Shoot me an email to [email protected]...
Tom: happy to discuss offline. Same..exact..situation...including a very very low decipher score of .12 Happy to discuss where I am at....
I love hearing about solutions to these lousy problems we are having!!! Do you mind us/me asking what medication Dr. prescribed for the ADD?...
That is great news to read!!...
Terrific news....
Hi. Yes, time for next steps. I would suggest a 1. immediate consult with a radiation oncologist...the time for your urologist has now passed, time to look beyond him for now. 2. Sending pathology...
Hoping you are well. You know that waiting until May will a. not impact any possible treatment, G-d forbid there is a recurrence and b. not impact your health... Go to Florida and enjoy...and we both...
Patrick, sorry you are going through this. What was your post-surgery pathology. I would also re-test pretty soon (why not tomorrow) to get it done. If you are at .2, you want to speak with a...
Djin, That decipher score is incredibly instructive. Not sure if you have seen the attached. Worth a read about the risks of high-risk clinical patients with low GC scores.......
very happy to hear this news!...
Rich. I might be very worthwhile to get a Decipher test on the post-RP tissue. It may instruct if/when you ever get salvage. Very important....
Hi. Similar situation. My suggestions mirror DjinTonic. 1. Worth sending the slides (or even better, have the tissue block re-cut) to Johns Hopkins for a pathology review. Might not change treatment...
That sounds like the perfect song for any day!...
JTwig. I am in Boston as well. Shoot me an email so I can email some thoughts etc. Best, Howard Gold EDIT: Howard, i removed your email address from your post. If left in, anybody can see your email,...
That is some really good news. Very happy to hear it....
You are making great choices. Adam Kibel is outstanding as a surgeon and Paul Nguyen is top notch RO. Best of luck....
Hi. Agree with all above---especially Dr. Epstein...one other suggestion would be to have slides sent for a "Decipher" test https://decipherbio.com/prostate/ which can determine the likelihood of...
Ken, hoping you are well and all looks good. Different labs, different results. Stick with the same one for peace of mind. Best, Howard...
Here is a ASCO article about lipitor and metformin....
I would see Adam Kibel, head of Urologic Surgery and Paul Nguyen (I would call him smartly aggressive). They are quality people and top-notch care givers....
Thanks everyone. Asked my PCP to put me on metformin/lipitor for off-label reasons to slow down PSA increase. Felt helpless seeing PSA increase and not yet time to pull trigger according to two top...
Grinnell86, i went on metformin 1700 mg/day and atorvastatin in March 10mg. lipids improved and today the psa dropped from .05 to .04. But isn't the metformin just masking the true PSA? It might make...
that is great news. Very happy to read this. Did you do ADT or just SRT? Was it offered etc etc. I am getting close to a SRT decision but I am going the statin+metformin route.... Interested in your...
Hi. I think the best way to think about this problem is that the lower the PSA burden, the higher the success rate of curative SRT. Once you have an established trend, that may give you the...
Prato Been thinking about you. Glad you are down in Florida and enjoying yourself. You deserve it, hoping you are feeling well!...
Prato, you have been in my thoughts. Glad you are getting this done and looking forward to you being done. Best, Howard...
Had my 3-month test and its still at .04 (since March). So i'm going to stand pat until there is another rise and then I will act. I see my uro/surgeon tomorrow for a little hand holding. He will I'm...
Third time is not a charm...met with Dr. Zeitman at MGH for a consult. Very nice guy. Unbeknownst to me...they reviewed my pathology from Dana Farber and...they found some G7 and close margins...so I...
Ken, Good luck tomorrow!...
Hi there. I think posting is unhelpful in your case. You know the facts. You know the data. You are informed. There is nothing any of the experienced and thoughtful folks here can add to the...
Tom: Who was your surgeon at Brigham?...
Hi TA. The tissue was re-cut and examined by Dr Loda at Dana Farber. He saw only 6. But Epstein could shed light. Decipher came in at... .12 so that is instructive. I think Dr. Kaplan is pulling on...
Had a consult with Dr. Irving Kaplan at Beth Israel today. He suggested starting SRT now...or at latest at next increase. No ADT. No whole pelvic radiation. just prostate bed. 68.4 GY. thought the...
great counsel and research TA. Agreed on all. Thank you....
Hi Everyone: The standard of care that appears to be developing is to add a minimum of 6 months ADT to SRT for...everyone. There appears to be "some" data that suggests metformin radio-sensitizes the...
Hi there All of what you heard, I heard as well. My RO would not want to treat until .1 He also wants a 6 month HT (with GS6) - the main risk factor...my age. He figures just hit it with everything....
Yes, that is exactly what he said. If I was 70, he told me we could talk each other out of ADT but at 50, why not just go all guns blazing and give it our best shot. Hard to argue with the thinking...
Hi everyone: Had a consult today at Dana Farber with Dr. Nguyen. Liked him a lot. So that part is done. He is not sure I am having a recurrence. Couple interesting notes: would wait until .1 to treat...
finally got the Decipher test back... .12 so that was a nice surprise. Meeting with RO at Dana Farber in mid-June after next PSA just for a consult.......
Prato, we are on the same path...why not make the appointment and go in and talk it out. You'll have another data point before you see him. Some of this is data driven and only retrospectively will...
Hi pasayten Couple thoughts: 1. Have you confirmed the Gleason 6 pathology. Might be worth doing. 2. Perhaps look into a Decipher genomic test (which may instruct further treatment). 3. I am sure it...
Thanks Chris Actually saw doc at Brigham and Womens. Pathology was confirmed G6 after re-cut and re-read. Decipher didn't come in because insurance wouldn't pay for it. Have to look into the why's...
Tomo: I was treated at Dana Farber/Brigham and Womens by Adam Kibel. Very skilled team there....
Prato: My sense is that he is not sure what is happening...wants to get more info with re-read of pathology (my idea) and Decipher (his idea). Offered me a 3 month follow-up, a referral to a RO or a...
waiting for decipher test results and pathology re-review. Anybody have an idea as to how long Decipher post-RP test takes to come in? Thank you all....
Philip, same question about pathology. We are on similar tracks although my psa has popped with no apparent reason. Doc has ordered path review and decipher and I will meet with him within month....
Had my 6 month check today. .04 seeing doctor this afternoon....ominous turn....
Hi Tom Sorry for the anxiety. A question...as my situation is a quite similar with exception of the positive margin. Why and how did this happen? "After my RP he did some genetic testing on the...
Hi We can do this... I am right there with you. I have a question about your PSA history. you were May15 0.01, Nov15 0.02 Feb16 0.04 May16 0.01 May17 <0.002 Are those the same labs? Was there concern...
Hi. With a detectable PSA with a Gleason 6, does anybody think I should be sending the pathology slides to Epstein for a second opinion? Surgery was at Brigham and Women’s Thanks...