Will it return?

[Ernie_Aguilar]

Good Day, everyone.  Not sure if I should be here because I am now cancer free (so far).  Short history:  diagnosed march 2014.  Life has been a blur since then so I am not sure if these are the right numbers but this is what is on the paperwork.  TNM pathhologic staging:  pT3b, pN0.  Gleason: 4+3=7/10.  Had radical prostatectomy.  They also took the seminal vesicles.  No other involvement.  I am on here, mostly, to get an idea of if and when the "beast" will show it's face again.  Thank you.

[Dr_WHO]

Thank you for your comments.  It does matter.  Two months ago I was "cancer free".  Now I am high risk cancer.  They will operate in 9 days but they are hedging their bets. It is nice to know someone that made it though the other side!

[Ernie_Aguilar in reply to Dr_WHO]

Good luck to you, Sir.  Try as it may, the beast cannot get us all.

[CERICWIN]

Nobody can predict if or when the cancer will return you may have a complete remission or it could return. I know it's difficult having something like this hanging over your head but it certainly is better then having an ongoing and active cancer.

The very best of luck to you.

CERICWIN

[pcasucks]

What were yourpost opp psa numbers, although my pathology report seminal vesicles evolved no margins I still had a post psa of 0.6 which was to high so adt plus 33 rounds rt along with two years ADT brought down to 0.01 currently 0.02. I would like to see it stay there but I'm not holding my breath. 

[Ernie_Aguilar in reply to pcasucks]

post surgery, 1 1/2 years ago, til now......psa <.013 ( or they say undetectable)...it may be< .13...don't have the labs in front of me.

[Hidden]

An important statement is "no other involvement".  This really means no other involvement KNOWN.  After prostatectomy, IMRT and one year of Lupron, my PSA was <.005 for two years with no treatment. My PSA then began rising and I started continuous ADT4 that has kept my PSA <.015 to present day.  Only time will tell whether or not the "beast" will be back.  Good Luck!

[motosue in reply to Hidden]

Hi clintmeek,

just curious, what lab do you use to measure your PSA?  My lab can only measure "less than .02".  And what does ADT4 include?  I should know this by now sorry. The best of luck.

Wilfred

[wellness in reply to Hidden]

Hi Clint....what is ADT4?  all I could find on google was an architectural design program by that name!  I am sure that is not it. I know what ADT is but never heard of ADT4.

[Hidden in reply to wellness]

The Austin Cancer Center, my oncology group, has their own lab and uses the Roche ECLIA methodology for their ultra-sensitive PSA test (as best I can tell from my lab results).

I follow the ADT4 protocol outlined by Chuck Maack, a great source of information.  See theprostateadvocate.com/obs...

Lupron to knock down Testosterone (less than <3 for me).  I take the monthly 7.5 mg injection to minimize hot flashes.

Nilandron(Nilutamide) 75 mg / day as anAnti-Androgen that desensitizes androgen receptors.  I was originally on Casodex, but it quite working.  

Avodart 0.5 mg / every other day as an anti-dihydrotestosterone.

Cabergoline 0.25 mg every other day for Prolactin reduction (desensitize androgen receptors).

I also take Metformin HCL ER 500 mg / day (off label per Dr Myers) - reduces O2 to PCa cells & reduces metabolic syndrone.  

I pretty much try to stick to a Mediteranean diet and exercise daily.

I assume that this site gives you access to my profile.  I'm new to this site from the Yahoo Advanced PCa Malecare Group.

Hope this helps, Clint

[Luvthemtrainz]

Hello Ernie.  I can tell you that the word for the rest of your life is "vigilance".  I, too, had mine removed via radical prostatectomy in 2008.  For whatever reason, a seminal vestical was left in there.  PSA was monitored twice a year.  It held ar zero for three years then began a slow incline.  It worked its way up to 0.4 and held that for a year.  Then, it jumped to 1.0.   After 40 radiation treatments, it's back down to 0.1.  The Dr tells me that roughly 25% of radicals end up with a return.

It's interesting to note that my PCP was not alarmed with the slow, then sudden rise of the PSA.  However, the oncologist wasn't pleased that it had gone past 0.4.  He said it's harder to stop once it's gone higher.  Seems as if the doctors have their own ideas on the best course of action.  Wish they'd come to a meeting of the minds.

Good luck, stay healthy but stay vigilant.

[rowboattom]

My understanding that 20 to 30 % will have advanced PC

[jimreilly]

Wouldn't it be great if we knew for sure that those of us in your boat were completely cancer free or not! There's that little holding of the breath every time we get a PSA update.....

[GARunner]

There is no way to know when it will show up again.  My numbers are somewhat similar to yours with a Gleason 7 (4+3) in 2 cores.  10/12 were positive.  I did have one seminal vesicle involved with positive margins.  For 17 months after radical prostatectomy in August 2014 my PSA showed undetectable at <.1.  Rise started in January this year with a .1 and .2 seven weeks later.  Now looking at next steps.  You did not give any information about your PSA history post surgery or your age.  While I am not a medical person, I would suggest you talk to your doctors about doing PSA's at regular intervals of every 3 or 6 months depending on past PSA's.  The vigilance can never stop.  It should not rule your life, but it must be given its due.  I have heard tales of recurrence as long as ten years post surgery.  If you would like to provide more specifics about age, PSA history, family history, etc. perhaps we can be of more help. Wishing you the best.

[Ernie_Aguilar in reply to GARunner]

Thank you for the info.....I am 54 years young :)....My first PSA was 5. That was the alert test.  2 months later it was 9.5.  Compared to some of the results that I have been reading about it seems low but my urologist seemed to be concerned.  My DRE was unremarkable.  Next thing I know I am participating in a clinical trial, CALGB90203, or Docetaxel and Androgen deprivation.  My liver couldn't handle the chemo so I only completed half of the treatments.  It makes me feel for all of the others, especially kids, that have to do chemo.  Then the radical prostatectomy with DaVinci.  I am currently being followed on a regular basis for the trial.