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Thread: Having second thoughts about post op RT

  1. #21
    Quote Originally Posted by DjinTonic View Post
    Busby needs to be concerned with his persistent and rising PSA and what treatment is best right now. BCR by 5 yr isn't germain (he is essentially at 0.2 and rising right now!). BCR is a return of, and rising, PSA only when it occurs after an essentially zero PSA--that is not Busby's situation.

    Djin
    Post prostatectomy, LVI 10-year bone metastasis rate was 16.9% and cancer specific mortality was 6.8%. There is no mention in the study of SRT and ADT, which could reduce those values.

    https://bmccancer.biomedcentral.com/...885-017-3307-4
    Last edited by Duck2; 08-20-2019 at 02:31 AM.
    YOB 1957

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

    2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic,

    3/6/19. Pathology - Grade Group 4 with Intraductal Carcinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 .03. (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)
    9/10/2019. <.02. (198 days)

    ADT - 6/19 - 6/21
    ART - 8/19 - 9/19. (78 Gy, yes, I glow in the dark)

  2. #22
    Senior User
    Join Date
    May 2017
    Posts
    175
    Some good articles. Thanks for posting. I'm kicking back on the sofa at the beach house right now after watching a beautiful sunset. I'm going to read the posted articles before I go to bed. Thinking about the reality of your mortality makes you appreciate the finer things in life like the sunset over the ocean and the costal breeze coming through the window.

  3. #23
    Hi Busby! Fully enjoy your well deserved vacation and the beautiful ocean sunsets as you face west!

    Upon returning to "reality after vacation," start to get up early, turn eastward and enjoy the sunrises and the possibilities of 100% Cure that lay ahead! IMO, your latest uPSA likely indicates that things are on the rise. Hate to see this! At this point, it appears that the PSADT is likely > 9 months.

    My single suggestion is to discuss with the RO: "Will the RT cover the location(s) of remnant PCa?"

    You have multiple FBs who have been through SRT with & without HT who can guide you through the process.

    My sense is you have many decades ahead before The Final Sunset! You now have an opportunity that will get you there free of PCa. Seize it!
    Good luck! We are with you every step, zap & hotflash along the way!

    Stay strong & remain optimistic.

    MF
    Last edited by Michael F; 08-20-2019 at 12:09 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. #24
    Quote Originally Posted by Busby View Post
    Some good articles. Thanks for posting. I'm kicking back on the sofa at the beach house right now after watching a beautiful sunset. I'm going to read the posted articles before I go to bed. Thinking about the reality of your mortality makes you appreciate the finer things in life like the sunset over the ocean and the costal breeze coming through the window.
    Also look at man up north’s signature. He seems to be doing rather well. Go Buckeyes.

    https://www.cancerforums.net/members...-MichiganMan16
    Last edited by Duck2; 08-21-2019 at 07:23 PM.
    YOB 1957

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

    2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic,

    3/6/19. Pathology - Grade Group 4 with Intraductal Carcinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 .03. (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)
    9/10/2019. <.02. (198 days)

    ADT - 6/19 - 6/21
    ART - 8/19 - 9/19. (78 Gy, yes, I glow in the dark)

  5. #25
    My RO told me that in the very least, he bought me another three years of life.

    I did the radiation and Hormone treatment [Lupron]. At six months the depression hit me hard but my PCP gave me Lexapro and I am much better now.

    After a year of Lupron, I found the hot flashes are much less now, and I have adjusted to them. I just hate putting on so much weight.

    I am thinking that if my naturally high Testosterone levels were a feature to driving the growth of my prostate cancer, and not having Testosterone makes cancer not grow. Maybe I should discuss getting castrated and going onto pill form Testosterone. Then we can tweak my Testosterone levels to any level I want. Without really waking the cancer up.
    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.

  6. #26
    Quote Originally Posted by organic farmer View Post
    I did the radiation and Hormone treatment [Lupron]. At six months the depression hit me hard but my PCP gave me Lexapro and I am much better now.
    The Lupron depression was awful. After a couple years on venlafaxine things have stabilized. Plus my wife has been in remission... that helps. Glad you got some help, as the emotional blowback from cancer can be debilitating.

    After a year of Lupron, I found the hot flashes are much less now, and I have adjusted to them. I just hate putting on so much weight.
    After two and a half years the hot flashes are a pain in the butt. Fortunately I haven't put on much weight, at least not that I can blame on HT. But I hear many other guys have an issue with that.

    I am thinking that if my naturally high Testosterone levels were a feature to driving the growth of my prostate cancer, and not having Testosterone makes cancer not grow. Maybe I should discuss getting castrated and going onto pill form Testosterone. Then we can tweak my Testosterone levels to any level I want. Without really waking the cancer up.
    New thinking is that low-T is more likely to lead to higher grade PCa. Check into some of Dr Morgentaler's statistics. Still, when I questioned my Uro about T supplementation last month, he said he was firmly opposed to ANY form of hormone supplements as I am still high risk.

    Testosterone and Prostate Cancer: Is There a Link?

    The big fear now is what's the PSA going to do once the Lupron finally wears off.
    Late 2012: PSA 4, age 62 all DRE's 'normal'
    Early 2014: PSA 9.5, TRUS biopsy (false) negative
    2015: PSA's 12 & 20, LOTS of Cipro ... Mar'16: PSA 25, changed Urologist
    Jun'16: MRI fusion biopsy, tumor right base, 6/16 cores: 2ea 15-40-100% G8(4+4)
    Aug'16: DVRP,
    "broad cut" 11 LN-,-SM, 53g 25% involved, multifocal EPE, PNI, B/L SVI, pT3b

    Jan'17:
    began Lupron ADT, uPSA's ~.03
    May'17: AMS800 implanted, revised 6/17
    Aug'17: 39 tx (70 Gy) RapidArc IGIMRT
    Jan'18-July 2019: PSA's <0.008, T~12
    Apr'18: Dx radiation colitis, Oct'18: Tx sclerosing mesenteritis
    "Everyone you meet is fighting a battle you cannot see"

    Mrs: Dec 2016: Dx stage 4 NHL/DLBCL,
    Primary Bone Lymphoma
    spinal RT boost+6X R-CHOP21+6X IT MTX via LP. Now in remission
    Read our story at CancerCoupleBlog

 

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