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What next, after Surgery and radiation?

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Posted 8/4/2012 11:55 AM (GMT 0)
Four years ago, Da Vinci, after three in half years 34 radiation treatments, PSA now 0.435, up from pre-radiation PSA 0.39--not sure next steps from here? I am age 64, is this a critical stage, is hormone therapy my next step?
Posted 8/4/2012 1:43 PM (GMT 0)
Luigi, sorry that radiation treaments didn't work out for you. You really should seek out and set up a consultation with best prostate cancer medical oncologist that you can get to. Don't hesitate to get a second opinion or two. You are at a critical stage. Learn all that you can and get the best advise possible before making a decision on next steps.
Posted 8/4/2012 3:16 PM (GMT 0)
I received both treatments at Mayo in Scottsdale. Meeting with my local family doctor this Tuesday and not scheduled for my Mayo follow up until November. I have a relationship with both the Urologist and Oncologist there. When I began radiation it was suggested I start Hormone therapy but the Urologist insisted we separate the two treatments. Based on my Gleason and clear margins plus the radiation therapy his statement was "we treated the right area it must be somewhere else!" I am concerned I maybe losing confidence in the next course of action. I have no idea how critical a stage I am at, at this present time. If hormone therapy is recommended should I seek other options. Confused and not really knowing if this is life threatening at this time. I will start the dialog with various doctors this week. Thanks for being there for all of us
Posted 8/4/2012 5:14 PM (GMT 0)
Luigi123

Be calm brother, take a breath.

Nope not life threatening.

The PSA going up to 0.435 could be a one time thing, I expect your medical team will want to have at least another PSA done at some point

Talk with your medical team. The people at Mayo will know a lot more about your specifics than we here ever could.

IF hormone treatments are needed - not a big deal - you can handle them.

Let us know how things are going for you.

HUGS

Bud

We will beat this crap!
Posted 8/4/2012 6:07 PM (GMT 0)
Thank you. May your healing be as awesome as your inspirational comments.
Posted 8/4/2012 9:38 PM (GMT 0)
Luigi,

Depends on what school of HT thinking your oncologist has in mind. Some, go for early HT treatment in a case like yours, where you have failed both surgery and radiation. I am in a similar boat, I failed surgery in 9 months, and failed salvage radiation in less than 9 months. I am 2 1/2 years out of radiation, and when my PSA was last checked in April, it was up to 37.x. So you have a long way to go in comparisom.

My oncologist, affiliated with MD Andersen, is of the school of Later HT, not early. He feels strongly about it, and it happens that both my uro and my GP agree with him. Right now, we are keeping an eye on things, and there is no evidence of any mets even with a reading of 37. He feels in my case, that he might bypass HT when the time comes, and use Taxotere, a chemo agent, instead, to shock the cancer.

The 20 million dollar question is, where is the cancer? With as much radiation as I had, 72 gys, its not believed to be in the prostate bed. It's believed to be in multiple micro sites, each giving off PSA readings, that collectively add up to my latest reading. It's kind of hard to treat, when its not know where it is at.

Best bet at this point for you, is to have a meeting with your oncologist, and see what his/her sense of direction is at this point. THough not impossible, it's highly likely you are in any danger of mets with a reading that low. But it is time to think about the future, and have a plan in place.

HT will effect quality of living issues for you in lots of ways, my doctor is sensitive to that fact. It varies a lot from guy to guy, and can be mild and annoying all the way to severe. That is something that you have to weigh into for yourself.

Good luck ahead, as you think through this juncture you find yourself at.

David in SC
Posted 8/5/2012 3:44 AM (GMT 0)
Thank you for this extensive review of your journey and valid suggestions. I will print this for my visitation with my family doctor this Wednesday. I will also forward to my Urologist and Oncologist at Mayo for my November follow up visit. I, too, realize this PSA readings are not from the Prostate area. I recently read the "China Study", have reviewed the diet change up as a long term treatment. At this stage I am simply gathering all info, again, thank you for taking time for me.
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