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Thread: Three year checkup

  1. #1
    Experienced User
    Join Date
    Dec 2015
    Posts
    59

    Three year checkup

    Just had my three followup. PSA undetectable and Dr said "I consider your cancer gone."!!!!
    -------------------------------------------------------------------
    First PSA in July 2014-5.0
    2nd PSA in August 2015-5.8

    Biopsy 11/19/15
    DaVinci surgery 1/20/16

    ------------------------------------------------------------------

    -------------------------------------------------------------------
    DIAGNOSIS:
    Radical prostatectomy specimen (40 grams):

    1. Moderately differentiated adenocarcinoma, Gleason''s 3 + 4 = 7 (
    see synoptic report.).

    2. Tumor involves the bladder neck margin, right posterior, mid a
    nd anterior prostate as
    well as the left posterior and mid prostate.

    COMMENTS:
    TUMOR SYNOPTIC REPORT

    Specimen
    Procedure: Radical prostatectomy
    Prostate Size: 6.2 x 4.4 x 4 cm
    Weight: 40 g
    Lymph Node Sampling: No lymph nodes present
    Tumor
    Histologic Type: Adenocarcinoma
    Histologic Grade: Gleason Pattern
    Primary Pattern: Grade 3
    Secondary Pattern: Grade 4
    Tertiary Pattern: Not applicable
    Total Gleason Score: 7

  2. #2
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
    Posts
    7,045
    Can't be any better than that.
    Keep those great reports coming!!
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Seven annual post-op exams 2012 through 2018: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

  3. #3
    Congrats! Perhaps you can get a bumper sticker: Undetectable Forever!

    Djin

  4. #4
    Excellent way to start 2019 jfredfc!

    What are your post RP PSA values?

    &

    What is your PSA monitoring schedule moving forward?

    Please continue to visit The Forum periodically.

    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 81 Months Post Op: Mean = 0.022 (19 uPSAs: Range 0.017 - 0.026) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

  5. #5
    Great news brother, great news.

  6. #6
    Top User garyi's Avatar
    Join Date
    Apr 2017
    Posts
    1,084
    Sweet, but do tell us your PSA readings.

    Even as your doc considers your PCa gone, keep doing PSA checks every six months!
    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
    We'll see....what is not known dwarfs what is thought to be fact

  7. #7
    Congrats, Great news! Nothing wrong with every 6 months getting checked. Stay Vigilant
    DOB:Feb 1958
    PSA: 9/15: 5.9 PC/Father
    DRE: Negative
    Biopsy: 10/1/15. Second Opinion University of Chicago. 9 of 12 cores positive. G6: 5 cores, G7 ( 4+3) 4 cores
    10/12/15: Ct scan/bone scan- Negative
    Clinical Staging: 10/28/15 T2c
    ( RALP) University of Chicago 12/29/15

    Final Pathology Report; Jan. 6 2016

    15 lymph nodes; no tumor present
    gleason upgraded to 9 ( 4+5)
    +EPE
    +LVI
    Right SV Positive
    Left SV and vasa deferentia, no tumor present
    PI present
    PM
    pT3bNO
    uPSA 2/9/16 0.05
    uPSA 3/23/16 0.11
    Casodex 4/1/16-8/5/16
    Lupron 4/15/16-5/15/18
    SRT 6/14/16...8/5/16 38Tx
    uPSA 8/10/16---2/14/19 <0.05
    Feb. 2017 Loyola Chicago
    11/15/2018 AUS 800 Implanted
    12/18/18...T Levels...Free T 42.8...Total T...262

  8. #8
    Experienced User
    Join Date
    Dec 2015
    Posts
    59
    Less than 0.001 and since I get my labs done every six months for other stuff, I will have it checked then. He still wants to see me every year as well.
    -------------------------------------------------------------------
    First PSA in July 2014-5.0
    2nd PSA in August 2015-5.8

    Biopsy 11/19/15
    DaVinci surgery 1/20/16

    ------------------------------------------------------------------

    -------------------------------------------------------------------
    DIAGNOSIS:
    Radical prostatectomy specimen (40 grams):

    1. Moderately differentiated adenocarcinoma, Gleason''s 3 + 4 = 7 (
    see synoptic report.).

    2. Tumor involves the bladder neck margin, right posterior, mid a
    nd anterior prostate as
    well as the left posterior and mid prostate.

    COMMENTS:
    TUMOR SYNOPTIC REPORT

    Specimen
    Procedure: Radical prostatectomy
    Prostate Size: 6.2 x 4.4 x 4 cm
    Weight: 40 g
    Lymph Node Sampling: No lymph nodes present
    Tumor
    Histologic Type: Adenocarcinoma
    Histologic Grade: Gleason Pattern
    Primary Pattern: Grade 3
    Secondary Pattern: Grade 4
    Tertiary Pattern: Not applicable
    Total Gleason Score: 7

  9. #9
    Quote Originally Posted by jfredfc View Post
    Less than 0.001 and since I get my labs done every six months for other stuff, I will have it checked then. He still wants to see me every year as well.

    Congratulations, if you have no lingering problems from your treatment, how long do they want you to see the urologist?

    I'm sure you'll have PSA tests for the indefinite future, but will your patient relationship with the surgeon continue?
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2. PSA test 1/2018 2.2 (after 7 months of proscar) PSA test 7/2018 2.3

  10. #10
    Senior User
    Join Date
    Feb 2017
    Posts
    121
    What great news! Thanks for posting this. It’s heartening to see such wonderful results.
    2010-PSA 3.59; 2011-PSA 3.58; 2012-PSA 5.28, 4.26; 2013-PSA 5.98, 7.37; 2014-PSA 5.90, 4.70; 2015-PSA 5.18, 7.35
    RALP 16 March 17, Wesley Long Hospital, Greensboro, NC
    Pathology: pT3a, pN1 Gleason 4+5=9 adenocarcinoma with + surgical margin at bladder neck; 3 of 16 lymph nodes positive; neg seminal vesicles, vasa deferens
    Referral to Dr. Ken Pienta, Clinical Dir Research, Brady Center, Johns Hopkins
    Enrolled in Clinical Trial IRB002120414 “Phase II Study of definitive therapy for oligometastatic prostate cancer post surgery"
    Completed: 4 sessions chemo Docetaxel 12 Jun 17, 3 Jul 17, 24 Jul 17, 14 Aug 17, 15 Sep 17
    Lupron every 90 days. 1st injection 12 Jun 17, 2d 15 Sep 17, 3d 18 Dec 17, 4th 6 Mar 18, 5th 5 Sep 18; 17 Dec 18
    Bone/Body Scans - 15 Sep 17 - negative
    EBRT: 69 Gy total (46 to fossa, 23 boost to suspect areas) 1st treatment 28 Sep 17, last 22 Nov 17
    PSA: 25 May 17=0.2; 5 Sep 17=0.1; 18 Dec 17=0.1; 6 Mar 18=0.1; 29 May 18=0.1; 5 Sep 18=0.1; 17 Dec 18=0.1

 

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