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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2005

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Stavros Moschos - 04 Aug 2005 17:08 GMT
Well, I have received my first post-RT check-up, first seeing the bad cop (a
resident) and then my oncologist (the good cop).  It seems disappointing to
me and I wonder if any of you can tell me what you make of it.  Between the
gloominess of the resident and the cheerful optimism of my oncologist, I am
(as usual) confused about what to make of it.  I have appended my record, as
best as I can do it.  My next check-up and PSA is in six months.  Thanks, as
always.

July 2005  DX PCa  PSA 26.5  Gleason 7 (4+3)  Stage T2a Biopsy (15

samples), digital examination, and CT body scan showed the cancer

confined to a single nodule in the prostate.

August 2004  ADT  First injection (2 drugs--I have forgotten their

names)

December 2004  ADT  Second injection  I have forgotten the PSA

April 2005  PSA 2.6

May 2005  Started RT 33 treatments, high beam, powerful doses

August 2005  Six weeks after ADT  PSA 2.9
Alan Meyer - 05 Aug 2005 02:05 GMT
> Well, I have received my first post-RT check-up, first seeing the bad cop (a
> resident) and then my oncologist (the good cop).  It seems disappointing to
[quoted text clipped - 21 lines]
>
> August 2005  Six weeks after ADT  PSA 2.9

Stavros,

I'm guessing that a PSA of 2.9 after radiation and with ADT
still active in your body means that the cancer was not eradicated.
Presumably that's why the resident was gloomy.  You still have
cancer and still have the possibility of dying of it.

On the other hand, it appears that the PSA is growing slowly,
not (yet at least) galloping away.  So you still have the
possibility of living for years before the cancer gets you.

At this point, you don't even know for sure that your PSA is
going up.  2.6 to 2.9 looks like a rise, but the PSA can vary
a bit from day to day and the .3 difference is small enough to
be within normal variation.

As to the question of how many years have you got, I think
nobody knows the answer to that.  Perhaps your oncologist
thinks there will be a lot of years, maybe enough that old age
will overcome you in some other way before the prostate cancer
gets out of control.

For the moment, it seems to me that the progress of the disease
is now out of your or your doctors' hands.  They've done
everything for you that they know how to do.  They have
probably set the cancer back and bought you some extra time.

I think you should not worry too much about the cancer.  Try
to live a healthy lifestyle.  Try to eat right.  Try to enjoy
yourself.  Try to do what you like to do.  Try to be the good
person you've always been.

I would keep an eye on new treatments.  There are some that
look promising.  You don't need them yet but, if and when you
do, it's possible that something will be available.

Good luck and good health.

   Alan
Stavros Moschos - 05 Aug 2005 16:27 GMT
Thanks so much for this reply.  You've confirmed my own interpretation of
the two points of view and that's a relief--I was so uncomfortable being
"caught" between them.  My bottom line is that I want to be realistic and
know what is happening (or that it is just ambiguous at this point).  Being
simply confused is  really unsettling to me. You've really helped.  Btw, you
did hit on my oncologist's thinking--he said that he is "sure" (his words)
that I will die from something other than PCa.   And he did say that the PSA
may not be an accurate sign at this point. My bottom line right now is that
I'm comfortable that I do have a good idea of my situation.  Thanks again,
so very much.

>> Well, I have received my first post-RT check-up, first seeing the bad cop
>> (a
[quoted text clipped - 67 lines]
>
>    Alan
Steve Kramer - 06 Aug 2005 21:18 GMT
My first PSA test after Lupron was 12 weeks.  I don't know how long it takes
for PCa and PSA to deminish after ADT, but I'm guessing there is a good
chance that in another six weeks you will have the result you desire.

Signature

PSA 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

> Well, I have received my first post-RT check-up, first seeing the bad cop (a
> resident) and then my oncologist (the good cop).  It seems disappointing to
[quoted text clipped - 21 lines]
>
> August 2005  Six weeks after ADT  PSA 2.9
 
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