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Pathology Report - Looking for Treatment Options

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Posted 1/28/2011 4:34 PM (GMT 0)
Harry,

Info overload is probably pretty common. But it also means you are doing the homework/research that you need to make a treatment choice. You now know that either rad or surgery will work for you. The only thing left is to think long and hard about the QOL issues that may result. You will get a lot of insight on that here at HW.

Only you can guage your comfort level with the final treatment. Once you have decided, go for it and don't look back.

Joe
Posted 1/29/2011 6:52 AM (GMT 0)
Good friend of mine had a PSA of 15. This was 10 years ago. The biopsy was positive in all cores. Surgery was not an option. He got radiation and then hormones. Recent chest xray showed a spot in a lung. Biopsy showed prostate cancer. Back on hormones and measuring it periodically.

Post Edited (Harryheart) : 1/29/2011 10:11:57 AM (GMT-7)

Posted 7/8/2011 7:04 PM (GMT 0)
4 months post op da vinci prostatectomy. PSA is <.01.
Posted 7/8/2011 8:17 PM (GMT 0)
harry, that is great news to report, nothing like a zero to brighten one's day
Posted 7/8/2011 8:56 PM (GMT 0)
Harry:
I am pleased to say that my prediction that you are "eminently curable" has been medically proven. You are so very much the happier than I.
Posted 4/26/2012 10:59 AM (GMT 0)
13 months post op and my psa is <0.1

My ED is 100% nothing has worked ....yet. 

Posted 4/26/2012 12:48 PM (GMT 0)
Harry, glad you are continuing with the zero's. ED has several workarounds, so maybe it's time to start to see if something can work, rather than just wait? You don't mention any attempts to fix it, is the reason I say that.. tongue
Posted 4/27/2012 1:27 AM (GMT 0)
I have tried the vac pump and the pills
Posted 10/5/2019 8:05 PM (GMT 0)
I am back with you all as I now have biochemical recurrence. If you want me to start a new topic let me know.
I am trying to set up my signature with some info.
Back in April 2019 my urol said we would do a pet scan when I reached .2. My appt with him is later this month. He also recommended salvage radiation and hormone therapy.
Just wondering if I can hold off treatment till Jan 2020. What do ya think?
Posted 10/5/2019 8:28 PM (GMT 0)

Harryheart said...
I am back with you all as I now have biochemical recurrence. If you want me to start a new topic let me know.
I am trying to set up my signature with some info.
Back in April 2019 my urol said we would do a pet scan when I reached .2. My appt with him is later this month. He also recommended salvage radiation and hormone therapy.
Just wondering if I can hold off treatment till Jan 2020. What do ya think?

sorry to hear that man. in my opinion .2 is late for salvage radiation. maybe not to late though. I would proceed with treatment ASAP. specifically I would be seeking a shot of firmagon ASAP while a radiation oncologist sets up a plan. do not wait man. why would you want to?
Posted 10/5/2019 8:51 PM (GMT 0)
Thanks F8

Correction: I just read the doctors notes again on my portal and it says pelvic radiation not salvage radiation. My bad. Maybe you could explain to me what the difference is. Thanks again
Posted 10/5/2019 9:33 PM (GMT 0)
Harry, sorry you had to rejoin us after so long a time.
First, as far as i know , salvage radiation is radiation to the prostate bed. Pelvic radiation is sort of the same thing, but I thing “whole pelvic radiation “ means the hit the lymph nodes as well. If I’m right (and others will correct me if I’m not, I’d want to ask the Dr why whole pelvic.
Second, more recent studies have shown that hitting it earlier is better when it comes to BCR. I HAD salvage and hormone therapy at .08. But that doesn’t mean it’s too late, just that you should probably get the ball rolling,
Third, urologists/surgeons tend to use .2 as BCR as yours is doing. Radiation oncologists, at least the ones I’ve spoken with, tend to want to hit it earlier, they seem to be more up on latest studies. I think, your uro/surgeon’s work is done here. You should be in the care of a Rad onc, or Medical ONC or both at this point.
Fourth, the good news is it seems like your PSA doubling time is pretty long, so that’s a good thing,

Hang in there, please keep us posted, and think in terms of taking action sooner rather than later.
Posted 10/5/2019 11:09 PM (GMT 0)
Harry,
I would want to do a consult NOW with an RO, regardless of when your treatment begins. As stated above your Uro's job is done and the sooner you start treatment the better chance to knock it out. Though not stated in your signature, I'm guessing your pathology report showed no positive margins. Maybe this explains the Uro's idea for waiting for a scan and pelvic radiation - maybe he assumes there are mets in the nodes. I would think an RO would radiate the prostate bed and the pelvic nodes regardless.

Again, this is all stuff for an RO to sort out, not your Uro.

Good luck!
Posted 10/5/2019 11:24 PM (GMT 0)
Harry,

So sorry to hear that your psa is on the way up.

Please keep us posted on next steps, radiation would seem to be the answer but it would be interesting to know whether the radiologist tried to pinpoint where the cancer is before zapping it, others might know whether this technology now exists at this psa level.

My husband is off to get his psa test done, he is 9 years from surgery with a 3+4 outcome, but the thing about prostate cancer is that you just don’t know.

Regards,
An
Posted 10/6/2019 1:05 PM (GMT 0)
More pathology info.

Question: What is the significance of : 6. Perineural invasion is identified
Posted 10/6/2019 4:07 PM (GMT 0)
PNI on SURGICAL pathology is considered not important and is extremely common. I got that from my surgeons NP, when she went thru my pathology after surgery, with me
Posted 10/6/2019 4:30 PM (GMT 0)
Harry - Sorry to hear about your PSA rise. I might suggest not looking backward so much. There does not seem to be much there from what you have shared that would explain where you are today after 5 years. Seeing a RO and MO would be prudent and possibly going to a respected cancer center might get it all done faster after one visit with a little more confidence. You can always get treated locally.
Posted 10/6/2019 9:32 PM (GMT 0)
Thank you all. I am going to try to get into the RO tomorrow.
Question-can theRO give me a diagnosis for active prostate cancer?
Posted 10/6/2019 10:01 PM (GMT 0)
Yes, he can make the judgement if he feels you are having recurrence. There isn't really "proof" involved. There are different definitions - some probably outdated. Commonly, three consecutive increasing PSA scores over time is used as compelling evidence.
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