First 3 months on combined androgen blockade...

[Arcticfox44]

Hello - My name is Graham Colville. I'm a 71-year-old Canadian living in Cyprus and was diagnosed in March 2002 while living in London, England. In May 2002 I had radical prostatectomy at Sloan Kettering in NY. My Gleason grade was 4 + 3 = 7 and pathology showed spread to a seminal vesicle but otherwise margins were clear. After surgery my PSA fell to a nadir of 0.003 (Nov 2002). It stayed low until late 2007 or early 2008 when it went above 0.2.

I did not have any other treatment apart from surgery until Oct-Nov 2008 when I returned to Sloan for salvage radiation. Unfortunately this did not succeed, and in January 2011 I started hormone therapy in Cyprus with Suprefact shots every three months. This knocked PSA down to very low levels, almost undetectable, and I was able to take a treatment "holiday" from hormones until the spring of 2014.

At the suggestion of my oncologist in Cyprus, I had a PET scan in London in early 2014 which showed cancer in the left abdominal lymph nodes. We decided to try robotic surgery due to the apparently very limited location, and this operation in London at the end of May 2014 succeeded in reducing PSA from 7.0 to 1.0. As would be expected, though, it did start rising again in the absence of any treatment and in March 2015 I went back on hormones, this time monthly Zoladex injections.

Despite that, PSA did not fall below 0.3 in July 2015 and doubling time was quite rapid, so that by November it was 0.8 and by January 2016 it was 1.6. At that point we began combined androgen blockade with daily Casodex (bicalutamide) added to the monthly Zoladex shot. This has succeeded in holding the PSA to 1.9 as of March 11 2016, which my doctor believes is not a significant rise, so we are staying with the current treatment at least until a PSA retest in June. Overall I feel well and physically fit with few troubling side effects apart from the obvious one of greatly reduced libido. That's where things stand now.

Arcticfox44 20 hours ago

[JoelT]

Arcticfox44 ,

Welcome to the group. Sounds as if you generally have the cancer currently under control. Good,

Joel

[mklc]

Hello from Toronto,

We are Brits now living in Canada!! If you dont mind, can you advise the oncologist you are seeing in England. We are looking at going back to England for treatment. Sincere thanks.

[Arcticfox44 in reply to mklc]

Hello - Dr Stephen Morris at London Bridge Hospital. He is quite young and I have found him good to work with. Good luck!

[mklc]

Thank you so much.

Best wishes and good health to you.

Warm regards,

Marguerite

[durango]

I see you mention seminal vesicals that the cancer was invading that area I have been led to believe that I can only have hormone therapy and my cancer has recurred at the bladder base and seminal vesicals could you give me any advice regarding this as I am due to see the consultant on the 31st of this month and any evidence to the contrary would be of a great help or even the right questions to put to him regarding scans ect  best regards Dave .

 

[Arcticfox44 in reply to durango]

    Hello Dave - At the time of my surgery in May 2002 and the aftermath, which of course included the pathology report, the main thing about seminal vesicle involvement was that it served as a warning of a greater probability of biochemical failure in future: in other words, spread to a seminal vesicle or vesicles, as with spread to prostate margins and lymph nodes, tends to mean that the surgery "didn't get it all" and the disease will eventually recur. In my case margins and lymph nodes were clear at the time of surgery, and it was nearly seven years before my PSA rose to the 0.2 level commonly used as the threshold for biochemical failure. Am I right to assume that you have already had a radical prostatectomy? Have you had radiation, either in addition to surgery or instead of surgery? Have you had a PET scan which identified spread to the bladder base and seminal vesicles?

  

[Arcticfox44 in reply to Arcticfox44]

Sorry, I should have said nearly six years after surgery instead of nearly seven years. My PSA rose above 0.2 in early 2008.  

[durango in reply to Arcticfox44]

No I never had prostate removed I had brachytherapy I will be asking for a pet scan on Thursday I can only ask thanks for the swift response to my question best regards and I wish you well Dave 

[pete0550]

Hi Graham, my initial picture was very similar to yours. PSA 22, Gleason 4+3, only spread being seminal vesicle involvement dx November 2014. I live in the UK, York, and protocol was immediate ADT (Zoladex) combined with 37 day course of radiotherapy (17/3/15 to 12/5/15). My PSA fell rapidly to 0.2 in May 2015 and then to <0.1. Side effects were an issue, ED (although libido has remained OK though not strong), hot flushes, psychological problems. Had a couple of chats with Psychologist and lots of heart to hearts with my partner & sorted those. PSA reduced further and remained at <0.1 on Zoladex. Last saw my oncologist in Feb and was advised that I could come off ADT, which I decided (feels a bit like russian roulette decision) so now on 6 monthly PSA checks. Interesting that, with similar presenting symptoms, you had surgery but I didn't. I was told categorically that I wasn't a candidate for surgery because of the spread. So I am now off the Zoladex and await the next PSA with some trepidation. The hot flushes are still a problem and I have been warned they may never disappear. I wish you all the best and hope your next PSA is good. Pete