3) = 6

    Pathological stage pT3aNx

    PSA post-surgery
    3 mths PSA 0.038 ug/L, 6 mths PSA 0.122 ug/L

    1 round RT, 3 mths post RT PSA 0.03 ug/L, 6 mths post RT PSA 0.016 ug/L

  3. #53
    Regular User
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    Jul 2018
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    24
    25th session done, 8 more to go!

    Bout of frequent poops today. :/
    Age at diagnosis: 58 in 2018

    Pre op PSA: Total PSA 7.52 ug/L, Free PSA 1.42 ug/L, p2PSA 29.64 ng/L, phi 57

    Biopsy: 5 of 13 cores, G7 (4+3)
    No perineural or lymphovascular invasion seen

    Tc-99m HDP whole body bone scan: Jan 2018
    No definite scan evidence of bone metastases

    MRI of pelvis and prostate: Jan 2018
    Prostatic capsule remains intact, No pelvic lymphadenopathy seen, no suspicious bony lesions identified.

    Da Vinci RP: Feb 2018
    Surgical Pathological Exam
    G(3+4) = 7 grade group 2, tumor 10% of total volume
    Positive margin: Right Posterior Mid, Focal, 2mm, Highest grade at margin G(3+3) = 6

    Pathological stage pT3aNx

    PSA post-surgery
    3 mths PSA 0.038 ug/L, 6 mths PSA 0.122 ug/L

    1 round RT, 3 mths post RT PSA 0.03 ug/L, 6 mths post RT PSA 0.016 ug/L

  4. #54
    Regular User
    Join Date
    Jul 2018
    Posts
    24
    hi all. My 32nd and *second last* session today....YAY!
    so far except for last wed which I had bad diarrhea (7 times) and a 38deg C fever, i'm quite ok for now.
    some weight loss of 2 to 2.5kg over 6.5 wks...

    my last RT is on thu.
    Age at diagnosis: 58 in 2018

    Pre op PSA: Total PSA 7.52 ug/L, Free PSA 1.42 ug/L, p2PSA 29.64 ng/L, phi 57

    Biopsy: 5 of 13 cores, G7 (4+3)
    No perineural or lymphovascular invasion seen

    Tc-99m HDP whole body bone scan: Jan 2018
    No definite scan evidence of bone metastases

    MRI of pelvis and prostate: Jan 2018
    Prostatic capsule remains intact, No pelvic lymphadenopathy seen, no suspicious bony lesions identified.

    Da Vinci RP: Feb 2018
    Surgical Pathological Exam
    G(3+4) = 7 grade group 2, tumor 10% of total volume
    Positive margin: Right Posterior Mid, Focal, 2mm, Highest grade at margin G(3+3) = 6

    Pathological stage pT3aNx

    PSA post-surgery
    3 mths PSA 0.038 ug/L, 6 mths PSA 0.122 ug/L

    1 round RT, 3 mths post RT PSA 0.03 ug/L, 6 mths post RT PSA 0.016 ug/L

  5. #55
    Congrats to you, Tony! Raise a toast to only good news from here on!

  6. #56
    Quote Originally Posted by tony1960 View Post
    hi all. My 32nd and *second last* session today....YAY!
    so far except for last wed which I had bad diarrhea (7 times) and a 38deg C fever, i'm quite ok for now.
    some weight loss of 2 to 2.5kg over 6.5 wks...

    my last RT is on thu.
    CONGRATS Tony!

    Glad this is now in the rear view mirror!

    Best wishes for a permanently vanishing PSA!

    MF

  7. #57
    Regular User
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    Jul 2018
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    Tks Michael, Djin and the other bros. I had my last one today, RO fixed a followup in Jan 2019 with PSA and kidney function test.

    Tks to all the guys who have encouraged me. I wish for you guys courage and a speedy recovery too. I realised too how important it is to have an encouraging other half and also a warm home environment.

    Much appreciated
    Last edited by tony1960; 10-11-2018 at 11:38 AM. Reason: typo
    Age at diagnosis: 58 in 2018

    Pre op PSA: Total PSA 7.52 ug/L, Free PSA 1.42 ug/L, p2PSA 29.64 ng/L, phi 57

    Biopsy: 5 of 13 cores, G7 (4+3)
    No perineural or lymphovascular invasion seen

    Tc-99m HDP whole body bone scan: Jan 2018
    No definite scan evidence of bone metastases

    MRI of pelvis and prostate: Jan 2018
    Prostatic capsule remains intact, No pelvic lymphadenopathy seen, no suspicious bony lesions identified.

    Da Vinci RP: Feb 2018
    Surgical Pathological Exam
    G(3+4) = 7 grade group 2, tumor 10% of total volume
    Positive margin: Right Posterior Mid, Focal, 2mm, Highest grade at margin G(3+3) = 6

    Pathological stage pT3aNx

    PSA post-surgery
    3 mths PSA 0.038 ug/L, 6 mths PSA 0.122 ug/L

    1 round RT, 3 mths post RT PSA 0.03 ug/L, 6 mths post RT PSA 0.016 ug/L

  8. #58
    Regular User
    Join Date
    Jul 2018
    Posts
    24
    Quote Originally Posted by tony1960 View Post
    Tks Michael, Djin and the other bros. I had my last one today, RO fixed a followup in Jan 2019 with PSA and kidney function test.

    Tks to all the guys who have encouraged me. I wish for you guys courage and a speedy recovery too. I realised too how important it is to have an encouraging other half and also a warm home environment.

    Much appreciated
    hi guys. as you know, I completed my RT in Q4 2018. My PSA at 3 mths post RT is down to 0.03, which was my initial value 3 mths post Da Vinci. Having my next PSA mid Apr 2019.

    so just an encouragement for you guys
    Age at diagnosis: 58 in 2018

    Pre op PSA: Total PSA 7.52 ug/L, Free PSA 1.42 ug/L, p2PSA 29.64 ng/L, phi 57

    Biopsy: 5 of 13 cores, G7 (4+3)
    No perineural or lymphovascular invasion seen

    Tc-99m HDP whole body bone scan: Jan 2018
    No definite scan evidence of bone metastases

    MRI of pelvis and prostate: Jan 2018
    Prostatic capsule remains intact, No pelvic lymphadenopathy seen, no suspicious bony lesions identified.

    Da Vinci RP: Feb 2018
    Surgical Pathological Exam
    G(3+4) = 7 grade group 2, tumor 10% of total volume
    Positive margin: Right Posterior Mid, Focal, 2mm, Highest grade at margin G(3+3) = 6

    Pathological stage pT3aNx

    PSA post-surgery
    3 mths PSA 0.038 ug/L, 6 mths PSA 0.122 ug/L

    1 round RT, 3 mths post RT PSA 0.03 ug/L, 6 mths post RT PSA 0.016 ug/L

  9. #59
    Top User garyi's Avatar
    Join Date
    Apr 2017
    Posts
    1,180
    Quote Originally Posted by tony1960 View Post
    so just an encouragement for you guys
    Golden
    72...LUTS for the past 7 years
    TURP 2/16,
    G3+4 discovered
    3T MRI 5/16
    MRI fusion guided biopsy 6/16
    14 cores; four G 3+3, one G3+4,
    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
    PSA 0.32 to .54 over 3 months
    DCFPyl PET & ercMRI Scans - 11/17
    A one inch tumor remains in prostate bed = failed surgery
    All met scans clear
    SRT, 2ADT, IMGT 70.2 Gys @1.8 per, completed 5/18
    PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19, .078 5/19
    We'll see....what is not known dwarfs what is thought to be fact

  10. #60
    Great news Tony! This result automatically grants you membership to "Club Zero!" Enjoy!

    My next PSA will also be in April! See you then!

    MF
    PSA: Oct '09 = 1.91, Oct '11 = 2.79, Dec '11 = 2.98 (PSA, Free = 0.39ng/ml, % PSA Free = 13%)
    Referred to URO MD
    Jan '12: DRE = Positive: "Left induration"
    Jan '12: Biopsy = 6 of 12 Cores were Positive: 1 = Gleason 7 (3+4) and 5 = Gleason 6
    Referred to URO Surgeon
    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" at 84 Months Post Op: Mean = 0.021 (20x uPSAs: Range 0.017 - 0.026) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

 

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