Had surgery, had radiation. Am now on... - Advanced Prostate...

Advanced Prostate Cancer
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Had surgery, had radiation. Am now on ADT successfully!


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.

Initiated Eligard 22.5mg 3-month shot and Casodex (Bicalutamide) daily pill continuous combined ADT.

Feb 2015: PSA: 0.572

Mar 2015: PSA: < 0.064

Sept 2015:Began lower dose Effexor-XR 37.5 mg and reduced

alcoholic consumption.

Jan 2016Age 63: CT w/ contrast chest, abdomen & pelvis; resolution of thickening in bladder wall!

7 Replies

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.


in reply to Hidden

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.

Where were you treated?

Also, it would be nice if future posts included treatment facilities!! Thanks all. God speed.

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.

in reply to yope4

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.

in reply to Pguenette

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. 

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