March 2008: DiagnosedAge 55 via Annual Physical Exam; PSA: 8.5; DRE neg.
Prostate biopsy: Prostate cancer in 16/18 samples. Gleason Estimate 8-10; DaVinci Robotically-assisted laparoscopic radical prostatectomy (RALRP) w/ lymph node dissection;
Dx: Stage III prostate cancer; T3b - Tumor (70% of prostate) with positive margins into seminal vesicles. GS 10 (5 + 5). Lymph node: negative N0.
July 2008 - Feb 2009: PSA undetectable
Feb 2009: Age: 56. Tomotherapy Image-Guided Radiation Therapy (IGRT); 200 rads x 37 treatments, 7400 rads.
July 2009 - Nov 2012PSA Undetectable
Nov 2012-Nov 2014 PSA slow rise from 0.09 to 3.91 while trying MPX clinical trial
Dec 2014Fine needle biopsy of bladder tissue swelling positive for prostate cancer; radiation already maximum rads to abdomen area. Stage IV: T4, N0.
Rx: Continuous androgen deprivation therapy (ADT) Casodex and Eligard.
Jan 2015at age 62 PSA 5.44 began Clinical Trial S1216 Phase III Randomized Trial Arm 1: Lupron + TAK-700, Arm 2: Eligard + Casodex. Selected for Arm 2.
I will say you've done a good job of tracking your disease. If I may ask, what made your doctor check your bladder?
My doc's knew I had a bladder blockage, but never told me. How did you feel, and how did your doc's take care of it. I'm very curious. I was in the ER just three weeks ago for it. Suffered for a couple years, and now I think it's blocked again.
I'm getting stabbing pains down yonder, like I had before. Let me know.
As part of my clinical trial, I got annual CT Scan. That showed a "thickening" in the bladder wall. I didn't experience any bladder blockage actually. Doc thought it was just a shadow but operator suggested a suspicious thickening. A fine needle biopsy of that tissue confirmed the spread of prostate cancer and precipitated the double continuous ADT regime that in a year "resolved" the thickening (in the CT scan one year later) and has kept my PSA at undetectable levels.
My bladder blockage experiences were trouble with the catheter in the two weeks following surgery, and some subsequent blockage post fine needle biopsy that "blew out" in the ER restroom while I was waiting for treatment.
Yes, though mine's strictly geographical. I live near Washington DC so have Johns Hopkins Prostate Cancer Center to draw on, including my Oncologist and the Clinical Trial involvement. Here's my facilities run-down:
George Washington Hospital; Dr. Jason Engle for DaVinci Robotically-assisted laparoscopic radical prostatectomy (RALRP) w/ lymph node dissection.
Sibley Hospital: Radiation Oncologist Dr. Gregory Sibley; Tomotherapy Image-Guided Radiation Therapy (IGRT); 200 rads x 37 treatments.
Sibley Hospital: Subsequent CT Scans, fine needle biopsy, infusion center for Eligard shots.
Good to hear of your treatment success. You started your Lupron treatment in Jan. 2015 and I'm not sure when you started your Eligard treatment. Did you discontinue the Lupron and switched to Eligard? Or did both? So which regimen brought down your PSA? I congratulate your medical team and you for having managed your treatment successfully. Your treatment doesn't seem to follow commonly used regimen... it's a sign your doctors are focused on you as a patient with specific advanced prostate challenges.
I misspoke perhaps. I'm on Eligard (not Lupron) and Casodex BOTH since January 2015. Eligard is the 3-month shot in the tummy, Casodex the daily pill. Onc calls it "Double continuous ADT" which means indefinitely (until failure, then stay on them and ADD another med). Together these two meds "resolved" the spread into the bladder wall (in one year), and brought my PSA back to undetectable (in three months) where it's held. Get a PSA check with my Eligard shot every 3 months.
Thank you for the clarification. I'm in a similar situation except I'm on 3-month Lupron shot. Thus far, my PSA has been undetectable for 9 months, knock on wood. After initial Ca treatment, my PSA rose to 7.8. It's this regimen that brought it down to .02 in 3 months, to undetectable in another 3 months. I took Casodex for only the first 30 days. So far, I'm tolerating the side effects. I get both chills and hot flashes, a few inches around my girth and loss of muscle mass. I counter with regular workout at the gym. I also play golf where I actually push my cart for 18 holes. The most bothersome to me is change to my sleep pattern. I have fewer restful nights and more frequent restless nights. The urgency and frequency of urination have gotten worse. I may have to eliminate my caffeine and alcohol intake which is moderate. There are times when I don't experience the urgency and at other times, I blot my pants before I can make it to a toilet. Like you, my onc/urologist (he's both) has me on the regimen for life until failure. His goal is to prolong my life and doesn't believe intermittent treatment is for my specific case.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Radiation v Surgery
PSA "undetectable" after one month on ADT; What about the PCa?
Chemo failed- Anyone with experience on Cabozantinib and Opdivo?
Did radiation cause new cancer?
Bioquimical recurrence after PRP, rescue radiation and now?
