10 Year Anniversary

[dac500]

Exactly ten years ago on this day I had brachytherapy for prostate cancer diagnosed Gleason 3 + 3 with low volume (2 of 12 core cancerous 15% and 10%). About a month later,I remember going into a lab in my department ( I was the chair of the Physics Department of a university) and checking with a GM counter how radioactive I was. As soon as I brought counter close to my pelvic region, it started clicking wildly. At that point I was quite confident that prostate cancer wouldn't trouble me again.

My PSA went done quite quickly reaching a nadir of 0.1 by December 2012 and stayed there until June 2014. Then it started rising reaching 1.5 by July 2016.

The brachytherapy removed the cancer from the prostate, even now I have no cancer inside the prostate. Unfortunately, a spot on the capsule survived and was probably a higher grade. In August 2016, a biopsy showed a cancer in a mass outside the prostate and attached to the prostate. An MRI found a mass an inch in diameter. It was treated with cyberknife and ADT for nine months. From January 2017 until April 2018 my PSA remained undetectable (< 0.1).

Then cancer struct me again. My PSA increased from 0.2 in April 2018 to 3.26 in October 2018. Luckily, I succeeded getting into NIH study on a 18F-DCFPyL PET/CT. On October 20 I had an MRI that came out to be clean. But 10 or more abdominal and pelvic lymph nodes lighted up in the the PET/CT scan. On November 9, a biopsy of one of the lymph (the one that can be reached easily) nodes found metastatic prostate cancer. By middle of November 2018, my PSA rose to 4.48. On November 30, 2018 I started ADT for the metastatic cancer. Right now I am on my second break from ADT.

I am quite lucky that my cancer remained hormone sensitive for two and half years. Because of my advanced age (80+ ), I think I would die with my cancer, instead of from it. However, the last ten years have taught me that prostate cancer can move in many unpredictable ways. Nothing would surprise me. People told me ignore Gleason 3 + 3, it cannot kill you. But when you are diagnosed with Gleason 3 +3 you cannot be sure it is pure 3 + 3.

My initial mistake was to treat my cancer too quickly. I was diagnosed in March 2011 and treated in June 2011. A second opinion might have found the cancer that escaped detection.

I am very grateful to have access to this board. Some of the posts and replies to my posts help me tremendously.

[Tall_Allen]

I have a question...in December 2012, did you have a CT within 30 days after seed placement to assure adequate coverage? Talking to patients who have had seeds, it seems that is a step that is often skipped. What sometimes happens is that the prostate becomes inflamed during seed placement and the seeds are not where the brachytherapist thinks he put them after the inflammation subsides.

[dac500 in reply to Tall_Allen]

Yes, I did have a CT scan a month or so after the seed implant. My PSA did increase in size between volume study on May 5, 2011 and brachytherapy on June 20, 2011. I had an Xray and CT scan about six weeks after the seed implant and RO told me that everything looks fine. Two years later he told me my cancer was cured. I protested and told him "You mean in remission?"