SRT Outcome Still Holding Up

Just had my regular follow up six month PSA test at Memorial Sloan-Kettering in New York City. Two + years out from SRT, the PSA is still returning "undetectable." Back in the summer of 2011 things were not looking so good: Gleason 8, PSA emerged 18 months out from surgery, rapid doubling time. I have now had five PSA tests since SRT, all "undetectable." SRT outcome does not get any better than this. I would never use the word "cure" with cancer, but I am feeling very hopeful and grateful to Sloan-Kettering. One note for those considering SRT -- my treatment also included radiation to the pelvic lymph, and six months of HT. This is more or less the maximum treatment possible at that point (as far as I know), but I figured it was my best shot. My history is below. Best wishes to all!

Newspaper Lover
Age 70
11/09 DaVinci surgery upstate NY; nerve bundle taken; clean margins, clean seminal vessels, no incontinence, alas no erections.
06/11 PSA re-emerged.
Gleason 8
Time to recurrence 18 months
Three month doubling time (summer 2011).
PSA rose from .07 on 06/11 to .17 on 11/11.
09/11 hernia surgery to repair hernia resulting from the DaVinci.
10/11 Moved management of my case to Memorial Sloan-Kettering in New York City.
12/11 Started hormones (Lupron/Casodex).
02/12 Began radiation (SRT), including pelvic lymph. 40 sessions.
03/12 Last Lupron shot.
04/12 Finished SRT.
07/12 PSA and testosterone "undetectable."
01/13 PSA “undetectable”; testosterone (T) level at 452 ng/dl.
07/13 PSA “undetectable”; testosterone (T) level at 444 ng/dl.
01/14 PSA “undetectable”; testosterone (T) level at 435 ng/dl.
06/14 PSA “undetectable”; testosterone (T) level at 444 ng/dl.
Have received no treatment since spring of 2012.
Started “Paleo diet” in 2013. Only eat what I plausibly could have fished, hunted, or gathered 40,000 years ago (but not with current skill set). No processed food of any kind. No sugars. No starch. Lots of protein. Feel physically strong and best in years on this diet.

I'm undergoing both SRT and ADT now after going from .1 to .2 to .3 at two, five and eight months post open RP. SEs from ADT are hot flashes and stomach/ bowel issues and some fatigue but nothing I can't take. I play golf three times a week and work out the other days. No SEs yet from SRT (thru 13 sessions of 38). I'm interested in hearing you did six months of ADT. I've heard 18 is standard for my high risk situation which is worse than yours. Not sure how many months I'll end up doing but I sense that six is what my uro and oncologist are thinking.

Newspaperlover, we have taken a similar road and I am happily in the same place that you are, 3 years out from SRT and HT and still undetectable. I don't consider myself cured, but very lucky. I didn't have lymph nodes included in SRT, but did have 12 months of ADT3. Very happy for you. BB

Lapilot,

Tolerated the SRT and HT combination well, except I did develop a "gut," despite exercise almost daily. Took a while to lose that. Hot flashes were not a big problem for me -- 3 or 4 a day, never had one while sleeping. My sense from this Board is that hot flash experience varies widely. Radiation created no problems I could discern. Best wishes!

NewspaperLover

Newspaperlover,

I participated in a clinical trial last week to identify the root cause for rise in PSA after having a prostatectomy 8 years ago. Using a non-approved radioactive tracer the radiologist found a soft tissue lesion, about 0.6 cm, within my prostate fossa. I am strongly considering Salvage Radiation Therapy.
I would greatly appreciate if you and others can share with me information as to side effects and quality of life issues experienced since treatment.


Lath42

Pre-op:
Diagnosed 9/2006
Radical Prostatectomy 3/2007, PSA 3.6 ng/ml

Post-op
Gleason 7 (3+4), pT2b., negative surgical margin, LNI and SVI

Current Status
Biochemical Relapse: 76 months after Radical Prostatectomy
Current PSA: 0.32 ng/ml, PSADT: 20 months

This is fantastic!! Best to you and yours. Continued PSA “undetectables” forever.

Kind of old thread, but Congrats to you Newspaperlover.

Lath...Which trial did you have? I just completed the DCFBC Pet/CT at National Institutes of Health in Bethesda. They're using a PSMA tracer. Waiting for the Dr. to call with results as we speak.

Lath42,

I have a friend who had surgery, and PSA did not emerge again for 11 years. He did SRT, and has been "undetectable" for nearly 4 years. I did not experience SE with SRT. As SRT is often accompanied these days with HT, you will find on this Board a variety of experience with HT. Best wishes!

NewspaperLover

Wampuscats,

I am assigned ARM 2 of the DCFBC PET/CT at National Institutes of Health in Bethesda for patients with biochemical prostate cancer relapse after definitive treatment.

1. For patients status post radiation therapy for prostate cancer, a PSA increase from post radiation therapy nadir
OR
2. For patients status post prostatectomy, a PSA > /=0.2 ng/ml
Nonspecific or no evidence for disease on standard imaging modality

I had a 3T magnetic resonance spectroscopic image of my prostate bed to establish a baseline. The radiologist found the soft tissue lesion as a result of the MRI. I am scheduled for the DCFBC PET/CT at National Institutes of Health in Bethesda on 12/15. Thee plan is to compare the two MRI's.

Lath