Next steps after Prostatectomy?

[JPnSD]

After being diagnosed with Gleason 9 PCa...I went through Davinci Surgery end of August 2019 (I am 66). Appeared to be only in Prostate, clean edges, no seminal vesicle involvement...some micro evidence of PCa in one lymph node. 8 weeks after surgery PSA = .01 (undetectable)...then 3 months later = .05...and 30 days later = .04. I met with the Oncologist for the first time...he wants to wait until PSA levels rise (which he assures me they will) before taking any next steps. Has anyone received any proactive treatments or aware of them? I feel like I am sitting on a time bomb....in the interim I continue with my lifelong routines of healthy diet and exercise.

[tango65]

You could discuss doing prostate fossa and whole pelvis radiotherapy since you had a lymph node that was positive for cancer. If the cancer is located only in the pelvis, this treatment along with short term ADT could offer a very good control of the cancer. You still have time to decide since your PSA is very low and you could wait until the PSA has 3 successive increasing values.

itnonline.com/content/combi...

[Schwah]

If “he assures you it will” go back up it means he convinced there is still PC cancer in you. If so, why not start the fight now? I’d add Lupron and Zytega ASAP. And consider salvage radiation.

Schwah

[JamesAtlanta]

I would consult with a radiation oncologist that specializes in prostate cancer.

I had a prostatectomy, instead of starting with radiation, so that I preserved the ability to radiate if the surgery failed to remove all the cancer. If you were me, I’d be starting the next phase of my plan.

Please keep us posted. And I’m sure others that are expert on this site might have additional insight that can help you.

Best wishes your journey! We are pulling for you!

James

[Magnus1964]

Those small bounces in PSA could be due to inflammation, don't sweat them. However you would do well to be proactive. Radiation or ADT drugs are your choices.

This is a difficult choice. At 66 you could do well on the fill list of ADT drugs for many years. With radiation you have a chance of zapping your cancer and then go to ADT drugs.

[Tall_Allen]

With a positive lymph node, there's no point in waiting - whole pelvic salvage radiation plus 2 years of ADT

[pjoshea13]

Your instinct is to act, but there is no evidence that a preemptive strike at this point will benefit you. Available drugs are paliative - not curative. Drug resistance will occur. Best to keep them in your back pocket.

I have made a number of posts on a wide range of topics. I believe that some are useful for slowing progression. One place to start is control of subclinical inflamation. See:

healthunlocked.com/advanced...

healthunlocked.com/advanced...

-Patrick

[Hidden]

Proactive treatments? I ve followed a naturalpathic MD ‘s diet and nutrition plan for five years now. Half of this website doesn’t believe that diet and nutrition helps pc much . I am the opposite. I did the 50 mgs Vit- c Ivs twice weekly for my first two years with pc . I went into remission from #4 over four years ago . Don’t feel like you are the only to have a rise after a rp . I didn’t have surgery .. my urology was shut down with pc tumors “ the horse was out of the barn” I was told . That said , I’ve done miraculously well by most standards.The PSA is still minute. No panick . Easy to say , hard to do . I’m sorry for this uptick . I do have the feeling that you will deal with straight away and push the ol PSA down to where it now should be .. You are not doomed. Welcome to our club . Ask anything and you should get answers. IM not the expert . Just a guy with pc that can relate to your position ... Exercise live healthy and you can be around for decades. It won’t be pretty or pain free but you can live with APC for a long while. It’s a slap in the face and horrifying at first . In time you’ll adjust to the new you .. stress and anger feeds the flames . Enjoy your life to the fullest now. There ain’t no guarantees with treatments. You will do what the drs say is next . Please let us know what’s going on . The collective knowledge thru experience here is a great value to us all .. Everyone here can relate to each other .. Peace of mind to you brother. You life ain’t over . Just altered . Good luck ...Scott

[JPnSD]

Thank you to everyone for your responses and concern. I appreciate the wisdom of your collective experience...and wish all of us improvements...and peaceful days.

[j-o-h-n]

Greeting JP of northern South Dakota....

From Tall_Allen's post above:

With a positive lymph node, there's no point in waiting - whole pelvic salvage radiation plus 2 years of ADT

Follow his advice.....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 02/10/2020 7:21 PM EST

[JPnSD in reply to j-o-h-n]

San Diego

[j-o-h-n in reply to JPnSD]

My bad.... I was never good in geography....

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 05/18/2020 8:51 PM DST