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Posted 1/12/2013 8:31 PM (GMT 0)
This is my first post after months of reading and learning from you guys, I appreciate your honesty, candor and humor. I am wondering if any one has experienced or opinions on the following psa rise.
Feb psa 11, biopsy gl 7, 12 for 12. Rp surgery may, pathology gl 9 sv yes, lymph nodes 0/3, now here is the thing... 6 weeks after psa 39.. Told "spurious" retest, same. Ht in July , psa in October 0.8, salvage radiation finished by Xmas, left illiac lymph node showed positive. Bone scans clear, ct showed only the one lymph node..... So how come the dramatic rise in psa after surgery? Any thoughts? Thanks.
Posted 1/12/2013 8:42 PM (GMT 0)
Any thoughts?

the only answer i can come up with is rapidly advancing aggressive cancer.

ed

Posted 1/12/2013 9:20 PM (GMT 0)
Let me say welcome to the world of posting - glad you decided to. When's your next PSA test? A Gleason 9 is an aggressive cancer. Hitting it with everything you've got makes sense.

The question is did the salvage radiation clean out whatever the surgeon didn't get or has it moved beyond the prostate bed.

Andrew
Posted 1/12/2013 9:23 PM (GMT 0)
with a gleason 9, and 12 of 12 positive cores, was likely from the front, that surgery would not get it, or get it all. other approaches other than surgery might have been better for you. with that kind of pathology report from your biopsy, a good meeting with a good oncologist (assuming you did), might have given you different options as opposed to having immediate surgery. but that is in the past, and you have to work with what you are working with. good luck. looks like your ht is working for now

david
Posted 1/12/2013 9:35 PM (GMT 0)
Thanks for the quick response, gl 7 prior to surgery and no evidence of spread outside prostate, hence surgery. Age 56 by the way, healthy. Seeing oncologist next month, will I expect to know then if salvage rad did the job? Psa bounce ???
Posted 1/12/2013 9:40 PM (GMT 0)
I see, the gleason went from 7 to 9 after surgery, misread that. Sorry. Unfortunately for a good percent of men, there have been upgrades in Gleason, once they have the entire prostate out for examination. At best, a biopsy is but a good 'estimate' of what is really going on. A few men get downgraded, but have seen more go up, then down over the past 4 years.

Please let us know what your oncologist reccomends at this point, doint the HT now is a good thing to keep it from climbing out of control.

david
Posted 1/12/2013 9:41 PM (GMT 0)
Great reply Purg!

Here, You won't necessarily get a PSA bounce. My husband never had one.
Aside from PSA test, I'm not really sure how one can tell if SRT did the job. I think the jury is out on imaging to make any determinations.

Best of luck in your journey. :)
Posted 1/12/2013 10:05 PM (GMT 0)
Thanks, while I am at it.... Thoughts on lupron only as opposed to double/triple blockade. Oncologist answer was to keep others up his sleeve. Wonder if hitting hard with everything may be better in my case, gl 9 etc.
Posted 1/13/2013 1:14 AM (GMT 0)
Here we go,

Well, then it's about time you joined us. Welcome to Healing Well officially. Don't wait forever the next time to join in. Ask away on anything.... And, unfortunetly, you had to join my gleason 9 group as well, didn't you. Well, it's been 3+ years for me, so hang in there.

What were your PSAs leading up to surgery? I got the 11, but were there other PSAs? Were you by chance taking Avodart or something similar before surgery?

You will get all sort of opinions on whether Lupron only, vs. ADT3, and other combinations. I started with Lupron, but my oncologist ultimately decided on ADT3.

Keep us updated...

Jerry L.
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