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Thread: PSA confusion update 2

  1. #1
    Regular User
    Join Date
    Jul 2017
    Posts
    37

    PSA confusion update 2

    Things haven't gone as well as hoped for.
    My psa has gone straight up since treatment.
    SBRT Mar./ Apr. 2018
    PSA 9/18 2.04
    11/18 2.22
    02/19 3.60
    03/19 3.94
    06/19 8.03
    07/19 24.00
    My oncologist says not to blame the treatment because the MRI indicated possible spread 3 months before the SBRT.
    Plus my Prolaris score was 5.8.
    Had a bone scan 7/19 that was negative, but the CT scan showed the lymph nodes were very large. I woke up with a great deal of discomfort in early July and have since started the retirement process.


    I wondered if anyone has tried the enzyme treatments?
    Studies?
    Hope you guys are doing well, I'm good.
    Thanks
    Mark
    Psa
    2010 1.70
    2014 3.79
    7/17 5.78
    15 days cipro
    Normal dre
    7/17 4.40
    Free psa 8%
    11/17 6.50
    Normal dre
    12/17 biopsy
    Lt.mid adenocarcinoma 1of2 ,2% 3+3= 6, length18(5%)19mm
    Lt. Apex adenocarcinoma 1of2, 22% 3+4=7 length17(40%)20
    Part c 20% pattern 4
    Gleason 3+4=7 grade group 2
    1/18 PSA 4.40
    1/18 3t mri Huntsman Cancer Hospital
    Dre hard
    MRI
    Tumor T2 hypointense lesion 1.8 centimeters There is greater than 1 centimeter of peripheral glandular abutment which is concerning for extraprostatic spread
    Pi-rads 5
    No sign of spread
    Biopsy slides read by second opinion pathologist
    Revised gleason 4+3=7
    Part 4 located at apex
    Prolaris score 5.8
    april 2018 SBRT
    Sept. PSA 2.04

  2. #2
    Welcome back Mark! We all hoped that you were returning to The Forum to to announce a fading PSA. The recent PSA #s posted suggest that something is going on that needs immediate braking. What are your Oncologists recommending/planning to do?

    Re "My oncologist says not to blame the treatment because the MRI indicated possible spread 3 months before the SBRT..." So why didn't the Oncologist take the necessary steps or make the appropriate treatment changes to address the MRI findings before starting SBRT?

    I know that you are a truck driver and wanted to avoid HT. However, discuss HT with the Oncologists as a means to shut down your rising PSA. Also ask if you are a candidate for one of the newer scan technologies such as Axumin or 68Ga-PSMA-11 PET / CT scan to pinpoint locate the site(s) of your rising PSA.

    Take a look at available clinical trials for the above scans:

    https://www.cancer.gov/about-cancer/...abeled-psma-11

    There are several "Open" trials: San Francisco, U Michigan, New York. It would require travelling but likely it cold be arranged to do everything in 1 trip. But take action today!

    Please demand that your Oncologists get you quickly into the next phase of PCa treatment/management.

    We are with you every "mile!" of the way!

    Take Action & Stay Strong!

    MF
    Last edited by Michael F; 08-06-2019 at 12:02 AM.
    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

  3. #3
    Regular User
    Join Date
    Jul 2017
    Posts
    37
    I'm not interested in the treatments they have to offer.
    That's why my question was about enzymes and or anything else that might show some promise.
    I was told that without treatment about 1 year with treatment (hormones and chemo) maybe a year or 2.
    Not much of a choice as far as I'm concerned.
    No chance for a cure, no reasonable extension of life. Not worth trading in my quality of life for a few extra months.
    Moving for trials is financially impossible for me, and frankly I don't really have the motivation anymore.
    Thank you Michael for your concern I do appreciate it. I'm just tired of all of THIS!
    lol
    I haven't been able to find any credible evidence for any of these alternative treatments.
    Thanks Michael

  4. #4
    716, i'm very sorry your PSA is up after your SBRT, but I'm not so sure your docs can make accurate predictions about how you would respond to further treatment. Many, many Forum brothers have done, or are currently on, HT. Why not try it, at least, and see what happens to your PSA? Yes, prostate cancer can reach a point where a cure isn't possible, but its progress can be halted. If it gets out of hand without treatment, you won't be happy with your quality of life.

    Alternative, whacky treatments have almost no chance of working--otherwise they would be mainstream, standard of care, not alternative. Give meds a chance and they could surprise both you and your docs with many years to come.

    Djin
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3 -
    7-05-13 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
    08-28-19 (2 yr. ) 0.016
    Avg. = 0.013

  5. #5
    Experienced User
    Join Date
    Nov 2017
    Posts
    83
    Dear Mark,
    I am sorry that you are going through my this. My question is what type of oncologist are you talking to? Is it a medical oncologist? It does not seem that your case is so extreme that current treatments could not extend your life with a decent quality. If you have already done this I apologize for suggesting it, but have you consulted a top medical oncologist at a top notch cancer center?
    Eric

  6. #6
    Regular User
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    Jul 2017
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    Thanks guys I appreciate your advice but I'm not going with hormones and chemo.
    I understand the consequences completely.

 

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