Mel's PSA result

Again,, another kick in the gut, but a mini one.

It has gone from 0.60 to 0.75 in one month. This is a tad over 3-month doubling time.

Just before my SRT, it had doubled in 2 months.

This was basically a test to confirm that HT failed. It has.

However, in Dr. Scholtz's notes, he basically indicated that when it rises above 1.0, it will be time for HT. In our discussions, he was clearly in the sooner-is-better-than later camp.

So, any opinions on starting HT?

I am thinking of NOT jumping the gun just yet, and doing another PSA in 30 days. I'll consider this a reprieve, but very temporary.

Incidentally, could it be the diet/supplements are slightly influencing my PSADT?

(OK, that's a rhetorical question -- I haven't done it that long, and we don't know if my PSADT has even changed, but I couldn't resist!)

Mel

 

Mel, I don't have any advice on when to start HT, but wanted to say that I'm sorry to hear the numbers have climbed a bit in the wrong direction.  If it were me, I think I'd do another in 30 days as you mention and hope that it's remained static or with a bit of luck headed back down at that time.   I hope the good effects of those supplements and life changes kick in big time.

Mel:

I'm also in for another PSA test for uou before considering HT.  I never began until my PSA had doubled a few times to a PSA of 3.44. I moved on it at that time for IHT. Presently on a vacation. In retrospect ( I feel it is the doubling pattern and not so much the number) I probably would have waited a little longer than rushing in as I did.  My same feeling with regard to SRT. Oh well.  I did what I thought was good for me at the time.  HT is pretty serious stuff.  Luckily I had few SE of a mild degree: fatigue, muscle loss, weight gain and loss of libido.  Exercise is critical.

Jack

Mel,

Sorry to read about your increased PSA.  This has got to be a very difficult time for you and your wife as you face the probability of HT.  Take care and hang in there...Tim

Hang in there, Mel.
best wishes...

Hey Mel, dissappointing for sure. All my hope for you.

David-- wait 3 months? I don't think so, if I buy into Scholz's viewpoint (which seems to be 1.0).

We are leaving for vacation on Sunday and will return the following Sunday. Day after that I have an appointment with Dr. Hussain at Umich. She is also a reciognized expert. My plan will be to get these two expert opinions. If they differ a lot, I will have to make a choice. From my own reading, I am in the sooner camp, but I sure don't want to be.

Mel

Mel, very sorry to hear about your latest PSA. You are in very good hands with Stoltz and I would clearly take his advice on when to start HT. However, I would expect it would be sooner rather than later. As you know I just came off of 12 months of ADT3. While it was no walk in the park, for me the side effects were merely annoying. We are of course all different in how we react, but my mental clarity remained good and I had no problem performing my job as I always had. Best of luck. BB

Mel

I to see Dr. Scholz. ALthough I do not know your stats he put me on triple blockade right away. PSA at time was .78 but had to consecutive rises from .2 to .78 in 6 months. I have full trust in what he is doing. I like his agressiveness.

Mel,

Sorry to hear about your PSA increase. No advice; just support.

Hang in there. I hope things turn around for you.

Jonathan

Wow, what a choice.

I continually ask myself if I rushed my RP, and coukd have enjoyed my pre-RP life a little longer with little or no difference in the ultimate outcome.

We see guys on here with psa's all over the spectrum, with few symptoms, or many symptoms, but who found good results with HT.

The six million dollar question can only be guessed at by us with 2 cent opinions. It appears that the medical community does not have a clear and convincing answers either, but maybe 2 dollar opinions.

I really hope you can find some respite from this decision on your vacation. My uneducated opinion is that you still have some time before you need to start the HT.

Goodlife

Mel:  Sorry to hear about the rise in PSA.  You are seeing what many consider to be one of the top five PCa oncologists in the country, he mentioned that he could help you get through eleven good years even with aggresive PCa.  If you were to walk in and ask most of the garden variety oncologists I'd bet they'd give the answer of 2 to 5 years.  That seems to be the stock answer most seem to give.  I would also guess that three years into the eleven he might even extend the years to fifteen or so because of new technology and medical discoveries being made.  The point is we can beat this stuff if we fight long and hard enough.

Here's something to think about, if you start HT at 1.0 it will take you much less time to get down to undetectable than the guys who start at 10.0 or something like that, which will mean that you will get a IHT break much earlier than the guy who starts at 10.0.  I guess what I'm saying is your going to do it one way or another, are you going to attempt to put it into serious remission or not.  Luckily you have a great Dr. who knows exactly what he's doing.  HT isn't easy but its not the end of the world either. 

My guess is that you've read Dr. Myers book but if you haven't its a must read for the trip you're about to begin.

Good luck

David 

 

Mel, It sounds like you have a very good plan in place.  Did you ever get another opinion on the feasibility of pelvic lymph node RT?  I remember you said that Scholz mentioned it as a possibility.  These are really tough choices aren't they?

Carlos