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Thread: I just realized today that I was 4 years out...

  1. #1

    I just realized today that I was 4 years out...

    August 10, 2015...Don't get me wrong. It's always in the back of my mind, especially with that wee amount of '4' in there, but I guess I don't stress as much.

    I still can't shake that image when I mentioned AS to my wife and I got that "yeah, because that's happening" look when meeting with Dr. Carter to discuss treatment options.

    As always, best wishes to all.

    Ron
    DOB: 8/1963--Great-Grandfather/Uncle had PC
    9/13 PSA 4.85, 2/14 PSA 6.7, TRUS Bx 12 core-neg, 6/14 PSA 4.8, 12/14 PSA 5.9, PCA3: 38, 1/15 PSA 5.4 (switched docs to JH), 3/15 PSA 5.8/fPSA 17.4/PHI 28.4, 3/15 3T MRI/Fusion-Guided Bx @ Johns Hopkins, 2/14 cores pos, bilateral, <5% involvement, Gleason 6, Open RP: 8/10/2015 w/ Dr. Carter @ JH

    Final Pathology:
    LN-, SV-, Margins-, EPE-
    Tumor Extent: Moderate, organ confined
    Gleason upstaged to 3+4=7 (2% pattern 4)
    Additional Findings: HGPIN
    pT2 NO
    PSA 11/2015 <.1, 05/2016 <.1, 09/2016 .02 & 3/2017 .02 (different assays), 09/2017 <.1, 03/2018 <.1, 10/2018 <.1, 4/2019 <.1

  2. #2
    Quote Originally Posted by Ron_G View Post
    August 10, 2015...Don't get me wrong. It's always in the back of my mind, especially with that wee amount of '4' in there, but I guess I don't stress as much.

    I still can't shake that image when I mentioned AS to my wife and I got that "yeah, because that's happening" look when meeting with Dr. Carter to discuss treatment options.

    As always, best wishes to all.

    Ron
    Hi Ron. Thanks for checking in to say Hi. Looks like you're all set! How much of your treatment decision was family history? Don't forget to come back for your Big 5 Year Celebration!

    Congrats !!

    Djin
    Last edited by DjinTonic; 08-11-2019 at 09:42 AM.
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (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

  3. #3
    CONGRATS Ron! You've crossed a Big post RP Milestone!

    You went to an Apex PCa Program and received guidance & treatment from HBC, MD, = one of The Pillars of PCa research & treatment.

    There are currently 2 active FBs who are "HBC MD" alumni! Interestingly, the # of "Open RP FBs" continues to decrease (fortunately due to RP surgical practice statistics and not mortality!!!) as Robotic Assisted RP increases. (I could not locate recent statistics = hint/challenge to Dj!)

    One day you will be a rare Old Guard Alumnus of Open RP. This will further support the fact that there is always more than one road to Cure!

    MF
    Last edited by Michael F; 08-20-2019 at 12:26 PM.
    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
    Quote Originally Posted by Michael F View Post
    CONGRATS....
    There are currently 2 active FBs who are "HBC MD" alumni! Interestingly, the # of "Open RP FBs" continues to decrease (fortunately due to RP surgical practice statistics and not mortality!!!) as Robotic Assisted RP increases. (I could not locate recent statistics = hint/challenge to Dj!)
    ,,,
    Will look. The studies I've seen have been comparing surgical outcomes and not stats for patient bases. Did find this study:

    ROBOTIC-ASSISTED RADICAL PROSTATECTOMY ASSOCIATED WITH DECREASED PROLONGED POST-OPERATIVE OPIOID USE [2019]

    Thay looked at opioid use by opiod-naive men after Open RP vs RALP. Text is an image, so I can't copy & paste.

    In the database they used they identified 6615 Patients: 13% Open vs 87% RALP. This may reflect the current trend.

    (See the study for the better opioid stats with RALP).

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

    A British Study

    Robot-assisted radical prostatectomy vs laparoscopic and open retropubic radical prostatectomy: functional outcomes 18 months after diagnosis from a national cohort study in England [2018]

    In all, 2219 men (77.0%) responded; 1310 (59.0%) had RARP, 487 (21.9%) LRP and 422 (19.0%) ORP.
    I think we have a rough idea.

    Djin, very open about his RP
    Last edited by DjinTonic; 08-11-2019 at 02:37 PM.

  5. #5
    Experienced User
    Join Date
    Aug 2017
    Posts
    74
    Congrats! "It's always in the back of my mind"
    I think most of us that have gone through this know that feeling.

    Best to you on all your Anniversaries to come!


    Al
    Biopsy Date 7-14-2017
    DIAGNOSIS: Adenocarcinoma
    PSA-6.3-T2A
    2/12 cores: 10 Cores Benign
    #1: 5% Gleason 3+3 Left Apex
    Number Of Cores Involved 1 Of 2
    Tumor Length 1.5mm
    Perineural Invasion Not Identified.
    #2: 25% Gleason 4+3) Right Base
    Number Of Cores Involved 2 Of 2
    Tumor Length 4mm (Aggregate)
    Perineural Invasion Not Identified
    Size Of Prostate: 50.6
    Bone Scan Negative, Prostate MRI Negative
    9/27/2017 Robotic Surgery Da-Vinci
    10/5/2017 Pathology Report
    11 Lymph Nodes Negative For Malignacy
    Prostate Weight 48.6 grams
    Urinary Bladder Neck Invasion-Not Identified
    Seminal Vesicle Invasion-Not Identified
    Margins: Involved By Invasive Carcinoma
    Margin Limitations: Less Than 3MM Rt Posterior
    EPE Present Focal: Site Rt Posterior
    Path Stage pT3A
    PSA Test 11/27/2017 <0.02
    PSA Test 12-5-2017 <0.02
    PSA Test 1-25-2018 <0.02
    PSA Test 3-28-2018 <0.02
    PSA Test 6-28-2018 <0.02
    PSA Test 10-04-2018 <0.02
    PSA Test 1-20-2019 <0.02
    PSA Test 7-29-2019 <0.02

  6. #6
    As far as history, my father is 74 and has never been diagnosed. My uncle, his brother, had surgery in the mid/late '90s via the perineum and no recurrence. My grandfather on my father's side died in his late '50s from liver issues (drank a lot), but was never diagnosed. I've heard that my great-grandfather had the beast, had an orchiectomy, but died of other issues in the early '60s.

    I hope this crap stays at bay. We are looking to potentially move from the Baltimore/Annapolis/DC area, but healthcare is always a concern...
    Last edited by Ron_G; 08-20-2019 at 01:50 AM.
    DOB: 8/1963--Great-Grandfather/Uncle had PC
    9/13 PSA 4.85, 2/14 PSA 6.7, TRUS Bx 12 core-neg, 6/14 PSA 4.8, 12/14 PSA 5.9, PCA3: 38, 1/15 PSA 5.4 (switched docs to JH), 3/15 PSA 5.8/fPSA 17.4/PHI 28.4, 3/15 3T MRI/Fusion-Guided Bx @ Johns Hopkins, 2/14 cores pos, bilateral, <5% involvement, Gleason 6, Open RP: 8/10/2015 w/ Dr. Carter @ JH

    Final Pathology:
    LN-, SV-, Margins-, EPE-
    Tumor Extent: Moderate, organ confined
    Gleason upstaged to 3+4=7 (2% pattern 4)
    Additional Findings: HGPIN
    pT2 NO
    PSA 11/2015 <.1, 05/2016 <.1, 09/2016 .02 & 3/2017 .02 (different assays), 09/2017 <.1, 03/2018 <.1, 10/2018 <.1, 4/2019 <.1

  7. #7
    Congratulations
    At age 55, PSA 22, Gleason: 9 (4+5), 8(4+4), 7(3+4), 6(3+3)
    8 out of 12 cores positive
    DaVinci 14 October 2014
    Pathology of surrounding tissue samples was negative, though they annotated it as stage 3.
    Post surgery PSA:
    Jan 2015 <0.04
    2016 <0.04
    2017 0.05
    2018 0.1


    In 2018; 45 radiation treatments and hormone treatment [with Lupron for the next 2 years].
    In 2019; on Lexapro to deal with the Lupron.

 

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