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Thread: Save the date!

  1. #1
    Experienced User
    Join Date
    Feb 2019

    Save the date!


    Earlier in the week I took a vacation from work to visit MD Anderson. I thought it was going to be a mid-treatment checkup, but was pleasantly surprised when the oncologist said I am ready for surgery. I spoke to the surgeon and we set a date for August 21st. After the DRE, they said they could not feel the nodule they felt earlier. I wish you got an ice cream cone after every third DRE.

    The oncologist was in a hurry and did not answer many questions, but the surgeon was more attentive. When I asked what we could determine from my PSA ( currently 0.3) and the DRE, he said that he believes we probably have not killed all of the cancer but have shrunk it considerably. We talked about penis rehab and what to expect. I can't say enough good things about Dr. Pisters.

    I'm excited to get this damn think out and see where we stand.

    Thank you for your support.

    Take care,

    DOB 6/27/69
    12/21/18 1st PSA 25
    1/9/19 PSA 21.7, Free 1.86
    1/17/19 TRUS biopsy:
    PNI+ on left
    MD Anderson review of slides: 12/12 cores positive
    RB 55% 3+4=7
    RM 29% 3+3=6
    RA 12% 3+4=7
    LB 44% 4+3=7
    LM 84% 4+3=7
    LA 100% 3+4=7
    RBL 2% 3+4=7
    RML 24% 3+4=7
    RAL 26% 3+4=7
    LBL 87% 4+3=7
    LML 100% 4+3=7
    LAL 100% 4+3=7
    CT and bone scans negative
    MRI: NVI, SVI, rectum, bladder neck, sphincter, LNs: negative
    EPE negative, however, lesion in left peripheral gland abuts capsule along the left anterior,
    lateral and posterior lateral aspect of the gland.
    4/9/19 Began 6 months Lupron + Zytiga
    PSA 5/7/19 2.3
    PSA 5/24/19 1.3
    PSA 6/27/19 0.4
    PSA 7/15/19 0.3

  2. #2
    That is splendid news and is direct (no pun intended*) evidence of what the neoadjuvant Lupron+Zytiga (abiraterone) has done, at least in the prostate. There may be benefits beyond that as well. Full speed ahead! Congrats on that smart decision, Josey! It will be interesting to see some study results; however, that's going to take a few years, since interim results will have to wait for BCR stats.

    With regard to erection rehab, as I mentioned recently, I asked my uro/surgeon about taking 20 mg sildenafil daily after cath removal to aid blood flow and healing (I had it in the house since I had started sildenafil for sex a few years ago because of BPH). He said there was no proof that it worked, but given the very low cost, it wouldn't do any harm and might help). I took it for a couple of weeks until erections returned with a larger dose. Bottom line is you can ask you doc what he thinks. I've yet to come across a study of low-dose ED medication after RP. I believe I remember a Forum Brother or two whose docs suggested the low dose.

    *... or was it
    Last edited by DjinTonic; 07-18-2019 at 05:24 PM.
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3 -
    2013 TURP (90→30 g) path neg. then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional
    SM EPE BNI LVI SVI LNI(16): negative, PNI+, nerves spared
    pT2c pN0 pMX acinar adenocarcinoma G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    11-10-17 Decipher 0.37 Low Risk: 5-yr met risk 2.4%, 10-yr PCa-specific mortality 3.3%
    Dry; ED OK with sildenafil
    9-16-17 (5 wk) PSA <0.1
    LabCorp uPSA, Roche ECLIA:
    11-28-17 (3 m ) 0.010
    02-26-18 (6 m ) 0.009
    05-30-18 (9 m ) 0.007
    08-27-18 (1 yr.) 0.018 (?)
    09-26-18 (13 m) 0.013 (30-day check)
    11-26-18 (15 m) 0.012
    02-25-19 (18 m) 0.015
    05-22-19 (21 m) 0.015

  3. #3
    In 34 days you will land on "The Good Side of RP!" Your Forum Friends will organize a Warm Welcome Party.

    Hope the Pathologist's findings are all amazingly good!

    Good luck Josey!

    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 = G7 (3+4) and 5 = Gleason 6
    Referred to URO Surgeon
    March '12: Robotic RP: Left: PM + EPE. 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 c tertiary pattern 5 / Prostate Size = 32 grams / Tumor = Bilateral: 20% / PNI: 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

  4. #4
    Good luck Josey. Glad to hear things are going your way, u have been thru a lot. Time to catch some breaks! best to u, MM
    DOB:Feb 1958
    PSA: 9/15: 5.9
    DRE: Negative
    Biopsy: 10/1/15. Second Opinion University of Chicago. +9 of 12 cores. G6: 5 cores, G7 ( 4+3) 4 cores
    10/12/15: -CT scan/BS
    Clinical Staging: 10/28/15 T2c
    ( RALP) UC 12/29/15

    Final Pathology Report; Jan. 6 2016

    -15 lymph nodes
    G9 ( 4+5)
    +Right SV -Left SV and vasa deferentia,
    PI present
    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


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