New PSA results, even more troubling

David; just read your news today and it ..SUCKS!!!! Do the HT!

Ron, you may be right, but I would think my most recent bone scan would show up any new hot spots, came up clean except for some old artithtis areas.

Sorry to hear the latest PSA results. I don't really have anything to add that hasn't already been said, except to say I understand your exhaustion with dealing with this thing.

Just the thought of embarking on additional doctor visits, uncertain treatments, uncertain side effects, a possible (if not likely) decrease in quality of life.  Without going into my personal details of an unrelated medical ailment that has plagued me for 20 years, all I can say is that I understand.  It gets very frustrating.

You'll continue the battle because that is who you are.  But it does seem relentless.  Best of luck to you, whatever you decide.

Dave

Sorry about the url

prostatecancerinfolink.net/2011/03/31/the-natural-history-of-biochemical-recurrence-after-surgery/

Post Edited By Moderator (TC-LasVegas) : 4/5/2011 10:40:29 AM (GMT-6)

Gee David, my son has been borrowing my laptop on and off over the last few weeks and it seems that each time I get back on you've copped another setback. There's nothing I can say that would make the news any less of a blow. But as usual you seem to be rolling with the punches ----- you're a better man than I am. I am quite sure I would be wallowing in self pity and snapping and snarling at my bad luck. I for one like your confidence in your main doc ----- you know the man and he seems to have been on the money so far. I hope you have reconsidered your position on HT ----- remember you can pull the pin on that at any time if it doesn't agree with you. The bone scan results were good so that's in your favour. Best of luck with your search for the good onco guy ---------- he might just be the one to break this chain of events.
All my best,
Bill

David, I also am sorry to hear your news.

I also am looking at HT in my future, not looking forward to it, as my uro said it would "turn me into an old man". He indicted that I should wait until a PSA of 10 before starting it. I have seen studies quoted here that indicate that starting HT early or late has no overall effect in survival time.

I know you also don't want HT, but others here have reported minimal side-effects, and it is reversible as other posters have said. If it has a too severe effect on your QOL then stop. It's another of those treatments that you don't know how it will work for you until you try it. Compared to what you have been through so far, it may be a breeze.

Another option is clinical trials, which I will ask my uro about at my next visit in about a month. It seems that with PSAs otherwise on a clearly defined upwards path, we would be ideal guinea pigs.

Good luck with whatever you decide to do.

Not the best news, no doubt about it. It hurt to even read the post. Despite the sense of calm you feel right now, I'd bet it hasn't quite sunk in completely.
I have only one thing to add. You've thrown 2 accepted treatments against your PCa. Your cancer cells avoided the surgeon's knife and laughed as it lurked just beyond the radiologist's beams. I'll make you another bet. Hit it with the third weapon of hormone treatment and odds are your variant is the kind that shrivels away. It was always just out of range of the first 2 treatments, but a systemic one may be the best form of assault against the slippery beast.
All blessings to your and your wife (and please take that honeymoon).

Still trying to figure out my new doubling time, confused about it.

Went from 1.24 to 3.81 in lets call it 7 full weeks. I keep coming up with different numbers

That lines up right, pro, casey came on chat night, and calculated 32 day doubling time. that is almost hard to believe, will have a third x.x point late in may to recalculate with. in theory, psa could be above 10.x by then if the rate stays this way. thanks for checking

David

Oh boy! What a nasty time for you.

You've done one bit of math, but I think the calculations that you will need to do are the very difficult ones that none of us want to be faced with, and they are not very scientific.
The question we all ask ourselves is: "how long have I got left?"
But the variation on that question is "how long have I got without treatment compared to how long with treatment?"
And if the treatment has side effects then the supplementary question is "what will those extra years be like?"

I guess some very tricky "cost benefit analysis" is called for to help you decide if HT is a "price worth paying", and it will have to be up to you to decide how you go about allocating value to all the relevant factors.

I can't remember who said it, but someone said that the thing they liked most in old age was waking up in the morning. But I think you have to wake up to a day worth living too. I want quite a lot of quantity when it comes to the number of days I have left, but I know I also want plenty of quality too. And I think you sound like quality is important to you.
If QOL is what counts, then it's quite reasonable that you make your decisions on that basis.

all the very best
Alf

David, the doubling time results we discussed last night calculated with the data you provided are shown here:  LINK

Keep in mind my comment that usually DT isn't calculated until three non-non-detectible values (>0.1) are obtained...so in other words, with more data in the detectable range, the result may change significantly.  But, this is how it looks with the data you have in-hand now.

Post Edited (Casey59) : 4/7/2011 10:42:24 AM (GMT-6)

 

David,

What can I say, I know what you are going through with my latest PSA at 3.5.  However, my doubling time is about 3 months since yours is at a month I agree with the others it may be time to try the HT.  At least you need to get to a good oncologist now, the time for waiting is over.  I also felt that the number 10 is the number where I would consider HT but if my next PSA later this month is high, I will give it a try.  Like the others before me have said if the side effects are more than you can take you can always stop. 

Jerry1

Hi David

Here is the information on time to castrate level.

In the majority of patients, serum testosterone increased by 50% or more above baseline during the first week of treatment. Serum testosterone suppressed to the castrate range within 30 days of the initial depot injection in 94% (51/54) of patients for whom testosterone suppression was achieved (2 patients withdrew prior to onset of suppression) and within 66 days in all 54 patients. Mean serum testosterone suppressed to castrate level by Week 3.

So with the one month shot the full effect is not achieved till 3 or 4 weeks.
So if you don't see a substantial drop understand it's full effect is going to start at 3 to 4 weeks.

My drop to 0.02 came after a couple of months on adt2

Best Wishes

Gerry