Had my follow up PSA test what is next?

Ed, I believe that the odds are that if PSA stays in the undetectable range for an extended period (like it did for you) after RP followed by BCR, then it is most likely a small amount of PC that was left in the prostate bed. If on the other hand, PSA never got to undetectable or was undetectable after RP for only a very short period, it was probably already systemic and beyond the prostate bed. These are only the "odds" and not firm "rules."

best wishes

Thanks Casey. I hope you are right.
Here are my stats

A agree with Casey. The fact that you went undetectable for 32 months is a indication that PCa may well still be local and effectively treated with SRT. Check out Walshes book. He provides a lot of info on the issue. My PSA came back after 9 months and when from .01 to .07 to .28 over a 6 month period. I did SRT with HT because of the strong possibity that PCa had escaped the prostate bed.

EdC,

Regardless, its probably time to transfer some of your cancer care from your urologist to a good oncologist. Go ahead and start developing a relationship, before you might actually need it. I think that would make sense with what you might be facing.

As much as I loved my urologist (and we had spent over 50 visits together, lol), he had no problem relinguishing my care over to my oncologist once my SRT quickly failed. Because of my urostomy, I will always need to see my urologist for that reason at least 2x a year, but as far as the cancer is concerned, there is nothing more he can do to help me.

david

Ed,  Charles Maack, Us Too Wichita Chapter, compiled a list of best of the best prostate cancer physicians.  His list includes your surgeon, Dr. Fagin, and a medical oncologist, Beth Hellerstedt, Texas Oncology, Austin, TX (512) 302-1771.  If you find a good oncologist, let us know.  My wife and I grew up in the Lubbock area and we are always looking for an excuse to get back to Texas.

 

Carlos

Hi All,

I have been fighting aggressive bony metstaatic prostarte cancer for about sixteen months. I have been through about a 13 months of hormone therapies (Casodex, Ketocanozole and I'm still on Lupron) followed by three months of chemo (Taxotere).

These treatments were supplemeneted by several radiation teratments where it was felt that the lesions had appeared in places that posed a risk to me that may prove crippling or cause severe pain(lesions on several verterbrae that were close to spinal cord or nerve fiber bundle exiting spinal colum, top of humerus etc). Four pet and one bone scan have shown no appreciable slowing of the disease. I have to rely on pet and bone scans because the form of prostrate cancer I have does not seem to have any significant affect on my PSA levels or other markers typically used to track progress of the disease.

Because my chemo did not seem to help (there were four new lesions found and two possibles), as a result my doctor recommended I try Zytiga. UnfortunatelyZytiga costs $6000 a prescription, my cost would be about $2000 after insurance pays there share. Money I don't have.

Has anyone heard about Zytigta and how effective it is. I saw the results of a phase three trial on it and while it may impress researchers it didn't do much for me. If I intepreted the trai results correctly it added about 3 1/2 months to ones life. Additinslly, there was no indication that it offered any substantial benefit to the quality of liife during that period. So basically I'd be paying $2k a month to be stuck at home (like I am now) feeling exhausted, in pain (living on morphine) like I am now.

Has any one heard anything that sheds a more positive light on Zytiga. I ask this because Zytiga is offering an instant savings program that would drop my costs for it to only $20 a month until I use up $6000 of the plans benefits (I'd probably be able to get up to three months treatments) when I factor in my private RX insurance.

Anyway if anyone has info on Zytiga that they feel would be helpful to me in deciding what to do I'd appreciate hearing from you.

Also if anyone else out there is suffering from the same tpe of prostrate cancer as I have I'd love to hear from you to compare notes. If it helps I have an aggressive, bony forrm of metastatic prostrate cancer that has neglible effect on my PSA level and any other blood and hormone tests that are normally used to mark the disease progress. Hence the need for pet and bone scans.

BTW, my highest PSA ever was 6.1 and it currently sits at 0.18. My prostrate is the size of a pea so I personally believe that the prostrate is no longer source of th new lesions but that the cancer is now jumping from one bone to another.

I have to decide soon what to do so please feel free to respond even if you feel it may not be exactly what I'm looking for, I'appreciate it much

Thak You, Fred

email: [email protected]

hi fred
Welcome
First thing is some anti-spam advice. I suggest you go back to your post and edit it by clicking on the little pencil button in the top right hand corner and remove your email address.
I will try and start a spearte thread for your PCa question
Alf