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Medical Forum / Diseases and Disorders / Prostate Cancer / June 2005KA-THUMP (Shoe number 2)
Not a huge surprise but a disappointment. Three and a half years post prostatectomy. My numbers have been: Feb 2002 0.06 July 2002 0.09 Sept 2002 0.09 Nov 2002 0.11 May 2003 0.18 Nov 2003 0.20 Apr 2004 0.24 Sept 2004 0.19 (I liked that one!) My latest PSA (May 2005) came in at 0.35 so, it's off to see the wizard of radiation next week. Rats. My pathology was lousy - both SV's positive, large cancer volume but the relatively low PSA's were nice while they lasted. Very interested in hearing what they can do about targeting the radiation. Not much I expect but will let you all know. JP joe - check out which type of radiation you can get. there is a difference. the problem with most radiation is that they are going to radiate the prostate bed in hopes of killing the bad guys. but radiation passes through the body. you want it to drop it's energy in the prostate bed where it can do the most good. i know that proton beam does this, but some radiation just goes through the body like sunlight through a glass. you're getting the radiation damage from the beam, but may not be the best kill rate for the pca. at least, it's something to kick around with the radiation guy. hope this helps. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." http://community.webtv.net/PALMER_ENT/doc Aw, geez! That sucks. Bev > Not a huge surprise but a disappointment. > [quoted text clipped - 22 lines] > > JP Joe Price, PCa does truly suck. You are in my prayers for good results from radiation. Steve U You had a nice run, Joe. But, dammit if the bastard didn't slip one in on you! Fight the good fight. My prayers are with you.  SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Not a huge surprise but a disappointment. > [quoted text clipped - 22 lines] > > JP Hi. This post leads me to ask two questions: 1. The psa's being quoted show two significant figures to the right of the decimal point. All of the psa results I have received have had only one figure to the right of the decimal. For example, my last several have been 0.7, 0.5, 0.3, 0.2, 0.1, 0.1 (over the last two years of testing; and I am five years out from seeding). My tests are all done at M.D. Anderson Cancer Center in Houston, TX. The tech who phoned me these results also said that the last one was 'undetectable', and was 'less than 0.1'. I have asked at MDA about getting more decimal places, but they keep telling me the test is not that precise. Where do you get yours done, and do you think your test is precise out to two decimal places? 2. Mr. Price indicates that he is to receive more radiation based on the rise over three years from 0.06 to 0.35. My first reaction (no doubt erroneous) is that is an awfully small rise on which to base a launch into a whole new regime of radiation. What are the general guidelines as to how much rise it takes to trigger further treatment? (My situation is different in that I had seeds w/o hormones or external radiation) Thanks John Hanley Brachytherapy: October, 1999 98 I-125 Seeds Age at treatment: 62 Pretreatment PSA: 7.5 Gleason: 3+3 = 6 Most recent PSA: 0.1 -------------------------------------- > You had a nice run, Joe. But, dammit if the bastard didn't slip one in on > you! Fight the good fight. My prayers are with you. [quoted text clipped - 27 lines] >> >> JP Hi Ho, Your graph of PSA readings is nearly the model for a brachy patient. You have an 80% chance of having no cancer at all within your body, i.e., cured. For us surgery patients, the model is drop to 0.1 and stay there for the rest of our lives. As far as hyper-sensitive testing, you don't need it. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > Hi. This post leads me to ask two questions: > [quoted text clipped - 60 lines] > >> > >> JP Perhaps I wasn't clear. My primary treatment was a radical prostatectomy. This course of salvage radiation will be my first experience with that therapy. Yes, sensitive PSA assays do read to the 50th of a nanogram per ml (.02ng/ml). Where do I get them done? I know the lab but, since I live in Canada, it wouldn't mean much to you. Here are a couple of random sites of dozens that discuss sensitivity of PSA tests based on a quick google: http://www.jnj.com/news/jnj_news/20020308_0924.htm http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 0470238&dopt=Abstract This one describes a method sensitive to another order of magnitude less PSA (.002ng/ml). http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9 120931&dopt=Abstract > Hi. This post leads me to ask two questions: > [quoted text clipped - 67 lines] >>> >>> JP "My pathology was lousy - both SV's positive,...." Joe, the long time to recurrence is promising but ask the wizard what HIS experience is w/ salvage RT in patients w/ seminal vesicle involvement. As you may/should know, it is a significant negative predictor of a durable response. Whatever type of RT they use and however they target it, if you have systemic disease it will not cure you. FWIW at M.D. Anderson they told me that plain ole 3D RT is sufficient for salvage treatment as opposed to IMRT, which is the superior primary treatment. Bill Denton RP 2/12/02 PSA .45 Memphis > "My pathology was lousy - both SV's positive,...." > > Joe, the long time to recurrence is promising but I see no reason for a "but". For one, Joe has been around the ng long enough to know the situation. But, more importantly, I'd say the time recurrence is remarkable and the cancer growth, considering he was only 50 years old in 2001, is remarkably slow. Positive SVs is a lousy pathology, but I'll wager EBRT will knock it back for another year or two. And maybe another 3½. And there is a small chance of a cure with salvage radiation, albeit single digit percentages. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum Steve, I acknowledged that Joe's long time to recurrence is a good sign - one that may put him in a different statistical group than the rest of us w/ SVI - and suggests local-only disease. I hope that is the case but I think most uros (and certainly rad-oncs ) are a little quick to jump into RT w/ attendant QOL issues. Joe has time to think this over - no need to rush into anything. I did not say RT would not "knock it back for another year or two" but that is not what I call a durable response. Shoot, based on Joe's time to recurrence I'd give him an even better chance of cure than you do. :-) You raise the issue that is troubling me - is a 2-year (?) delay in measurable disease progression worth the certain short term side effects and possibly permanent loss of remaining erectile function while I am at an age that it is relatively more important? That "knock back" could very well be like the effect Walsh says HT has - it appears through PSA that the disease has stopped progressing but it has no proven survival benefit. Another thing I have wondered about is that if you have systemic AND local disease (which would be the case if you only get a 2-year reprieve) would RT perhaps not prevent possible urinary problems associated w/ local disease down the road? That would certainly weigh in favor of RT regardless of the probability of cure. Bill Denton RP 2/12/02 PSA .45 Memphis > Steve, I acknowledged that Joe's long time to recurrence is a good sign Yes you did. I intended to quote that remark. I apologize if I missed it with my mouse. > Shoot, based on Joe's time to recurrence I'd give him an even > better chance of cure than you do. :-) I am wary of muttering (and re-muttering) the estimate of Year 2015 as the year we might have a cure. But, if pressed, I'd say Joe is going to make it without much of a doubt, assuming he stays off bus routes. > You raise the issue that is troubling me - is a 2-year (?) delay in > measurable disease progression worth the certain short term side [quoted text clipped - 7 lines] > urinary problems associated w/ local disease down the road? That would > certainly weigh in favor of RT regardless of the probability of cure. That's a tough one, Bill. If it were me, I'd do a whole lot of research and probably end up right back where I started. SignaturePSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05 PSA .07 .05 .06 .05 non Illegitimi carborundum > I am wary of muttering (and re-muttering) the estimate of Year 2015 as the > year we might have a cure. But, if pressed, I'd say Joe is going to make > it > without much of a doubt, assuming he stays off bus routes. You too, brother. You too. Orientation at the Cross Cancer Centre tomorrow. Rad onc on Monday. I plan to drive with care. JP "That's a tough one, Bill. If it were me, I'd do a whole lot of research and probably end up right back where I started." Steve, this comment proves that you truly understand the strange mileu (sp?) in which we find ourselves. Bill Denton RP 2/12/02 PSA .45 Memphis Joe: Just saw this post. I am sorry to hear that you are in for another round of treatment. I wish you the best. Thank you. David S. > Not a huge surprise but a disappointment. > [quoted text clipped - 22 lines] > > JP "Joe Price" <joeprice@shaw.ca> wrote in message > news:LG8le.1482645$8l.1416357@pd7tw1no... > > Not a huge surprise but a disappointment. [quoted text clipped - 21 lines] > > Very interested in hearing what they can do about targeting the radiation. > > Not much I expect but will let you all know. Please keep us informed. I'm due for another PSA in a couple months and the Rad doc has already cautioned me to expect higher numbers, the "PSA Bounce", that a lot of guys see. On the plus side, the side effects are waning. Still a little stinging when pee'ing. The fatigue is fading. I'm working longer hours. |
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