Clean for 27 Years ~ Then a relapse...

One of my best friends has stood by me since my diagnosis and has provided support I will always remember.  His father had prostate cancer in 1981.  His surgery removed the prostate and his testes (orchiectomy). He was 55 at the time.  Last month he was diagnosed with bladder cancer.  And last week after tests were completed, his diagnosis was changed to metastatic adenocarcinoma of the prostate, Gleason 10.  The tumor was negative for PSA, but positive for PAP...He will start seeing my oncologist soon.  An interesting note, they stopped doing PSA tests when he turned 75.  He is having a new PSA test today, and will have results next week.  I am not certain there will be a PSA since the tumor did not have any. 

His father lived to his 90's so he will likely treat it to some degree.  He is 82 now.  I find this story facinating.  27 years after surgery, he relapsed.  I don't know the details of his story in 1981.  There was no PSA tests.  He had a positive DRE test that led to biopsy.  I don't know the original Gleason, and back then is was not uncommon to do the orchiectomy with the RP.  I am trying to find out what the stage and Gleason were in 1981.

The only thing I can say is, don't skip those PSA's, and ask if a PAP can be run with it.

Sheesh...The patient is doing ok, he is an open faucet in regards to incontinence, and the bladder will be treated with radiation.  Further tests are being done to determine if the mets have gone to other organs.

Tony

Wow Tony, that is astonishing. I do remember one of our posters here (or was it YANANOW?) having a relapse (or at least becoming PSA detectable) after 15 years of undetectable readings following surgery. But 27 years! I guess it is a reminder to be well pleased if our PSA is undetectable following surgery but always remain vigilant. It is an eye-opener that the tumour produced no PSA but PAP was detectable. I shall ask about including PAP with the next PSA test although acording to this article, other things may produce a reading which may then cause unnecessary alarm.
adam.about.com/encyclopedia/Prostatic-acid-phosphatase-PAP.htm
I hope your friend's treatment works out well for him.
Bill

That's was some story, Tony. Feeds into my thinking that there really is never a 100% clear from prostate cancer. But to go 27 years is pretty amazing to me, to have that many more free years so to speak. Especially since I am less than 8 months out of surgery with clear pathology and may be looking at a reaccurance already. Already dreading next Monday's visit to the Radiation Oncologist. Since they are in the biz of radiation, sure they will want to push to start something, but I am still insisting that I have to be convinced that there is reaccurance.

David in SC

hi montee,
Pretty much. And it only takes one cell. Cancer cells are mutations that can live for quite some time. I spoke to them this evening, they thought it was gone for good. It is extremely rare for a relapse this long after treatment.

Tony

Tony, you made me crack up, you said "Cancer cells are mutations that can live for quite some time. I spoke to them this evening".

You speak to your cancer cells? lol. Do they answer back, or are they good listeners, perhaps this is a craft or treatment method you should teach us all.

Just kidding you, brother, but it struck me as funny how I read that.

David in SC

Les,
I can't answer that question, but like Joey said, there was a combination of things going on more than likely.

David, i meant to say that I talked to the patient and his wife. LOL...But I can see the typo.


Joey, mutated mutations...lol...but you are correct. Cancer is a mutation, and when it goes hormone refractory that is yet another change in the dicease.

Tony

I'm not surprised by this at all.
My father relapsed 23 years after his initial prostate surgery.
He was told that a small piece of his prostate was not removed and it had developed cancer.
If that is true than his second case may have been new and unique.
He got proton beam radiation for that and lived another 10 years.

I will bet that the relapse actually is shorter than the 27 yrs., it took 27 years to find enough or to have an issue that became detected and/or found. Likely it was there long ago but took this long to become aggressive and Gleason 10. Having orechtomy along with surgery would naturally be helpful against PCa, even done by itself as some patients have done so. Surely for having surgery and then having your _uts literally cut off has lost favor with the public, if everyone were told today that this is standard surgery(today), probably more radiations and alternative treatments would find customers.

This also shows why the words cure, and "we or I got it all" should be not be said to a patient in haste or so easily spoken out.  I noticed ,what I believe is the wiser and/or better docs do not actually come out say such words. They may say control or longevity and such verbage.

I literally cringe when I see posters or their wives go on and on about the surgeon says he got it all. Totally ridiculous, he cannot see PCa cells (unless it is tons of it) and cannot see beyond where he operated, etc. So with this limited wisdom the doc is going to say I got it all???? Maybe he bragging he got all the prostate out, even that task is difficult but kind of a no brainer (as that is why you went to him).  Maybe the I got it all means the insurance money or payment(lol), then I agree totally, yeah you got it all. Not against surgery as a realistic choice, just be totally informed and straight up about risks, rewards, side effects, healing issues and time frames etc.  (look beyond the docs sugar coated words, via using books, internet, second opinion(s), forums and such). The truth will set you free.