Biological recurrence: Had radiotherapy... - Fight Prostate Ca...

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Biological recurrence

SammyNUFC profile image
7 Replies

Had radiotherapy in 2012, after biopsy revealed PC - PSA 29,9, Gleason 4+5, T3, later had bladder cancer with bladder plus most of prostate removed - positive margins found in the prostate, PSA now rising (0,3, 0,7, 1.8, 2,68, 4.8

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SammyNUFC
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MelbourneDavid profile image
MelbourneDavid

Hi Sammy. That's a really difficult set of experiences you have had. Gleason 9 prostate cancer is usually very aggressive.

If you are not already on it, the usual response is Androgen Deprivation Therapy for the rest of your life (or removing the testicles). Adding Zytiga has been shown to improve outcomes significantly.

A pelvic MRI might show a growth where the positive margin was, which could be targeted with a salvage treatment - cryotherapy, HIFU, or irreversible electrophoresis (IRE) are all options.

Dr_WHO profile image
Dr_WHO

Sorry that you are here but you will never find a better group of people. Extra sorry about having to deal with two different cancers.

You may want to look into following the Stampede/Latitude approach and taking Lupron and Zytiga (with prednisone) at the same time. Lupron shots down the testies from making Testosterone (the super food for prostate cancer). Zytiga stops production of testosterone from the adrenal gland (why you have to take it with prednisone) as well as from cancer cells. Over time some prostate cancer cells mutate to produce their own testosterone. Listed below are some references.

nejm.org/doi/full/10.1056/N...

ascopost.com/News/55700

Another great source of information for me is the downloadable booklet fro the Prostate Cancer Foundation. You can find the booklet at

PCF.org

You can also find up to date information on prostate cancer at

cancer.org/cancer/prostate-...

Please know that we are all pulling for you. You are part of our family. After all, people like us we have to stick together!

Hello Sammy, sorry to hear of your recurrence. I don't need to tell you your case is complicated. I am presuming that your prostatic radiation treatment was intended to be curative. It's unusual to have a prostatectomy following radiation therapy as I guess the radiation leaves the prostate somewhat scrambled. I therefore presume that this was done at the same time as the cystectomy, while the opportunity arose, as it were. Incidentally, I assume you have a urostomy

As you're probably doing anyway, the best thing is to discuss things with your urologists. I guess they'll have some ideas about what options are available for you. Also they'll know what's available in whatever country you're living in. Options are different in each country, what might be available in Australia or the US might not be available where you live.

It will help you have some idea what your options are and what the relative merits and disadvantages of each are if you follow the links Dr Who kindly provided. If you live in the UK, I can offer some more local.

You only indicate that the recurrence has occurred in the prostate site. If this is the case and it's only "advanced locally" then there's a chance it's still possibly curable, but I wouldn't presume to say what your options are.

I do think life long hormone therapy or castration is not automatic at this stage.

sammysusie profile image
sammysusie in reply to

My oncologist said that the cancer hs spread from the prostate to another site in my body, but the bone scan and ct scan did not show it up. Normally with Prostate cancer it spreads to either the bones or lungs. I am on active surveillance until my PSA reaches 20. I live in the UK. I have decided to forego HT treatment, as my quality of life was so bad last time I could not go through that again. When I had the cystectomy I did indeed have a bag fitted. When they also removed as much of the prostate as was possible (it was welded to the bowel due to the earlier radiotherapy) the urologist said that it as “riddled” with cancer - the radiotherapy had failed !

in reply to sammysusie

I'm sorry to hear that. It does appear that your options are limited. It is now, as you say, about your quality of life. I hope you are not on your own. I . Do some voluntary work for MacMillan. They are excellent. If you haven't already contacted them, I suggest you do.

SammyNUFC profile image
SammyNUFC in reply to

Cheers, I have my wife who has had to support me through this horrible cancer journey, as well as my 2 grown up children and my grandchildren. We just have to make the most of every day.

Lucky man to have such support. I did a mindfulness course a couple of years ago, offered free by a cancer charity. Mindfulness practice really helps you live and savour each moment. Takes the mind off the journeys end by enjoying the scenery as it passes.

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