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Psa level increase 6 years post DiVinci

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Posted 9/18/2014 12:42 AM (GMT 0)
I have been absent from this site for almost 7 years, since my husband has been fine post DiVinci. My father in law was diagnosised the following year and like his son, chose the DiVinci. We just found out today that on his 5 year psa test it was .02, 6 months later, .8, now 2+, still running test, doctors talking castration, radiation, or chemical treatment. He is a very young 80 year old who is scared to death at this point. Think he thought all would be fine.... Just need advice! I know this puts him in a none to low cure ratio, but all opinions are appreciated. And by the way, if there are some of the old users still on here like mama bird, tc, etc we are kzizzi! And still doing great!
Posted 9/18/2014 2:55 AM (GMT 0)
With most surgery failures, it would be salvage radiation with added help from a little hormone therapy..That path has about a 50% success (cure) rate...With today's newest generation of LINACS (the machines that deliver the radiation) side effects from that are minimal..Two years on HT will have have some profound side-effects. The two people you talk to now are a Medical Oncologist and a Radiation Oncologist..

The standard treatment for advanced PC is changing everyday as new drugs and treatments are approved and the insurance companies and drug makers fight over treatment protocols..
Posted 9/18/2014 2:20 PM (GMT 0)
With a psa of 2+ (and an unknown doubling time) the chance of radiation cure is small, in my opinion, though still possible. The duration of hormone treatment in such a case is likely 10+ years taking him to age 90+ with tools available today. It is not likely that prostate cancer will cause his death. This does not diminish the risk it may bring to his quality of life.
Posted 9/19/2014 1:08 AM (GMT 0)
Salvage radiation is a possibility, and he may be lucky, and experience few symptoms from it.

Another option is to do nothing. He has no symptoms, and it might stay that way a long time. If he does eventually have some symptoms, they can be treated with hormone therapy then. There is no survival advantage in going on hormone therapy sooner rather than later, so why rush into it?

"Our study suggests little or no survival benefit of immediate ADT initiation for immediate ADT initiation compared with deferred ADT initiation (at clinical progression or at least two years after PSA relapse) among prostate cancer patients with PSA-only relapse."

Immediate versus deferred initiation of androgen deprivation therapy in prostate cancer patients with PSA-only relapse.

- Allen
Posted 9/19/2014 3:24 AM (GMT 0)
Hi Kzizzi,
Glad to hear your hubby is still good after 7 years. Mine is too. Mama Bluebird flew away about 6 and a bit years ago approximately maybe a little more. TC drops in from time to time, and Swim does too. A few names here and there might be familiar to you. People here will be able to advise on your F-I-L's situation. There is still a lot of good advice and assistance. Hope you get some tips which help and provide information for him. Good to hear from you again. All the best, Lana.
Posted 9/19/2014 3:55 AM (GMT 0)
At 80, I wouldn't be pushing radiation on the gentleman, perhaps HT would be a better option at that age, and one with less physical risks involved. I hope the best for him and that his doctor(s) will find a secondary treatment plan that works best for his condition at that is time.

David
Posted 9/21/2014 10:31 PM (GMT 0)
Thank you all!!! And Creed, glad to hear all is well!!! Your hubby and mine are close in age and dx age!! I used to have TC's email and would keep up with him that way, but years has passed, new challenges came, etc... I did check in as a visitor a few years back and thought I saw mama bird was still an active user.... I am going to research these hormone/radiation choices for my father in law. I really fell in love with this forum when Kurt was diagnosed on the 10 year anniversary of my dad dying from PCa, both young dx. I am going to now stay active and help where I can!!!!
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