New PSA results

My mistake, diVinci was in May.

Pint Please..............Congrats Kev

>Adjuvant Radiation Therapy<

radiation was part of his treatment plan. 

ed

Fallcrop,
Seems like pretty agressive treatment for your initial stats. Why did you go for radiation plus Lupron right off the bat? Did you have positive margins at surgery or was that in the plan all along?
The psa number is most likely caused by the Lupron. You can't really tell the effects that the radiation had until the Lupron wears off in 4 to 6 months.
JT

Good for you Fallcrop,
And thank you for sharing. You keep us posted on your progress. I think you went a great rout and hopefully you will have similar success that I have enjoyed with that combination. Surgery with adjuvant radiation therapy has shown to perform as well as any other form of therapy in intermediate/high risk cases. The Harvard/Stanford ART study is approaching the median of 9 years with excellent results (highest Level 1 ART study trial results I have yet seen).

Good luck and may many zeroes come your way.

Tony

This is my initial post and I first want to thank everyone for the time and effort and support given by all!! I'll try to be as thorough as possible but I don't have my "numbers" in front of me. Here goes: Current age - 59

My GP noticed a rise in PSA in early 2009 from 3.6 to 4.1 and referred me to a urologist. I saw him in 4/09 and PSA had risen to 4.6. Biopsy next month (5/09) confirmed PC in 1 of 6 samples and only to a disease degree of 6%. Pre-op Gleeson score of 3+3. After considering my options, I had RP via DaVinci robotic method on 9/17/09. Post-op Gleeson of 3+4; margins "clean", no lymph node involvement therefore no lymph nodes were removed because of my minimal amount of disease.

First post-op PSA reading on 1/5/10 was .19. Surgeon considered possible lab error and confirmed .19 a week later. One of his associates recommended radiation of prostate bed; I decided to "watch and wait". On 4/8/10, PSA rose to .46. I saw a radiation oncologist (RO) who was alarmed and sent me to see a medical oncologist (MO). On 5/10/10 my PSA fell to .27, which I showed to the MO a few days later during my consultation with him. He recommended no hormone therapy nor radiation therapy "unless and until you see a sustained rise in the PSA number." My RO concurred with this since he was the doctor who referred me to the MO.

On 7/21 my PSA rose from .27 to .28 which is negligible and my RO recommended to continue "active surveillance". On 10/4 my PSA rose from .28 to .38 and my RO has now recommended radiation therapy. I have an appt with another RO this Thurs. 10/21 just to see what he thinks but I feel pretty sure that I'll go ahead with the radiation therapy.

Here is my frustration............when my PSA was .19 last January and I considered radiation therapy at that time, I was told by my RO that there was a 50/50 chance of actually hitting and killing the cancer cells. In other words, the protocol is to radiate the prostate bed as soon as possible, however, there's no guarantee that the disease has not moved on to somewhere else. (By the way, a full bone scan and MRI of my organs surrounding the prostate bed were both negative.) So I chose to "watch and wait". And now that it has been 13 months since surgery, who knows where the presumed cancer cells have traveled to??

This post-operative PSA rise......and fall.......has my docs scratching their respective heads as to why it would drop from .46 to .27. And the inability of these "pros" to definitively say that radiation therapy would wipe out the disease, is frustrating me. I worry about healthy organ tissue getting "fried" in the radiation process, based on some horror stories you read about.

Thank you for the time taken by anyone who is reading this. I will keep you posted going forward and I would appreciate hearing from anyone who has experienced a similar situation.

Thanks for your input, Mel. You're correct re: "no guarantees". I guess my disappointment stems from the fact that my initial prognosis was "low-grade" disease. In fact, I thought I was being a little radical with my decision to have the surgery, as opposed to radioactive seed implantation or single-beam radiation. I even remember being embarrassed at my first consult with the second radiation oncologist I saw because he is the dept chair at a well known city hospital and I felt like my case wasn't serious enough to warrant taking up his time.
Now I'm reading that I should probably consider combination therapy, i.e. radiation along with hormone therapy is supposedly getting better potential cure results. And the RO that has now recommended radiation told me to get an opinion from the medical oncologist again that I saw back in May.

Thanks again for your input!