Start of the Final Lap

So, six month PSA shows .26, up from .11 last June. Surgery in 2009 failed in 18 months, SRT did better -- "undetecable" for 2 1/2 years following radiation, but that nice run came to an end in December 2014 (history below).

My wife and I met with my oncologist at Sloan Kettering last week. Very serious meeting as you might expect, he was particularly emphatic about the doubling time. He prefers to hold off hormones for as long as may prudent, so no treatment yet and another round of scans and blood tests scheduled for the end of May. If mets are visible, then chemo + hormone therapy. If no mets, and PSA still below 2.0, probably no treatment, and see again in six months.

The most interesting thing about where I am at is the absence of a universally agreed "standard of care" for this stage of disease progression. Perhaps some day "big data" might be employed retrospectively to provide more guidance about this (recognizing the limitations of retrospective studies).

So, while the serious nature of last week's meeting was no surprise, I still could not help thinking of the epithet WC Fields had inscribed for himself: "On the whole, I would rather be in Philadelphia."

In the interim, my wife and I are about to embark on our traditional two month winter trip. This time, Ireland, Belgium, and capping off with two week apartment rental in Amsterdam. I have not been in Amsterdam in 48 years, but I understand the "coffee" houses are just as good.

Best wishes to all!

Newspaper Lover
Age 72
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—06/12 SRT plus HT (Lupron, Casodex).
07/12 – 06/14 Five six-month tests returned PSA "undetectable" and testosterone in “normal range”
12/14 PSA .06
01/15 PSA .08.
07/15 PSA .11
07/15 CAT and Bone scans find no evidence of metastases.
01/16 PSA .26
Next PSA and scans scheduled for end of May, 2016.
Currently receiving no treatment. Except an aspirin a day.

Tall Allen,

My physician at Sloan is Dr. Michae Morris -- I went to him because his practice focuses on men with the toughest outlook, that is failed surgery. In my case G8 too. My wife and I both think he is terrific, evidence based all the way. Which suits us. Best wishes.

Newspaper Lover

Cigar58, A little of both. Editor of my university newspaper, drifted into systems after school. Still love newspapers, sad to think what may be in 20 years. Best wishes.

Newspaper Lover

I suggest that you retitle the thread.... I think it is the Next Lap, not the Final Lap. There are a lot of treatments that are viable and, compared to many other, you have barely begun.

Have a great and worry-free vacation.