How to handle a relapse after treatment for prostate cancer

Marc B. Garnick, M.D., discusses what biochemical recurrence means and what your options are

“Am I going to die?” This is the first question a patient usually asks me when a follow-up blood test reveals that his prostate-specific antigen (PSA) level has risen after he has already undergone treatment for prostate cancer (usually a radical prostatectomy or radiation therapy). The fear is understandable: When PSA levels rise to a certain threshold after prostate cancer treatment, the patient has suffered what is known technically as a biochemical recurrence, sometimes also referred to as a biochemical relapse or stage D1.5 disease. Whatever term is used, it means that prostate cancer remains within the prostate after radiation therapy, that it survived outside the excised area after radical prostatectomy, or that it has reappeared in metastatic form in other tissues and organs. In most cases the cancer remains at a microscopic level, and many years will pass before any physical evidence of it is detectable on a clinical exam or any abnormalities are seen on a bone scan or CT scan.

That’s usually of small comfort to the patient whose PSA has risen. It’s emotionally traumatic to go through treatment for prostate cancer, thinking it is cured, and then learn that it might have come back. For many men, it’s as if they’re dealing with another diagnosis of cancer, except this time it’s much worse because there is less likelihood of getting cured. A man’s confidence and sense of safety may be shattered, especially because the popular misconception is that when prostate cancer recurs, it is deadly.

Which brings me back to my patient’s question: “Am I going to die?”

The simple answer is yes, eventually — we all do — but you may not die from prostate cancer. Of course, with prostate cancer, nothing is simple. This may be one disease, but it can appear in multiple forms, so every diagnosis or recurrence requires individualized assessment and intervention. To start thinking about the salient issues, see “Four key questions.”

Four key questions

If your PSA rises after prostate cancer treatment, answering four key questions will help you and your doctor determine next steps:

  • What were your risk characteristics, such as Gleason score, PSA, and cancer stage, at the time of diagnosis? (See Table 1.)
  • What type of treatment did you have? That will help determine your next treatment options.
  • How long has it been since you underwent initial therapy for prostate cancer? This helps indicate how aggressive follow-up treatment needs to be.
  • How fast is your PSA rising, as determined from several evaluations?

In practical terms, biochemical recurrence means that you are now dealing with a chronic disease, like diabetes, so that your clinical monitoring will have to increase and you may need to choose or adjust treatment to meet new challenges. Unfortunately, we don’t yet have sufficient research to provide clear guidance about when a second therapy (referred to as salvage therapy) should be considered after biochemical recurrence, and which type of salvage therapy is most effective in particular circumstances. (Salvage therapy is a terrible term, but I use it in this article because it is the standard name for follow-up therapy.)

For those who have already suffered a biochemical recurrence after being treated for prostate cancer — or dread each follow-up blood test because it might signal such a recurrence — this article explains what a rising PSA after treatment really means and what your treatment options are.

Table 1: Predictors of biochemical recurrence at time of diagnosis

Although a number of clinical factors contribute to your risk of relapse after treatment, the parameters below provide a simpler assessment of your chances of biochemical recurrence, based on your clinical profile at the time of diagnosis. For more sophisticated estimates, based on specific risk factors, see Figures 1 through 3.

Low risk (33% chance of biochemical recurrence within five years) Gleason score less than or equal to 6
and
PSA less than or equal to 10 ng/ml
and
Cancer stage T1c or T2a
Intermediate risk (50% chance of biochemical recurrence within five years) Gleason score of 7 (if 3+4)
and/or
PSA greater than 10 but no greater than 20 ng/ml
and/or
Cancer stage T2b
High risk (85% chance of biochemical recurrence within five years) Gleason score of 7 (if 4+3), or 8 or more
and/or
PSA greater than 20 ng/ml
and/or
Cancer stage T2c or more

Defining biochemical recurrence

As you are probably aware, both normal prostate cells and prostate cancer cells manufacture PSA. That is why the PSA level should fall to undetectable levels in men treated with radical prostatectomy, in which the prostate is removed, but is not likely to drop to zero in men treated with radiation therapy, even when treatment is successful. This is because after radiation therapy the prostate gland remains intact and can recover some function. This is also true if you received hormone therapy as part of your radiation treatment: As you recover, testosterone levels rise, and so does your PSA.

The real challenge is defining what constitutes a biochemical recurrence after a particular type of therapy. There is no consensus on this issue, but the working guidelines are summarized in Table 2.

Table 2: Guidelines for determining biochemical recurrence

Initial therapy PSA threshold Comments
Radical prostatectomy 0.2 ng/ml on at least two successive tests Some physicians continue to use a higher threshold of 0.4 ng/ml or greater
Radiation therapy (external beam or brachytherapy) Three successive elevations in PSA compared to nadir (low point), regardless of actual reading, according to the American Society for Therapeutic Radiology and Oncology Many oncologists use a working definition that biochemical recurrence has occurred if PSA levels are greater than 1–2 ng/ml 12 to 18 months following initial treatment.

Ideally, post-treatment PSA levels should be less than 0.5 ng/ml, but this is rare; levels of 0.6–1.4 ng/ml may occur.

Neoadjuvant hormone therapy and radiation therapy Unknown

Further muddying the water, it is not clear what PSA levels should be in men who have undergone neoadjuvant hormone therapy in addition to radiation therapy. Hormone therapy suppresses levels of testosterone; once the therapy is stopped, testosterone levels rise, and PSA generally increases rapidly until the hormonal environment stabilizes.

Moreover, some men who have undergone external beam radiation therapy or implantation of radioactive seeds (brachytherapy) experience a phenomenon known as PSA bounce, a temporary spike in PSA that does not necessarily indicate recurrence. Studies offer varying conclusions about how common this phenomenon is, probably because they use different definitions of what constitutes a “bounce.” Until more is known, if you have had some form of radiation therapy for prostate cancer and experience a spike in your PSA level, it is wise to ask your physician whether this could be a PSA bounce.

A common challenge

Rising PSA after initial treatment often comes as a shock to the person affected, but it’s actually a common problem. Studies indicate that biochemical recurrence affects roughly 15%–30% of men initially thought to be curable with localized treatment of prostate cancer. Certainly if you find yourself in this situation, you are not alone.

For example, a study published in the Journal of Urology, which followed 3,478 men who underwent radical prostatectomy for prostate cancer, found that 32% were likely to suffer a biochemical recurrence within 10 years. (The study actually followed patients an average of a little more than five years, but used actuarial tables to predict outcome at 10 years.) Another study, published in the Journal of the American Medical Association, examined the outcomes for 1,997 men who underwent radical prostatectomy and were followed for an average of a little more than five years, and found that 15% experienced biochemical recurrence in that time. (For further details about these studies, see “Biochemical recurrence after surgery,” below.)

Biochemical recurrence after surgery

Pound CR, Partin AW, Eisenberger MA, et al. Natural History of Progression after PSA Elevation Following Radical Prostatectomy. Journal of the American Medical Association 1999;281:1591–7. PMID: 10235151.

Roehl KA, Han M, Ramos CG, et al. Cancer Progression and Survival Rates Following Anatomical Radical Retropubic Prostatectomy in 3,478 Consecutive Patients: Long-Term Results. Journal of Urology 2004;172:910–14. PMID: 15310996.

Other studies indicate that a similar (or perhaps slightly higher) percentage of men treated with radiation therapy will experience a biochemical recurrence (see “Biochemical recurrence after radiation therapy,” below). For example, a study of 1,449 men with prostate cancer treated with brachytherapy, published in the Journal of Urology, found that anywhere from 19% to 26% experienced biochemical recurrence within 12 years, depending on the definition of recurrence. It should be noted that nearly half the men were also treated with either neoadjuvant hormone therapy or a combination of brachytherapy and external beam radiation therapy, which may have increased the success of treatment or delayed recurrence. And a study comparing the outcomes of 393 men who received different doses of external beam radiation therapy for prostate cancer, published in the Journal of the American Medical Association, found that 19.6% of those who underwent high-dose radiation therapy experienced biochemical recurrence within five years, while 38.6% of those who underwent conventional-dose radiation therapy did.

Biochemical recurrence after radiation therapy

Potters L, Morgenstern C, Calugara E, et al. 12-Year Outcomes Following Permanent Prostate Brachytherapy in Patients with Clinically Localized Prostate Cancer. Journal of Urology 2005;173:1562–6. PMID: 15821486.

Zietman AL, DeSilvio ML, Slater JD, et al. Comparison of Conventional-Dose vs High-Dose Conformal Radiation Therapy in Clinically Localized Adenocarcinoma of the Prostate: A Randomized Controlled Trial. Journal of the American Medical Association 2005;294:1233–9. PMID: 16160131.

Assessing your personal risk

Several factors contribute to your risk profile. One important factor is whether you have localized or more advanced disease at the time of biochemical recurrence. As indicated in Table 1, your pretreatment numbers such as Gleason score and pathological cancer stage will provide some indication of whether the recurrence is local or metastatic. Also important is how much the PSA increased within a given time period (known as the PSA velocity) before treatment, and how long it takes for PSA to double in value (known as PSA doubling time) after treatment.

For example, two studies that looked at the relationship between PSA velocity and post-treatment outcomes in men treated for early-stage prostate cancer found that men with a PSA velocity of 2 ng/ml or less in the year before diagnosis had a much better prognosis than those whose PSA velocity was greater than 2 ng/ml per year (see “PSA velocity and prognosis,” below). In a study of 1,095 men treated with surgery, published in the New England Journal of Medicine, investigators found that men with a PSA velocity greater than 2 ng/ml in the year preceding diagnosis were 50% more likely to experience biochemical recurrence than the men whose PSA velocity was less than that. These men were also likely to experience biochemical recurrence faster and faced a greater likelihood of dying from prostate cancer than the other men. In the second study, involving 358 men treated with external beam radiation therapy, published in the Journal of the American Medical Association, researchers found that men with a PSA velocity greater than 2 ng/ml in the year preceding diagnosis were 80% more likely to experience biochemical recurrence than the others, and less likely to survive (see Table 3). Similarly, post-treatment PSA doubling time can also be used to assess the likelihood that disease is local or metastatic and provide insight into prognosis.

Table 3: PSA velocity before diagnosis and estimated chances of survival

An analysis of PSA velocity in the year preceding diagnosis reveals that it can predict the likelihood of survival seven years after external beam radiation therapy. (Similar findings have been reported for an analysis of men who underwent radical prostatectomy.)

Overall risk profile (based on PSA, Gleason score, cancer stage) When PSA velocity is less than or equal to 2 ng/ml per year When PSA velocity is greater than 2 ng/ml per year
Low risk 100% 81%
High risk 96% 76%
Source: Journal of the American Medical Association, July 27, 2005.

When the post-treatment PSA level doubles in less than six months, for example, and certainly when it doubles in less than three months, the cancer has most likely spread and therefore requires systemic treatment. Research has also shown that the length of time it takes PSA to double can be used to estimate likelihood of whether disease will become clinically evident (detected by symptoms and scans) following biochemical recurrence (see Table 4).

Table 4: PSA doubling time and outcome five years after biochemical recurrence

A study involving 2,809 men who were treated with surgery and subsequently experienced biochemical recurrence (defined as a PSA of 0.4 ng/ml or more) found a clear relationship between PSA doubling time and eventual clinical outcomes.

PSA doubling time Percentage of men without prostate cancer*
Less than 6 months 38%
6–11 months 46%
12 months–9 years, 11 months 62%
10 years or more 87%
*No clinical indication of local or systemic disease, based on digital rectal examination, transrectal ultrasonography, biopsy, or bone scan.

Source: Mayo Clinical Proceedings, June 2001.

Of course, estimates of average likelihood of progression are simply that — estimates — and may not indicate what is going on in your own case. So to better determine whether your cancer recurrence is localized to the prostate or has spread elsewhere, your doctor will not only look at your pretreatment numbers, but also restage the disease by repeating some of the tests you had at the time of your initial diagnosis. You will likely undergo a bone scan and an abdominal pelvic CT scan. You may also undergo a ProstaScint scan, which uses monoclonal antibodies tagged with a radioisotope to identify metastatic prostate cancer in lymph nodes and other areas in the pelvis. It’s important to note, however, that not all doctors recommend such tests because in most men who experience rising PSA, these scans will usually not reveal any clinical evidence of metastases.

PSA velocity and prognosis

D’Amico AV, Chen MH, Roehl KA, Catalona WJ. Preoperative PSA Velocity and the Risk of Death from Prostate Cancer After Radical Prostatectomy. New England Journal of Medicine 2004;351:125–35. PMID: 15247353.

D’Amico AV, Renshaw AA, Sussman B, Chen MH. Pretreatment PSA Velocity and Risk of Death from Prostate Cancer Following External Beam Radiation Therapy. Journal of the American Medical Association 2005;294:440–7. PMID: 16046650.

Knowing whether and when to act

If your PSA indicates that biochemical recurrence has occurred — or if you are tracking your PSA closely, to determine whether you may need to consider treatment — you probably want to know what your options are. But as you evaluate options, consider not only what to do, but whether and when to act.

Unfortunately, experts don’t agree about when salvage treatment for recurrent prostate cancer should begin, or which salvage treatments are best. Of course, if you experience biochemical recurrence and the cancer appears aggressive — as indicated by your pretreatment risk profile (see Table 1) or a PSA doubling time of less than six months — your physician is likely to recommend immediate treatment, probably with hormone therapy, to delay metastases.

But many other men will find themselves in a gray area, with clinical profiles and PSA doubling times that are not sufficient to trigger immediate salvage therapy. If you are in this category, your physician may recommend waiting to treat until your PSA rises to a particular level. That means you may have more frequent PSA testing, which can be nerve-racking but is necessary to detect progression earlier. (For more insight into what this feels like, see “A couple’s story: Tracking PSA,” below.)

Although many men diagnosed with biochemical recurrence will want to take immediate action to stop the cancer, going ahead with therapy for the sake of simply doing something may cause more harm than good. The risks and complications of surgery or radiation, already high when delivered after an initial diagnosis of prostate cancer, may become even greater when these therapies are delivered as salvage after biochemical recurrence. Data are sparse on the side effects of salvage therapy, simply because not many studies have been done on the topic, but I always advise patients in this situation to consider that any complications of the initial therapy may be increased if their abdominal and pelvic areas are subjected to a second therapy. For example, some research indicates that the likelihood of developing urinary incontinence after prostatectomy is greater following salvage treatment (where it may affect 20%–60% of men) than when it is the first mode of treatment (where it may affect 2%–15% of men).

It’s also wise to consider the impact of further treatment if you have other diseases besides prostate cancer, such as diabetes, cardiovascular disease, or a pulmonary disease such as emphysema. If you do, it is likely that you are on medications for these disorders, and are already dealing with significant health challenges and risks. Undergoing additional treatment for prostate cancer may add to these risks, or may require that you readjust medications you are taking.

Finally, remember that you have time to make an informed decision about whether and when to undergo additional treatment for prostate cancer following biochemical recurrence. The evidence shows that you can expect to live for many more years. For example, the Journal of the American Medical Association study cited earlier, which reported that 15% of men experienced biochemical recurrence in a little over five years, also analyzed what happened to the men afterward. The authors found that it took an average of eight years for the cancer to metastasize to the bones, and the men survived another five years after that — for a total of 13 years, on average, after biochemical recurrence.

Remember that average survival times are based on studies of men treated in the past, and sometimes as long as 10 or 20 years ago. What’s more, some of these studies (including the Journal of the American Medical Association study cited above) included men who did not undergo further treatment after biochemical recurrence occurred. It’s likely that these men would have survived for a longer time if they had received additional treatment after biochemical recurrence was detected (although longer survival would come at the cost of treatment side effects). For these reasons, the “average” chances may be much better for a man treated today. And such averages can never predict what will happen in your particular case. That’s why, when I talk with patients about studies like this one, I encourage them to make decisions based on their own risk profile. As shown in Figures 1 through 3, your particular risk will vary, depending on factors such as PSA level at diagnosis, PSA doubling time, and Gleason score. Finally, when it comes to evaluating your options, much will depend on whether you were treated initially with surgery or radiation therapy, with or without hormone therapy.

Figure 1. Preoperative PSA level and freedom from relapse

Preoperative PSA levels and freedom from relapse

Source: Journal of Urology, 2004

Figure 2. Gleason score and freedom from metastases

Gleason score and freedom from metastases

Source: Journal of the American Medical Association, 1999

Figure 3. PSA doubling time and freedom from metastases

PSA doubling time and freedom from metastases

Source: Journal of the American Medical Association, 1999

Options for men who had surgery

How long after treatment it took for the PSA to rise and how quickly it rose provide important clues to whether it’s likely that your cancer is localized or metastatic. Generally speaking, the prognosis is worse for men whose PSA never becomes undetectable after surgery, or rises quickly a short time after treatment. Prognosis is better for men whose PSA rises slowly and begins to rise a long time after treatment. A few scenarios will help clarify what the options are in each situation.

Some men learn right away that they have residual disease. The surgeon sends any tissue excised during the operation to a pathologist for analysis. If the pathologist finds positive margins — meaning that he found cancer cells at the borders, or margins, of the excised tissue — this means that you may need to undergo radiation treatment to eradicate the cells remaining in the prostate area.

Scenario 1. Sometimes the PSA level never becomes undetectable after a prostatectomy. This situation, which is fortunately rare but among the most challenging to treat, means either that some cancer cells remained in the prostatic fossa (tissue left behind during surgery in the area once occupied by the prostate gland), or — more likely — that micrometastases had already spread beyond the prostate. A man in this situation may need additional therapy right away. The options offered may be radiation or hormone therapy, or both, or an investigational therapy.

Scenario 2. Sometimes the PSA falls to undetectable levels for several months following radical prostatectomy, and then begins to creep up. Typically, a man in this situation learns during one of his follow-up tests that he has experienced a biochemical recurrence. If the PSA level rises within the first year after surgery, it usually indicates metastatic disease. The treatment option most often offered is hormone therapy (either intermittent or continuous).

Scenario 3. The PSA does not begin to rise until a year or more after surgery. This is more likely to indicate localized disease, although it is possible that the disease has spread. Your treatment options depend on the PSA doubling time — how quickly PSA is increasing. If your PSA doubles in less than six months, and certainly less than three months, your doctor may recommend treating the area again, but this time with radiation or hormone therapy, in order to eradicate the disease.

Scenario 4. The PSA rises a year or more after surgery, but the doubling time is slow (a year or longer). This is probably the best scenario of all, as it indicates that the cancer may be localized and not aggressive. In this situation, you may opt for active surveillance — monitoring PSA and periodically having other tests, but not necessarily choosing an active intervention right away.

Salvage options after radical prostatectomy

Most men who experience a biochemical recurrence after prostatectomy and decide to undergo treatment have three options. The best strategy depends on your risk profile and comfort with side effects.

Radiation therapy

Many men opt to undergo salvage radiation therapy. Although few studies have been done to evaluate long-term results, many men do respond to salvage treatment. One study involving 368 men who had initially undergone radical prostatectomy, for example, found that five years after undergoing salvage radiation therapy, 46% remained free of biochemical recurrence, and 92% were still alive; at eight years, 35% remained free of biochemical recurrence, and 80% were still alive. Other studies have reported that salvage radiation therapy is likely to be most effective in men whose Gleason score, PSA level and doubling time, and other clinical features indicate less aggressive disease (see “For more information: Salvage radiation therapy,” below).

Side effects. Be aware that radiation therapy delivered after a prostatectomy markedly increases the likelihood of impotence and may increase the likelihood of incontinence. If you are already incontinent after surgery, then having radiation therapy is likely to make the problem permanent. For that reason, most men who become incontinent after surgery will wait until they regain control over their bladder or rectum before undergoing postoperative radiation therapy.

For more information: Salvage radiation therapy

Buskirk SJ, Pisansky TM, Schild SE, et al. Salvage Radiotherapy for Isolated Prostate Specific Antigen Increase after Radical Prostatectomy: Evaluation of Prognostic Factors and Creation of Prognostic Scoring System. Journal of Urology 2006;176:985–90. PMID: 16890677.

Sengupta S, Christensen CM, Zincke H, et al. Detectable Prostate Specific Antigen Between 60 and 120 Days Following Radical Prostatectomy for Prostate Cancer: Natural History and Prognostic Significance. Journal of Urology 2006;176:559–63. PMID: 16813889.

Stephenson AJ, Shariat SF, Zelefsky MJ, et al. Salvage Radiotherapy for Recurrent Prostate Cancer after Radical Prostatectomy. Journal of the American Medical Association 2004;291:1325–32. PMID: 15026399.

Radiation with hormone therapy

Another option is to undergo hormone treatment while undergoing salvage radiation therapy, because this may increase the effectiveness of radiation therapy.

Hormone therapy

If the PSA doubling time is less than six months, indicating that the cancer is aggressive, radiation therapy may not be adequate, as it is likely the cancer has already spread. In that case, a better option is a full course of hormone therapy, which can delay the time of onset to bone metastasis.

But other considerations also come into play. If you are sexually active and want to remain so, hormone therapy may not be the right option for you. Or you can opt for erectile-sparing hormone therapy, which involves a single agent like bicalutamide (Casodex), or bicalutamide and finasteride (Proscar) (see “For more information: Erectile-sparing hormone therapy,” below). Another option is to go on intermittent hormone therapy, in effect taking occasional “holidays” from treatment. This allows men to recover some quality of life while at the same time reducing levels of testosterone, which fuels the cancer.

If you are elderly (defined as having less than 10 years of life expectancy), you may not want the full spectrum of hormone therapy because it causes other complications.

For more information: Erectile-sparing hormone therapy

Boccardo F, Rubagotti A, Barichello M, et al. Bicalutamide Monotherapy Versus Flutamide Plus Goserelin in Prostate Cancer Patients. Journal of Clinical Oncology 1999;17:2027–38. PMID: 10561254.

Salvage options after radiation therapy

If your initial cancer treatment was radiation therapy and you experience a biochemical recurrence, the salvage treatment you choose depends on whether you received external beam radiation therapy or brachytherapy, as well as whether you also received hormone therapy.

Salvage prostatectomy

When one of my patients experiences biochemical recurrence following radiation therapy, the first question I expect to hear is, “Can we just go in and take it out?” Salvage prostatectomy is a possibility for some men, but it is not used often, simply because it’s such a difficult operation. Radiation therapy causes scar formation and the development of fibrous tissue in the treated area, so that a surgeon may be unable to distinguish among different types of tissue. It may be difficult, for example, to distinguish the specific boundaries of the rectum and the bladder because of prior radiation scarring. Some highly skilled surgeons can perform a salvage prostatectomy, but the larger consideration is whether it is worth doing at all.

One could make a strong argument that in most cases, rising PSA after radiation therapy indicates systemic disease, and any type of local therapy — even salvage prostatectomy — is not going to solve the larger problem of cancer cells that have metastasized elsewhere. For those cells, you need hormone therapy.

Salvage radiation therapy

In certain unusual circumstances, if recurrent cancer is found only in a limited part of the prostate gland, it may be possible to place radioactive seeds in the area to eradicate the cancer. The techniques for performing this are still under investigation, and long-term data on effectiveness are not yet available. Be aware that it is not known whether this additional radiation will increase the risk of other types of cancers.

Cryotherapy

Another option, also appropriate only when a localized area of cancer is found, is cryotherapy. This freezes the prostate gland to kill any remaining cancer cells. This highly specialized treatment is not practiced widely, and substantial complications have been reported.

Metastatic disease: Hormone therapy

If your doctor determines that you have a metastatic rather than a localized recurrence, hormone therapy is your best option — and it is appropriate whether you initially underwent a radical prostatectomy or radiation therapy. Before a man who has experienced biochemical recurrence decides to have hormone therapy, however, the first question is whether he has had it before. Some men who were at intermediate or high risk of relapse (see Table 1) and decided to have radiation therapy initially probably also had hormone therapy beforehand because this increases the chances that initial therapy will succeed. If the patient had a hard time of it, in terms of side effects, he may not want to consider hormone therapy again.

Hormone therapy works by reducing testosterone levels. Because testosterone fuels the growth and development of prostate cancer, reducing levels of this fuel helps stop cancer from progressing — or at least slows the rate of progression.

Hope for the future

Experiencing biochemical recurrence can be emotionally devastating — there’s no doubt about it. But research continues about how best to treat men who experience a relapse following initial therapy for prostate cancer, and it is likely that new therapies will emerge in the coming years. In the meantime, stay informed about your treatment options and work with your doctor to determine whether it’s time to consider some type of salvage therapy.

A couple’s story: Tracking PSA

Joe and Patricia Shields* have been married nearly 25 years. Mr. Shields received a diagnosis of prostate cancer in 2001, at age 57, and underwent a radical prostatectomy. In the summer of 2004, a routine blood test revealed that Mr. Shields’ PSA had doubled, from 0.02 ng/ml to 0.04 ng/ml. It held steady for the next few months, then jumped to 0.1 ng/ml, where it’s remained for more than 15 months. Mr. Shields has not experienced a biochemical recurrence (see Table 2). Even so, the Shields are concerned about the fact that the PSA level has increased at all, and find themselves living in a gray area, where medical science can offer little guidance.

Joe Shields: I mostly put it out of my mind. The day I go in to have the test done is hard. The day I need to call in for my results is hard. But otherwise I try not to worry about it. It’s not that I’m cavalier about risk. But I could spend the next 10 years worrying about dying of cancer, and then die in a car crash.

Patricia Shields: I think there’s a gender difference in how we cope. Joe says, “This is the hand I was dealt, I can’t worry about it, I just need to get up and get on with life.” Meanwhile, I have a female, “protect the nest” outlook. There isn’t a day that goes by when I don’t think about it.

In some ways, learning Joe’s PSA increased was much worse than the initial diagnosis. The first time around, you’re in shock. Then you think it’s behind you. But now it feels like something hanging over us all the time.

Joe Shields: One aspect of this that has been difficult is the ambiguity. When I was evaluating my options the first time around, there were guidelines. I felt like I could make an intelligent choice. But with PSA elevation after surgery, there are no clear treatment recommendations.

*Note: Names and some biographical details have been changed to protect this couple’s privacy. All medical details are as reported.

Originally published April 1, 2007; last reviewed April 22, 2011.

Comments
139
Jack Stopforth

I had radical surgery in October 2012 and was told in my first post-op exam that my PSA had not been fully eradicated and was measured at 0.01. Six moths later (June 2013) I was told it had doubled, but at 0.02 was still very low and should be monitored: only if it shows growth after 3 quarterly blood tests would my physician recommend radiotherapy or other salvage treatment. I want rid of the cancer and would rather have immediate treatment. Should I insist?

Bob

I’ll be 70 in January 2014. I had open RP on 9/7/13 after Gleason 9 PC was discovered in 2 of 6 biopsy cores on 6/24/13. Pathology was not good: Gleason 9, SVI, pos. margin and extraprostatic extension at base with Gleason 7. No PC was found in the 10 lymph nodes removed.

PSA two months later is 0.1, which is not surprising and not bad IMHO, all things considered. I still have minor incontinence and have ED which I had prior to surgery. So I’m biding my time at this point waiting to talk to my surgeon.

Michael Heinlein

I had robotic surgery 4/6/2013 showed lesson 8 after surgery with positive margin cut in on area by left blood vessel and never which could not be saved 3 month blood test showed less than .oo6 psa before operation was 2.9. No lymp node involvement no semen or bladder either. 6 month psa was 0.014 9 months .023 and then a 6 week test showed .04. Doctor wants send me to radiation oncologist next week for his info. What’s my chances what should I be looking at? What questions should I ask and is radiation the way to go. Should I buy green bananas ? Anyone have similar experience and how it turned out.

Patrick Dawson

At 52 I had a Prostatectomy in Nov 2013 with a pre op PSA of 53 and eventual pathology report after surgery with Gleason 8
38mm tumor apex to base and both sides of the prostate with Margin and Extension..I chose not to have follow up Radiation because my first Post op PSA was undetectable….told the stats of chance of reoccurence by the Oncologist which are the same as here 85%…I guess some very nervous months await me!!

Jerry

I had Gleason 7 (4, 3) I think it was 4, 3 any ways, I remember the combo was the best combo with T1C added in. It was found after my PSA hit 12 and two very painful biopsies. I was treated in the fall of 2011, proton beam. For the last three months my PSA has gone from 1.2, 2.7 to 3.8. I’ve undergone a bone scan, nothing, prostate MRI, nothing and tomorrow, a spinal MRI. Dr. wants to conclude that a accident I had, which scarred my spine, is just that, a scar. After that a biopsy then a sit down to discuss options.

I’m 65 years old very disappointed and confused as to what my options are. I feel that someone just put a medical harness on me. They tell me that at my age and, moving forward, it will always be something.

Vinnie StJohn

I had a radical prostectomy Dec 2012. 9 months later, my PSA rose to.2. 6 months after that rise, to .3 I was sent to an oncologist who did a PET and MRI with contrast. Everything was completely clear with the exception of a 1.2cm lytic lesion in my right proximal humerus. How can I have mestastasis with a PSA of.3? Also it’s lytic and not blastic.
Oncologist wants to be “sure” at the expense of open surgical biopsy which 2 other doctors disagree on. Lesion is metabolically active with an SUV as high as 5.5, yet X-ray reveal non-aggressive. I’m in no man’s land.

Don Jay

Hi, Im 56 y/o, 2 years ago I had RP via the da vinci robotic system. My highest psa was 6.44. Post surg, my psa was undetectable for approx 15 mos. Subsequently in Oct 13 my psa was 0.03, in January 14 it increased to 0.07 in May14 it increased to 0.10 and one month later this June it remains 0.10.
Path post surg indicates 0.9cm intra- postive margin w/ gleason of 4+3 . My urologist has referred me to the radiation oncologist, whom I saw last week 6/5/14. He is recommending radiation therapy. Your thoughts on if I should have the treatment as rx’d or should I take the wait and see approach. Your time and comments would be most appreciated, thank you very much!!!

Bob

I was stage pt3b gl9 at pathology post RP. PSA at two, five and eight months post op was .1, .2, and .3 respectively so I started lupron and IMRT. My Uro and RO both think PCa is still in prostate bed, but I don’t know why they think so. So I have taken the plunge hoping for a cure this time. What else could I do? Standing pat and doing nothing seemed like giving up. I have no PCa symptoms but side effects of ADT have started, primarily hot flashes, fatigue , upset stomach and bowels, and muscle pain. Side effects of SET have not begun. Can’t wait for those bad boys! I’m not sure I’ll get another three month lupron shot.

jim

hi,,i had surgery in 2002 to remove my prostate. 11 years later my psa went up to .6 had radiation treatment. 33 hits..had another psa three months later and it was .8 ouch..four months later it was 1.2,,now i am worried. so the doctor put me on horomone treatment..so far no side effects..but what i would like to know is why the radiation did not work…i am 68 years old…

Scott

Hi Jim, just wondering how things are going, I am in the same boat, any information would be appreciated.

Scott

CJ

Jim- My best guess is because the cancer is not where the radiation was targeted. I assume the pelvic bed was irradiated — were there scans that indicated something was there? Hormone therapy can keep the cancer at bay for an unknown period of time. If you want to try to pinpoint where the PCa is, you might want to try a different type of scan — research C-11 PET scans on Google.

GB

I had high dose radiation treatment via SBRT for my PCa, gleason 6 (3+3), 5/12 cores, all on left side. I was 50 when diagnosed and treated. I get my first PSA test next month and the waiting for results is difficult to know if it worked. I think I have 93% shot of it working but as difficult as it is waiting to know the results, I feel for those of you who have gotten the results and know the initial treatment did not take care of it. My prayers are with you!

Bud

30 years ago I had PSA of 18. I had seed implant to prostate and 6 weeks of radiation. Not broad band. All was fine for for 25 years, PSA today is only 0.50 ,however, the radiation has caused scar to bladder and prostate that has been terrible for past 5 years.Broken scar tissue and blood clots blocking my urine off and on for 5 years.Finally I tried hyperbaric oxygen therapy for 80 hours and stopped the bladder blood clots.Now 3 years laterand years and 30 years after original treatment I have same problem with prostate blood clots. The oxygen treatment did not work this time.i pass clots on a regular basis praying they will not block me. Some have,most don’t I am 87 years old and very active or was until my activity caused scar tissue to break off.My doctor has no good answers.I say think twice before radiation. It comes home later and bites hard.

helen collins

Goodday
My name is helen collins from united states, i am here
to thank Prophet Kasakika the powerful spell caster that rescue
me from CANCER . I was diagnosed of this disease in the
year 2012, and because of this, i was very unhappy with
my life, and i went into research on how i can get cured, i
contacted a lot of spell casters and none of them could
help me rather they scammed me and took away my
money without helping me. All this period of my life, i
was sad and unhappy so one day as i was in the internet a
decided to sign in a friend guest book, only for me to see
was a testimony of a lady on how she was helped by Prophet Kasakika so i was confused to contact him at the moment
because i didn’t want to be scammed again but after one
week, i decided to contact him, so when i contacted him,
he assure me that he will help me and i told him that
many spell casters has also told me this but they all
scammed me, he told me not to worry that he is going to
help me, So i believe in him because all i wanted was to
be cured, so he prepared a healing spell for me and told
me to wait for just 24 hours, after 24 hours, i went to the
hospital for test and to me happiness the test stated that i
was cured from the disease.. This gladdens my heart and
everybody in the hospital was surprised even the Medical
Doctor, So viewers Prophet Kasakika is a God Gifted man and can
help you to cure all types of sickness like HIV AIDS,
CANCER, PILE, Kidney problem, Syphilis and lot’s more.
You can contact him through his email on
(prophetkasakika@gmail.com ) or you call him
+2348129406564. For more details you can reach me

Jim

Like the other Jim (June comment) I had a radical prostatomy in 2003. Undetectable (<0.1) PSA until about 2010 then slow steady rise from 0.1 to 0.29 to mid-2014, now a jump to 0.42 in under 3 months. Abdominal CT and bone scans show nothing. I'm reluctant to start radiation so tomorrow I get a biopsy of (I think) the prostate bed. Then may have to weigh up risk vs reward – wait and see, or blast it before it goes any further? Can't say either option sounds good! I kind of hoped that the delayed and slow increase in PSA was a good omen but suspect that is probably unsubstantiated optimism.

john

Had a RPT on 8/31/10..Gleason of 4+3 and SI invasion. Went 3 years with an undetectable PSA. A recurrence of .07 to .1 ..Although still considereda low number to me any rise is not good..So..Had all scans they were all clear and opted for Radiation of the prostate bed with a total of 42 sessions over 2 months..after 3 months PSA was undetectable once again..Will follow up in 6 months but feel really good we might of got it for good..All it takes is a PMA..positive mental attitude to beat the dreaded rise in PSA..

zorro

Radical prostatectomy on 29March 2014.All margins clear.Psa pre-op 2.37.Psa post-op at 3 weeks forty-five.Psa at 6 weeks post-op seventeen.Psa 12 weeks post-op 1.29.Psa 18 weeks post-op 1.24.Decided to respond with treatment only when a doubling time excist.What tests can be done to be certain that the urologist did not leave prostate tissue behind during prostatectomy. Robotic da Vince surgery was executed.

John faro

See my comment today

Your the only individual that approach your diagnosis methodically and intelligently

Be well – John faro

louise

my husband had a psa of 25 which rose to 49 in three weeks. There was no sign of any spread. He then had radical surgery and it was determined that his gleeson was 6. His PSA went down to .4 and then to .111 over the first 18 months. Now it has gone up to .3. The doctor wants to see him in 3 months to determine whether it is a trend. I am very concerned. Is this a sign of recurrence? What are his options?

Michele

My father had a gleason score of 4+3 PSA of 6.9. Radical prostatectomy in 2005. 16 of 32 lymph nodes positive. Had hormone injections and radiation. 6 years later PSA started to rise slowly. Now at 9 years we are at 10.1. Since January his PSA went from 6.54 to 10.1 last week. I am scared to death that this is it and that we could have done something more other than watch and wait. He has no pain, is 74 years old and is very active.

Pauline

How do wives cope with testing every 3months after prostatectomy then a year later radiotherapy then 6years later a rise ,,that was 3 years ago bone scan clear…..the psa is now 2.95,,,,,
Husband has no symptoms but I am so anxious every 3 months..how do wives cope?

Sherry

Good question. For us, we stay busy. Very busy. My husband was diagnosed 12/2014. Radical prostectomy 9/29/15. All path reports were clear, first post appointment GREAT. .. We’re coming up on his next appointment 2/25. A little nervous, BUT. … we’re really staying busy.

nordin sahad din

Robotic prostatetomy was done in August 2009,at age 60,now am 66,first 3 years post-op follow ups psa was 0.01 starts to increase in December 2012,0.02 after every 4 months,0.18-0.23-043-(2013 reading)=0.39-0.42,latest 0.53(2014)repeated MRI and Bone Scan results are negative,but oncologist advice for radiotherapy,even after finger probe reveals nothing significant,another spcialist advice not to undergo the treatment,should wait and see,and monitor the future psa reading,basically I am fine and in good health,no urinary problems or incontinence,I am confused,PLEASE ADVICE,THANK YOU.

Caren Tidwell

My husband had 0 psa for years then after 6 years it suddenly went to 1.6 and the repeat in 4 months was 6.0 He was a Gleason score of 8-9 and a T3 at the original surgery 6 years ago. He is in poor health and can not walk 20 yards without resting, his legs give out on him and he is short of breath and coughs a lot. He is on dialysis. I have to dress him a lot because he is so weak. We just found out about the high PSA yesterday and go to the urologist next week…any guess if his has recurrent cancer and if so his outlook. I know it is just a guess and you have not seen him but what are the signs if it has gone to the bone or lung. Thanks in advance for answering. Caren

joe ragg

Gleason 10
radiation was the treatment psa was 2 at start
after radiation then seed implant psa 1
then 0.7
six month later 0.6
12 months 0.4
18 months 0.7 psa went up

what does this mean in layman’s terms

Jerry A

Diagnosed with prostate cancer in 2011 at age 63, Stage 2a. Had RP in September 2011 with PSA at 5.6.
Gleason score was 7 (3,4) with a tertiary small amount of 5. No positive margins, no lymph node involvement;tumor was contained and encapsulated. PSA remained <0.1 until November 2013 when it hit 0.2. In May, 2014 it hit 0.3 and in July, 2015 it hit 0.5. I entered a clinical study that had 2 Lupron shots over a 3 month period and Casadex regimen of 123 days. Had 39 Radiation treatments ending on November 17, 2014. PSA after start of hormones went to undetectable.
No significant symptoms during radiation. Hormone therapy left me with frequent hot flashes.
I was already incontinent from RP so present therapy didn't change incontinence.
Entering data of PSA tests into PSA Doubling time Calculator revealed a doubling time of 6.2 months.
Otherwise asymptomatic and hoping we got it this time

Jim P.

Diagnosed with P.Ca. at age 48 in 2008. Gleeson 6. Pre-surgery PSA was 3.1. Robotic RP in Novemeber 2008. PSA bounces around. First 2 readings after surgery .12 and .13 (after 2 months and 5 months). PSA fluctuated <.1 — .14 for first 3 years. Fluctuated .1 — .14 since Oct. 2011. Last PSA was .2 one week ago. Scheduled to have another PSAtest in 2 weeks. Assuming it will be .2 again.
Any advice?

Richard

Radical Prostatectomy (11.4 psa,9 gleason) in 2002 followed by 37 beam radiation treatments, and have been on 4-month Lupron for 12 years. PSA has been undetectable at every 4 month test. I am considering stopping Lupron(at least temporarily while testing psa every three months. Am now 68 years old, Type 1 diabetic for 18 years(on insulin pump for 13 years), and Ankylosing Spondylitis since 22 years old. Considering my diseases I am in good shape and strong. I worked a full career until 62 years old, now walk 2 miles daily with workouts, and do my own yard work. Any advice regarding Lupron stoppage?

Ben B

Diagnosed April 2004
Glesson 5+5 and PSA 8.

RP undertaken July 2004.
Jan 2005 PSA 5 Thus 6 weeks of Chemo.

PSA level at 0.1 (with slight variations ) until June 2013. Gentle but steady increases until this month, December 2014, up to 0.5.

I seem to fit the category where a relapse is active. 74 so slightly scared that may not have clarity to make correct decision and then follow through.
Life very active, work increasing. Comment and or advice would be really appreciate. Reading other posts is really useful and inspiring.

Great site, thank you.

Dave

My dad is 71 and had PC at age 63. Had it removed numbers stayed at .01 for 4 years the. Crept up to 1.4. He was given the 3 month shot to reduce testosrone which took his numbers back down to.03 for a year. He had some side effects like hot flashes that he didn’t like. His dr moved out of the area and he gets a new dr. Who says psa numbers are just that..numbers and that we can’t treat what we can’t see so with that he stopped taking the shots. Well 3 months ago he was a 3.0. Now today he is a 24!! The docs say they never have seen this before and are baffled. All scans and test show nothing. We are very concerned but what should he do?

Trevor Greaves

In October 2013 I had a RP using the
Da vinchi robot Gleason 7 clear margins PSA went from .01 to.018 in one year Dr sent me for a PSMA Pet scan which showed a small leasion at the surgery site margins were clear

Joe

Diagnosed January 2011 PSA 65, Gleason 9/10 no mets. 38 rounds of radiation and 3 years hormone therapy. Maintain negligible PSA throughout treatment <0.02. Finished treatment January 2014, 1st check up August 2014 PSA 0.5, 2nd check up January 2015 PSA 1.5, watchful waiting for next 6 months….advice?

jim

Started hormone treatment after 33 hits of radiation.Cause psa did not go dowm. Had CT scan and bone scan. Did not see anything. Psa 1.2 before hormone treatment. Now after two shots Psa is dowm to 0.05..radiaction doctor total me that Psa would go up and go down after treatment. It would take two years before the Psa would settle down. Wonder if doctor started hormone treatment too early or not. This all started 11 years after removal of the prostate.

Deanna

My husband had a RP by the DaVinci Robotic procedure in 2005 the PSA has risen in the beginning slowly now its gone from 191 to 332 its in his lymph nodes and bone but he opts for no treatment unless he has extreme pain in the bones where he will then accept radiation for the pain. He is still feeling pretty good so I feel this is a strange disease to grasp and it depends on each person how it reacts. I can never get a solid answer as what his survival time is and they probably don’t know but as long as he is feeling fine I guess that’s what he wants. So far I can’t find anyone on here that has that high of PSA so now I’m more concerned.

kevin

I had prostate cancer detected in 2008 from a biopsy. PSA levels over the previous year were bouncing between 5.5-7.5. Diagnosis was stage 1.
Three months after the prostatectomy(jan2009) the PSA was 3.5 and my urologist had a cow. Had more negative CT scans and 2 months later the PSA was somewhere ~2.0. Urologist put me on Proscar and went to another Urologist who did more biopsies and concluded there was a chunk of prostate tissue left behind from the original prostatectomy and that was the cause of the PSA. PSA continued down to ~.51 and I stopped taking the PROSCAR in early 2010.

After stopping the PROSCAR the PSA slowly went up and stabilized to between 1.47-1.11 between 2011-2014. In Feb14 I had to go the emergency room for a UTI and another urologist saw the prostate tissue and went in to take another biopsy. After the negative biopsy in May14, the PSA jumped to 1.67-1.81 between May-Dec14.In Feb15 saw a radiologist about Salvage therapy but the PSA went back down to 1.61. Radiologist is chomping at the bit for me to to do radiation, but seems a little cavalier about the risks (Didn’t even mention most in the above article). I think the PSA is still coming from the renegade prostate tissue and the urologists aren’t really very analytical. I also don’t think they understand the impact that stirring up prostate tissue has on PSA levels.
Sure wish I could find studies on what a ‘normal’ PSA would be for someone who had a chunk of prostate tissue left over from a screwed up prostatectomy. Don’t like the idea of doing radiation just in case.

Bobby Mac

Kevin,
I had prostatectomy on 4/20/16 psa 3 months later was 2.4.
Pathology report 2/10 nodes positive, positive margins and extracapsular extension.
Had 68 Ga PSMA scan showing activity in the prostate bed and a few poitive nodes.
I will do radiation and lupron.
Best to you,
Bob

Chris Redfern

I had a Prostatectomy in 2008 and have been having my PSA levels checked ever 6 months, and the PSA levels dropped with in weeks,to 0.05 and have stayed at, what i am told, a none recordable level since….I’ve been having my PSA tests now for 6+ years and have just started to have the test done yearly, the first yearly one i now have just received the results….and cant believe the results..the PSA level have increased….and doubled in a year to 0.1 and i am worried that after 6 + years i’m now going back to still having cancer.(recurrence) i am now and have been for some years been under my GP and am worried as i now need a referral to get back to a Urology department……

Madden

Age 52 : 2007 : PSA 1.7
Oct 2008 : PSA 3.11
Dec 2008 : PSA 3.71
Feb 2009 : PSA 4.69
Mar 2009 : Biopsy (8/12 infected) Gleason 7(4,3)
Apr 2009 : Radical Prostectomy
Jun 2009 : PSA < .1
..
..
Oct 2012 : PSA = .1
Oct 2013 : pSA = .2
Dec 2013 : PSA = .225
Feb 2014 : PSA = .234
Feb-Mar 2014 IMRT radiation treatment 38 sessions
Apr 2014 : PSA = .267
Aug 2014 : PSA = .336
Dec 2014 : PSA = .555
Mar 2015 : PSA = .674
Seems like radiation was ineffective
I confusion is : When to start hormone treatment.
Doctor says wait and see
I am anxious, waiting means allowing cancer to expand its volume and territories.
Any recommendations?
Would a 3D MRI buy anything
Lupron vs surgical castration to reduce testtosterone levels?

Thomas chiaruttini

I had lupron 6 months before radiation with psa 45 and Gleason of 9.

After the radiation my psa went down to 0. Got tired of side effects of lupron and stopped for 6 months. Psa went to 4. Started lupron and went to 0.2

6months later went to 0.9 and 6 months after that its 2.9. Have 5 months to see if it doubles sgain but i think i change ul to include casadex or use another type of hormone treatment.
Dont sweat it i just keep moving between test. We may have cancer but its manageable. My doc says. I try not to thi k about it.
Thomss

jim

chris,,,wow…sounds just like me….over ten years after surgery before my psa started back up…took radiation, 33 hits..the doc said dont worry about psa readings for two year,,,than we worry about psa than,,cause it will go up and down..well my other doc said we are not waiting…1.27,,month after a shot of lupron it when down to 0.06..after two shots it is 0.05..got two more shot and than it is a waiting game for sure…if it did come back than i am on the shot for life…ha…i cant tell you what to do…but i did not wait..kill it..right..the only side effects i have is hot flashes, which i am having one now..ha..and little weight gain..jim..good luck

jim

sorry chris,,,was not paying attention..madden who i was writing about..we are going thru the same thing..

Bill

Madden & Jim my dad is going through the exact same thing now. 15 years after radical prostatectomy his PSA level are now at 6. Salvage radiation is being recommended, CT scan negative, MRI scheduled…but they did not recommend hormone therapy as of yet. They said they would use that as a last resort for him.

jim

bill,,,good luck,,,remember one thing..they are going after the lymphnodes,,cause the gland is gone…..not saying my radiation did not work..but my doc went ahead with hormone therapy…just in case…but like i said only side effects is hot flashes and little wt gain..

Ken Smith

I have a rising PSA after prostectomy. What’s wrong with opting for old fashioned physical castration?

paula

Initial PSA 2834. Started hormone therapy and radiation. It was metastatic to bones, lungs and spine. After 6 mo on hormone therapy PSA increases from 16 to over 100. Chemo with docetaxel started for 6 cycles extended to 10. C diff has set in. On Vancomycin for 6 weeks while taking 2 more chemo treatments.

PSA went down to 18 now at 21. What would be recommendation for quality over quantity of life?

Peter

Four years ago I was found to have prostrate cancer had 42 sessions of radiation ,then had homo theorphy,for four years,the Tumor moved to the spine t4 I think,& found a spot on my pelvic,doctor said my cancer is aggressive t4 type of cancer or 1V should I say,Chemo did not work for me so I have being on Zytiga for the last two years,& this worked very well,but now my PSA has started to rise from .02 to 5.45 in the last two months,they the oncologyist think the Zytiga is stopped working,dose this mean my cancer is back,they are thinking oh external rad beams,they are not sure what to do next,the are going to run some more tests,I would like to know if you taught of cancer has returned ? Kind regards peter God bless

Russ

I want to enter this conversation.

I had a radical prostatectomy in 2006. My PSAs in the years that followed were never zero (to my chagrin), but they were low (hovering around .1). I was told by my family doctor and the urologist who did my surgery that it was nothing to worry about.

Last year the number started rising–at first .26, and then .76. Saw a cancer specialist who ran a CT scan that showed a “small mass” (how’s that for an oxymoron?) on my bladder. Again, he said not to worry–but after consulting with some of his colleagues, he called me back a week later and said that I should seek the advice of a (different) urologist.

Met with that urologist yesterday and he was the first person NOT to say, “Don’t worry about it.” I’m going to have a cystoscopy on Monday and he will take a biopsy. He has warned me that it’s likely (but not certain) to be cancerous, and that if it is, he’ll put me on radiation therapy.

As you can imagine, I’m not happy about this development. Looking for all the info I can find about similar situations.

KB

Diagnosed PC 5-15, Gleason 7(3/4), t1c,RRP 6-21, clear margins, getting first PSA results tomorrow, 8-31. Nervous as hell

Russ

RP in 2003. Slow rise of PSA and watched until rose to .35 and then had salvage radiation in 2011. PSA never dropped below .2 and now slowly rising to .58. Gleason 6 and seems to be 2-3 year doubling time. Wondering when to start hormone therapy or is I can continue to wait. If anyone has personal knowledge on whether the Choline C11 scan works and can find cancer for curative intent.

Jim

RP in 1995 (age 50)PSA undetectible for 17 annual physical exams in a row. I figured I was “cured”.

Two years ago PSA unexpectedly showed up at 0.6. This was so totally unexpected that both I and my family doctor (GP) never even noticed the change. Missed my annual physical last year. This year, PSA is 5.7.

So my PSA has increased roughly 10 fold in 2 years. Go figure. Right now I am in search of new urologist since I am loading up to move out of state – great timing eh?. I am open to hormone treatment, but radiation is going to be a hard sell. I have lived without sex for 20 years, but I don’t want to risk incontinence as well. I am 70. Most people in my family live into their 90’s. I would be happy to make 80.

Desi

My dad had a gleason of 7 and had surgery. 5 years later he’s had a reccurance. He’s had radiation and now his PSA is 1.5. What exactly does that mean? My mom is hysterical because no one seems to have the answer. I’ve looked all over the web an no one has answers as to what it means after surgery AND salvage treatment AND the PSA is still there. No one’s PSA levels are what my dad’s are…could someone please help me…?

Andrés

Desi,

Please do not panic, there are always other options. Looks like your dad could probably go for hormone therapy next; this is something that you should discuss with his doctor. Best wishes!

Victor

Medical care is not a perfect science
It’s a crap shoot All is in the hands of
The Creator God Bless all

BC

Husband had robotic rp 2 years ago followed by 33 radiation treatments because psa was not as low as Dr. Had hoped post surgery.
Psa’s:
Pre surgery: 28
Post: 1.8
Post radiation: .02<
Has been doubling last 3 psa's: 1.8, 4, 8
Has had 2 rounds of CT and Bone scan..both times clear.
Is considering a study. Not sure what to think here. Need some help, He is having some trouble with the possible side effects of hormone therapy..can anyone help with some REAL effects and not just the "maybe this and maybe that happens with this treatment".
He feels better than he has in 5 years and has stopped all prescription and otc medications in the last 12 months just to clean out his system. He thinks that it is impossible that he has any cancer in his body, but all indications are that it is in there somewhere. How long before it shows up? Leaning toward study…but he doesn't want it to effect his life, work, etc. HELP!

Jim

See above story. I had my PSA retested. It went from 5.7 to 6.3 in 10 days. I guess they would just call it a six. Anyway, it was no fluke.

Saw a urologist in Florida yesterday. He said radiation after PSA is above 2.0 has not been shown to be worthwhile. My only choice is hormone therapy, but the side effects are horrible. Going in for my scans on the 19th. The idea is to delay hormone therapy as long as possible, and then decide if maybe I do not want to do anything at all. Hard evidence that any of this stuff actually prolongs a person’s life is sketchy and theoretical at best. I would actually opt for surgical castration over chemical castration to lower my PSA scores.

Desi

My dad’s PSA is now 1.8 after waiting 4 months. Based on what I’ve read online, after surgery and radiation and he still has a PSA rising, he’ll never be cured. Just gotta keep it at bay for however long we can.

My mother and I are both disabled and cannot take care of ourselves. He makes the money. On our own, our SSI checks will not support us. My mom is talking suicide because she refuses to live without him.

On top of that I have Lupus that could flare at any time.

Anybody got and friendly advice for me? Cuz last night my mom was looking up ways to shoot yourself properly online.

ED

Desi,

I can’t imagine what your mother is going through but there is always hope. My PSA has risen from 1.4 to 2.3 in just the last 3 months (10 months after Proton Therapy). I am expecting to go on to hormone therapy as I intend to fight the disease as best I can.

I will pray for you and your family,

ed

Lorreen

Hi Ed, I was sad to hear (and surprised) that your psa had risen after proton therapy. I have been reading about proton and it seems to have such better outcomes than other treatments. This seems to not be your experience? My husband had prostatectomy 1 yr ago and now has recurrence….I have been wishing we had known about proton therapy back then and am considering paying out of pocket for it as a salvage treatment. Would you not recommend it?

Robin

My husbands PSA was 9.6 during pyhsical in December 2009, by the time he saw the urologist less than 1 month later 11.7
RP via DaVinci, positive margins with a Gleason of 9 (4+5)
After regaining urinary control, underwent salvage radiation. For 5 years his PSA was .01 rising to .02 in January 2015
July 2015 it had risen to .56 6 weeks later to .67
Negative CT of abdomen and pelvis, negative bone scan. Has anyone else gone thru this same scenario? I have noticed most people have said their scans were also negative after treatment and recurring PSA. Are there any other tests that he should have? I have forgotten his T score, but know it was very aggressive. Thanks in advance

Maher

here is a chronology of events in my case:
75% kidney function Loss at age 49.
3 procedures to stabilize the kidneys. Kidney disease settled at stage 2.
no heart beat for 20 seconds due to morphine overdose at hospital.
Blood clot; on levonox for 6 months.
Finally diagnosed with Stage 4 metastetised prostate cancer (Gleason 10, PSA 36).
Hormone therapy (Lupron every 3 months for life).
3 months of chemo (taxoter) PSA dropped to almost zero before the 3rd session, clinical remission.
49 sessions of radiation.
Provenge.
9 months on Xtandi (PSA went up to 10 after 9 months)
2 full body scans showed no sign of cancer)
One week later urine was full of blood. Cancer was too small to show up on any scans. Cystoscopy/biopsy showed cancer on bladder wall.
Up until this point (2.5 years after diagnosis I was body building, no stimulants/steroids ever) full of strength and energy.
Surgery to remove bladder & prostate unsuccessful, had to settle for Illium divergence.
4 months on Zytiga, PSA went from 0.9 to 2.9 This month. Turns out different test facilities use different machines/different calibration. Retest showed PSA 1.2. Plan for next step pending.
I have 3 young kids, still go to work and coach two soccer teams. My wife has seen me at my lowest points through all this. I keep crawling out of every relapse. Why? only God knows. I follow the doctor’s advice religiously. I watch what I eat/drink. I was jucing like crazy in the beginning, turns out that the vegetable and fruit juice lower the acidity in the body. Cancer loves acidity, and cancer cells commit suicide in alkaline body, so they say. I do it anyway. I promised my wife that I will fight to the end despite all my weaknesses and frequent desire for the end. From the beginning I took the role of a soldier going into war, I will either survive and come home or die in battle. No difference. If there is one word I would want on my grave stone, it would be “Defiant!”thats the only way you can stand up to this bully called cancer. for those of you who have this disease or supporting some one who does, stay defiant and keep hope. progress is made ever day. God doesn’t forget anyone.

Hassan

You are my inspiration and the very rsoean I am filled with so much hope after my own recurrence this year. I am climbing along with you in spirit and praying you have a wonderful experience in Africa. Much love to you, Monsignor. You touch so many people’s lives on a daily basis truly Grateful that God brought you into our lives.

Merlin

RP at age 58 in 2000. Gleason 7 (4+3), PSA 4.2, Stage III

I’m now 73. In 2013, PSA was 4.2. No symptoms. Had testicles removed in November 2013. In six months, PSA was 1.4. A year later it was .03. A year after that, 0.07.

Got another needle stick today and will get results in 2 days.

Mahmoud

I had robotic prostatectomy five years ago. My PSA has been steadily increasing to 0.9 as shown in blood work done 2 weeks ago. My family doctor is referring me to a urologist. I’m expecting two options; radiation or hormone therapy. I’m 55. Anyone knows of any medical advancement other than these two awful options?

James

Aged 56, PSA 14, Gleason 9. RPT in Sept 2014 with nerve and lymph node removal, 1st PSA 0.08, increasing weekly. All scans and there were many were all clear. Lymph nodes, seminal vessels, gland margins all negative, docs really confused. PSA climbed within weeks to 0.5 and was rushed in for salvage radiotherapy combined with hormone therapy. Drugs triggered Myasthenia Gravis..so put on more drugs. Got married 3 months before PC was identified. Put on steroids for the MG and combined with the hormones for the PC, added 2.5 stone in weight, in months. ED, incontinent and radiotherapy messed up my bowels. Post radiotherapy, my 1st PSA was <0.03, just had my second blood test today, so tomorrow will be interesting. My wife has been my rock, she never expected 3 months into marriage to see her new husband unable to walk 300 meters without being out of breath, checking before any plans as to where the nearest toilets are located. So, I go to the gym every day to fight the cancer and the MG, I have stopped the drugs for a while (my choice), as I want to be me again and wherever this ends, I hope to keep my dignity. God bless you all, fight on to the end.

Ntombizethu Dlamini

My dad is 81 years old. In 2011 he was diagnosed with prostrate cancer. Zoladex had to be administered for every three months. We were told that PSA had dropped to below zero. In 2015 November he had to change doctors. The second oncologist tested PSA and discovered that its in a range of 7. He suggested Radiotherapy. We are scared of it as we have seen some men passed on after Radiotherapy. We are undecided at this moment of whether we allow Radiotherapy to be administered or not. What could be the advice?

John

At 81 most health providers are more cautious regardless if they admit it or not. If hes doing quite well that’s a plus for him. For one they know life expectancy is about his age. And second, at that age they expect pneumonia or something else to step up to the plate. Hope that is not a harish statement for you, but have seen it one time to many. But I would ask about hormone treatment and see what they say if not already brought up. I’m not familiar with remaining many options. Im a not doctor but if he is vibrant, functions well, has positive outlook on life I would look in to it. Granted very, very tough call with a loved one even if he’s confined to wheelchair, depressed etc, you usually want them around as long as possible. I understand, lost ALL my family to cancer. There’s just me and my sister left. What brutal, punishing disease this is. Hope it goes well for you.

Jim

So far:
Diagnosed with PC July 2012. Gleeson 8 PSA 45
Radical prostatectomy Sept 2012. Positive margins and left incontinent and with ED. One year of monitoring PSA but it never got to undetectable level.
Salvage radiotherapy began Sept2013 and PSA at Dec 2013 was undetectable (>.02)
Since then I’ve had surgery to my bladder neck because it scarred up and I couldn’t urinate. That hurt! The incontinence became much worse after the operation and I was using 8 pads per day. I’ve now been fitted with a mechanical urinary sphincter and this has given me back control of my water works. I can highly recommend it to anyone who is suffering severe incontinence.
Unfortunately my last PSA test showed a small rise to 0.05 and I’ve been told that no action will be taken until it gets to 0.2 Don’t know how long that is likely to take.
I am now preparing myself mentally for the next step which will be hormone therapy. Sometimes I find it very difficult to cope with it all despite having lots of support from family and friends. I know I should be positive and get on with life but it’s not always possible. Cancer is a terrible disease.

John

I am 64 years old. I had rising PSA over the course of 3 or 4 years, but didn’t want to deal with a prostate biopsy. I don’t like going to doctors or getting poked with sharp things. So I put it off until my PSA went from 3.8 to 5.5 to 7.8, at which time my doctor said no more watchful waiting. The urologist did a biopsy which showed 3 of 8 biopsy sites positive, Gleason of 3+4. Had robotic assisted radical prostatectomy Feb. 2013. No lymph node involvement, seminal vesicles negative, margins negative, slight capular penetration. PSA tests were <0.02 for 6 months. Began to rise at 9 month check, from undetectable to 0.2 to 0.3, 0.5, 0.72, then 0.9. At this point, underwent 7 weeks of radiation therapy (35 treatments). Again, PSA <0.02 for 6 months. Last March, 2015 (9 months after completion of radiation therapy), PSA started rising again. Went up to 0.12, then 0.32, and 0.64 in July 2015, at which point I had a PET/CT scan, which was negative for cancer spread. Just had a PSA test last week December, 2015, and now it is 1.97, five months after the 0.64. So it’s tripled in 5 months. That would indicate a rapid doubling time and fast PSA velocity. Not sure how to proceed. There are negative side effects to hormone therapy. Will probably do more imaging at some point to look for spread of cancer. But not sure what else to do at this point. Hormones vs. waiting to start hormones. Don’t know. Very disappointing, though, when PSA started going up again each time, first after RP and then after 7 weeks of radiation therapy. Any advice? -John

John

John
I’m also John my story is in here. My RP was 11-17-15. I have been getting some hope from many of these stories. I have a friend who at age 60 discovered stage 4, that was 7 years ago. Gets regular hormone shots, his negitive comments have mostly been hot flashes. Others have indicated quote ” messes with their brain.” What that means exactly I have no idea. But he puts in 50 hr work weeks. Active in car clubs. He’s African American and they are hit the hardest with COMPLETE nightmare disease. Hard to believe if you have to pick a cancer this seems to be top choice. I may be on hormone myself soon, who knows. First app coming up in Feb, for now I wait. My advice do the hormone especially over radiation. Sadly something has to kill you, but there has been hope for many from this worthwhile site.
Good Luck

jim

john, cant say much,,,but i had my surgery 13 and a half years ago…10 and half after surgery my psa started moving up…from .1 to .2,,,when and had a ctsan and a bone scan,,all neg…waited and it kept on going up to .6 when and had 33 hits of radiation therapy,,three month later it was .8,,,waited 4 more months,,it was 1.2…so doctor said we are not waiting and i started my hormone therapy june of 2014..after one month it went from 1.2 down to 0.07,,six month later it was 0.05,,another six months and it was 0.02…get my last shot next month..each shot is for six months…starting in july it will be a waiting game…now when i got my 33 hit of radiation the doctor there said dont worry about psa for two years cause it will go up and down..but the doctor i have said dont wait and i did not..now each of us are different..i have only weight gain and some hot flashes..i cant tell you what to do…but me i did not.wish you luck,,,jim

Alan D

My journey started about one year ago through ‘normal’ medical check up which found I had a prostate that was firm and a had a lump. Prior to this I had regular PSA tests which showed no abnormalities for my age and did so right up to my RP. (I am now 72)
The biopsy showed I had 5 out of 10 positive and a Gleason score of 8. I was given three options by the Urologist: Do nothing, a RP or radiation. I then saw a specialist oncology radiologist; the option of radiology first would preclude me from a RP after this treatment. The reasons were fully explained to me at the time.
I elected to go for a RP.In hind sight the possible bowel problems were never fully explained apart from medical mishaps and I did not visualize how difficult recovery process would be. The August RP resulted in three days in hospital and then many weeks of recovery, now five months later my sleep patterns, bowel and bladder still are far from what it was. My three monthly test and visit to the urologist showed I had a PSA level of 0.04. Now the wait and see has started to a follow up PSA test at three months and at six months.
Radiation? At the moment I am not sure if I want to go down with that option.
I need to look at the percentages of fixing the problem, the average after effects I can expect and the velocity of the PSA change (if any) and the time span that will give me.
I live in Australia with free medical care so this has cost me zero and they even paid for travel and accommodation for my wife whilst I was in hospital. The consultants and care I have been given has been first class has was the stay in hospital.
What the future holds? I do not know, but which ever way it turns out I have had a very good life with a great and very supportive family and look forward to a long and happy time ahead.

Alan D

THANKS TO DOCTOR JENNIFER OSINACHI

THANKS TO DOCTOR JENNIFER OSINACHI

Hello public,
i bring you good news, My name’s venessa james. I’m 55 years old living in Germany,berlin, In May of 2007, I had a heart attack and subsequently had a double bypass. As a result of the heart surgery, for 4 plus years, I have been plagued with chronic debilitating pain from a maligned sternum and post sternotomy neuralgia/syndrome. I was ingesting copious amounts of various pain killers 24/7. They barely touched the pain. I spent my days in agony, waiting for evening so I could try to sleep. I took sleeping pills nightly in a futile attempt to escape the hell I was going through and failed miserably. Within 2 hours of taking the pills, I would awake in agony.

Fast forward to July of 2011. Already coping with 2 spots of skin cancer on my collar bone, I was stunned when I was diagnosed with Anal Canal Cancer. (This is the same cancer that took Farrah Fawcett’s life.) Following 2 surgeries, the doctor told me they did not get all the cancer and I would have to endure a regime of radiation treatments. I started researching what this would entail, and attended a intake meeting at the Cancer Clinic. I was informed that “this is the worst area of the body to radiate”, the radiation beam would hit both my coccyx and pubic bone potentially causing permanent damage.” They would try not to hit my spine,but i went online and i saw a post of mr mohammed whom had same sickness with me and was helped by doctor Jennifer osi,i contacted the doctor online and i send them money they had to send the drug to me online though i never believed it will work until i used it,to my greatest surprise it works under a week and three days.i was so happy and now am lively again and i decided to direct as many people to her.this is her email address(jenniferosi1@OUTLOOK.COM)you can also contact her because good works needs to be advertised.God bless you madam thanks.

jim

hi all….just got my last shot,,,wow…psa was 0.06..lowest it has ever been…next psa is in july. than every 4 months to see if it has settle or start to rise…if it stay down no more shots,,,whew,,but if it starts back up…hit .4 than back on the shots for life..the only think that i got was hot flashes and weight gain…it takes about a year for it to wear off…cant wait,,lol…

Phil

Aussie Phil.
( age 71 )8 years ago I presented with PCA of 24 Gleeson 4/3 -7. High risk prostate carcinoma. treated with Radiotherapy consisted HDR brachytherapy 19.5 Gy in 3 fractions.plus, External beam radiotherapy 50.4 Gy in 28 fractions. 4 years later with no other treatment my PCA had risen to 10.19. Started Hormone treatment consisting of an injection every 3 months for 2 years ( cost per needle $1100 au dollars. )Government picked up the tab. I payed only $6.50 per needle. Went off the hormone treatment because my PSA had dropped to 0.03 six months later my PSA is rising now 0.17. I have decided to watch and wait because I know the hormone therapy will fail after time and there is nothing left for me. so , its a juggling act.

Ralph wilson

Hi Phil.
Thank you for your story.
I was diagnosed with PC, in late 2012.
I started Radiating Therapy and Lupron quarterly shots, in early 2013.
It is almost 2017 and my PSA has risen to 0.12.
My doctor says if, my PSA rises to 3.o, I will need to start Chemo.
Plus my urine test indicates a CT Scan is necessary and Cysoctomy.
Looks like they suspect cancer of the bladder, but not sure.
I am not in any discomfort.
Anything similar happen, to you?
Thank You.
Ralph

Bill

I had surgery 6 years ago, Gleason score was 6, margins clean. In the last 14 months my PSA went from undetectable to 5.54. I just got the test results 2 days ago and am in shock. My GP is testing again and the soonest I can get into a urologist is 7 weeks away. How concerned should I be?

jim w

bill, question,,the minute your psa got to 0.2 to 0.4,,something needed to be done than,,why wait till it got to 5.54,,,sorry but i would be getting on someone right now..dont wait,,,get a another GP..and get to a urologist now..when mind it 0.2 i had c scan and a bone scan..than 33 hit of radiation…please dont wait…

carrie vincent

Thank God Almighty that lead me to Dr Al-Jamali in Dubai, My brother lungs cancer has been cured by Dr Al-Jamali. My brother has been through chemo 3 times, but this time his condition was getting worse that I was afraid it will kill him. When a friend of mine directed me to Dr Al-Jamali at: (drjamaliremedycenter@gmail.com ) where I could buy the medication from, because the Dr Al-Jamali has help cured his own Brain tumor and he strongly recommend that he would helped me with my brother cancer and cure it completely, I never believed the story, but today, with thanks giving in my heart, My brother lungs cancer has been cured within the Dr Al-Jamali hemp oil and I want you all to join hands in appreciation of the great work that is been done by Dr Mahmood Al-Jamali , he is the man that saved the life of my brother with hemp oil, thanks to him. for all those who have problem relating to cancer and other diseases should contact him through his emai(drjamaliremedycenter@gmail.com) I’ll keep thanking him because his God sent to save my family that was at the stage of collapsing all because of my brother cancer, if you have cancer is time to save your life thanks everyone again bye.

chris

If a psa test reveals that antigens are circulating in the bloodstream, how can it be said that cancer is contained within the prostate.

Alan Davis

Alan D

Following my previous post, I had a RP in August last year. A PSA test three months ago came up with a 0.04 reading. A follow up test last week had a reading of 0.09. After consulting my urologist by phone the GP says I have to wait until my test and appointment in June. The gist is that consideration will then be made for further tests then possible hormone treatment. The key to further treatment is a PSA reading of 0.2 – 0.4 My preference would be for castration if given the option. All things health wise are good apart from this rising PSA reading.
Alan D

Mike sheth

Why no one talks about Orchectomy or sub capsular Orchectomy. It is safer cheaper and less side effects.

Gielie van Aarde

To everyone,that contributed to this most informative article,thank you.To those fellow humanbeings,with this dreaded disease,someone said these words of support to me,remember,while you are alive,everything is possible.Regards,Gielie van Aarde.

Bill T.

Fellow PCa brothers – Please consider other options before allowing urologists to do blind biopsies or RP. They are trained to do blind (unguided) 12-needle biopsies as their “standard of care” for diagnosis. Instead the first thing you should do is get a 3T multiparametric MRI from a *competent* facility and radiologist. IF (and only if) the MRI indicates suspicious areas, then follow up with an MRI-guided biopsy which can be precisely directed. Blind 12-needle biopsies make NO SENSE since they can easily miss cancers, giving you a false “all clear” signal which can delay treatment and cause serious consequences.

Today there are something like 29 different options for PCa treatment, and each case is different. If your urologist suggests Radical Prostatectomy, go find a competent oncologist that will look at the full spectrum of treatments available before making any decisions. RP may be the urologists’ “standard of care” treatment, but it has serious irreversible consequences like ED and incontinence, and it should be among the last options you consider.

I highly recommend the website inspire.com and the US TOO community there. You’ll find people in the same boat as yourself who are very knowledgeable and unbiased (unlike most urologists).

Read the book “Invasion of the Prostate Snatchers” by Blum (PCa patient) and Scholz (MD Oncologist). It is now a little dated for some of the latest treatments, but it is spot on with its advice about being wary of urologists’ diagnoses and treatments.

It’s your body…inform yourself before allowing anyone to make choices that you may regret later.

Dina K Branham

husband gleson score is back up 28.6 he was dianoised 2009 just found out to day that has 4 x sence last visit need to find a new treatment please help

ROY GOREE

HAD MY PROSTATE REMOVE IN JULY 25 2014 WILL BE TWO YEARS THEN.APRIL 13 2016 MY PSA WAS 0.4 WHAT ARE TREATMENT OPTION

Rob Freitas

Hi my name is Rob. Thanks to all of you who have done meaningful posts here Diagnosed with PCa in 2010 at the age of 60, never had high PSA, highest it got was 3.46, but rising a small amount every year at regular physical, and my PCP saying he felt something on DRE but PSA too low to be alarmed about. After some urinary bleeding decided to see urologist who after biopsy diagnosed cancer with Gleason score of 8, a second opinion at Dana Farber in Boston said the Gleason was 7 (4+3). Opted for radiation and hormones as both RP and EBRT had same survival rates for me of 80% and EBRT seemed much less side effect laden. Have had low PSAs since therapy, but over last year PSA went from .4 to .9 and rad onc doc felt lump on prostate on DRE. In Nov had MRI which showed high likelihood of cancer throughout prostate followed by 14 core biopsy which showed 12 cores with cancer.

After discussion with rad onc and a surgeon it was felt that a salvage prostatectomy was my best option. Has lots of surgical risks associated with it due to the scarring from the original radiation and definite impotence and a high likelihood of incontinence as well. The surgeon does maybe 1 monthly, I did get a second opinion from another urologist who felt that I should go with that surgeon. Anyway…scheduled for surgery yesterday and turns out the surgeon was double booked and I didn’t have the surgery and wont for another 2 weeks. I am using this time to take a fresh look out there for information. Has anyone had a salvage prostatectomy post radiation and willing to share information? Thanks Rob

Dennis

I appreciate the information and the style in which Dr. Garnick presents his material. The posts by Dr. Garnick address the key questions men have. The material is informative but also sensitive to the feelings and emotional concerns of men going through prostate cancer. I have not found the in-person doctors who treat prostate cancer to be as helpful and supportive as this.

john

PSA started rising appox. 5 years ago went in for biopsy no cancer found.Another 3-4 years go by PSA up to 4.9 than 5.4 another biopsy FOUND CANCER Gleason score was 6 non-aggressive wait and watch approach.Couple more PSA’S GOING UP TO 7 does another Biopsy and camera cancer not spreading but decided after talking to doctors to proceed with seed implants as they say with gleason at 6 have 98% success rate.Praying it was a good advise.God bless everyone on this board

Bob

May 2013, PCa per biopsy, Gleason 3+4, opted for 25 sessions IMRT followed by Brachytherapy in October. Feb 2014 PSA 0.31, over the course of the next year it increased to 1.34 then receeded to .69 by early 2015 and stayed relatively constant for that year. Early March 2016 it increased to 2.5, over the 2.0 above the lowest, and early May it was 6.37. So…I’m just starting the process of exploring a next decision. Am wishing now I had opted for RP as it seems to be the best from what I’ve heard at numerous groups. Good luck all.

Rob Freitas

Hi Bob
Please read my post from April 21. Don’t look back at what you should have/could have/ might have done earlier. I think we all make the best decisions we can with the information at hand. That decision to not have RP is among the hardest of my life. I chose EBRT earlier on what I thought was a well thought out decision, reading as many journal articles as possible, talking to friends who are physicians. I had the same 80% chance of success with EBRT as I did with RP. I felt that I was not ready for the impotence/incontinence that went along with RP. After about 5-6 months post radiation my libido and erections returned and had almost 5 years of relative ease. My last PSA was .94 but it had doubled from .47, which I now know is a bad sign. I had a salvage prostatectomy on 5/5, just had the catheter removed Friday, am incontinent like you read about and glad to be alive. There was a chance I might end up with a temporary colostomy as getting the little devil out after radiation is not easy, but it turned out the surgeon got it out without problems. If you are considering salvage prostatectomy you must go to someone who does them “frequently”, in my case here in the northeast it was only one monthly but lots more than others in the area that did one yearly or none at all. I am a healthcare consultant and have access to many databases so have done my research on the stuff and am willing to share. If you want to communicate off line let me know and I will send you my email address. Everyone on this blog has had to go through the agonizing decision making process of which course of therapy to pursue. Don’t look back, just look forward….”you cant drive your car by constantly looking in the rear view mirror” Get all the info you can, talk to your friends, your partner, get second or even third opinions, and then go for it.
Rob

Irv Smith

Hi Rob, I would like to talk to you through email as I am deciding what treatment to take for prostate cancer with a Gleason score of 7 and a T2a rating. Thanks

Irv

Alan D

Following up from my 29 Dec post. My Psa has gone up to 0.1 as of last week. Consultant thinks I have as much chance of passing away from Stroke or heart attack. I have to go back in 6 months I am back to or above my level of fitness prior to the RP and feel 100%.
As a 72 year old im going well
regards Alan

Mohammad

Prostate cancer PSA 14.5 and Gleason 7 (3+4) RP October 2015. Margins positive, negative lymph nodes and seminal vesicles. 3 months post PSA 0.4. Started and completed radiation 39 treatments. Advised to wait 6 weeks to recheck PSA, Very stressful . Needs advise. (age 57)

Alan Davis

Hi Mohammad,
The best thing to do is seek out good doctors and get second opinions. Every case is different.(See my entry above on this blog)I had a Gleason of 8(4+4) went for a RP only because it left open a lot more options but at the same time the oncology Dr did have a honest assessment and agreed with my final.
Look closely at the Dr past successes.
Treatments are getting better all the time and as my consultant said there are plenty of options still open.

Alan D

John Gabriel Otvos

Hi lads, @ 68 I’m not able to help anyone here other than to say bless all of us. I’ve been through EBRT as an experimental invasive therapy for PC. I, like all of us here who have testified, have lived through these debilitating and oft times horrendous side effects from these “experiments” My psa #’s were headed down until I had an 85% bump ^ in a 3-mo period! I’m fully vegan now (5 years) + no added oil, sugar or salt, as I believe that the new nutritional science is telling us that animal food is the link between these lifestyle diseases and the rate of early death for we menfolk. There’s no magic bullet as the docs {bless all their souls} can only work with these numbers. It’s a game and they play as well as their teaching allows them. No more psa’s, no more biopsies {I’ve had 4} no more fingers up the bum. I’m healthy and the next time I see any doc, it’s because I am sick! Believe you are healthy, get lots of excercise, love well and love deep, *everyone* and everything you come into contact with, not just family and friends. Be of the world but not in it. Turn off all negativity and know that yes, our body does perish, but our soul, that inner part that belongs to The Formless One and the non-local consciousness, lives eternally in the NOW.

Dave P

Had RP in July 2014. After surgery had a Gleason score of 6 and no involvement to be found outside of the prostate. From 6/14 to 6/15 my PSA on three month testing was .01. In June 15 .01/ 9/15 .06, 12/15 .02, 3/16 .03, and 6/16 .1. Mu urologist said this was normal in all cases. When I see him in 2 weeks, there will be some serious discussion about the levels. I was 65 at the time of surgery am now 67 with no signs of incontinence and slight ED problems

jim

i would not worry about .1,,,that was my psa reading for 10 and a half years before it started up…it has been 14 years from the time i had it cut out…been thru 33 hits of radiation and four shot of hormone. now it is wait and see..turn 70 in sept…

Eldie Mares

Had Rp Jan.2014 and recent PSA indicates a rise from trace to .2 in 6 months. Urologist recommended Salvage Radiation. MRI and bones scans are negative. Is this(radiation ) the right course of action at 64 years old or should I take a bit more time. No real issues now with urinary and fear I will cause damage undergoing Radiation. Eldie

jim

i was 66 when i had it done and my psa was .2,,,,i dont have any side effects from it…i am not 69 going on 70 in three months..please read my statement right above yours. good luck,,jim

gale

Gale
My dad had a RP in 8-93. 10/93 PSA .1. 3/94 PSA.3. Bone scan performed–negative. 35 radiation treatments. Then in 12/97, PSA .3 Three years of Hormone Treatment ending in 11/99. PSA started rising in 4/08 .2. 10/09 PSA .4. 2/10 PSA .9. 9/10 PSA .6. 2/11 PSA 1.5. 8/11 PSA 1.6. 11/12 PSA 6.. 2/13 whole body bone scan. 8/13 PSA doubled to 11.9. 12/13 Hormone Therapy-inj every 6 months. 4/14 PSA .4. 11/14 PSA .5. 5/15 PSA 1.2 Lupron. 11/15 PSA 6.37. 3/8/16 Clinical Trial. stopped trial. 5/16 Colonoscopy showed cancer. CT–shows metastasis or extension from prostate. possible mass on bladder and rectal thickening. we are getting ready to start Chemo–Xtandi. Doctor appointment tomorrow. besides prostate his overall health is good. He is 82 years old. Is this the best/last option? He has started to have problems with bowel removal..

jim

well not good..after four hormone shot, being the last in jan of this year,,,when in friday for my psa check…up from 0.06 now it is 0.21..been thru lots of things..had prostate taken out in 2002..11 years later psa rose to .6,,took radiation of 33 hits..psa did not come down,,dont understand why, but it did not..guess it missed ha..than for the next two year had 4 shots of hormone…worked great till this past psa..now back on pills to see if that can keep it low..ha…if it gets back up to 0.4,,ct scan and bone scan again…than more shots..fun time is coming

Catherine

My husband was diagnosed with terminal cancer that spread from his brain into the lungs and liver. he became so ill that it tired him out to do the smallest task; to walk across a room would take great effort and all his breath away. I was unable to bear his situation anymore and ibegin to ask questions about cancer in my neighborhood and work place, above all i was praying that God should send healing to my husband and take the sorrow away from my family, one faithful evening my neighbor who recently moved to the neighborhood came to me that she heard that i have been asking question about cancer and told me about fountain water spiritual book she have and how they had help her in the it cured her 9 years breast cancer. She gave me their email (fountainwatercoven@yahoo.com). It was a great joy that day and he’s my husband life saving angel, i ordered the spiritual oil and i received it that week and followed his instructions and gave my husband the oil. Finally, my husband is totally cancer free and he is healthy and strong now, after which he reported that he could breath well, was not experiencing any pains and felt the good cells in his body. four days later our family doctor, vincent, reported there were no signs of him having any trouble breathing or problems with physical tasks and cancer; Thank you lord, my husband is much alive with the helpof fountain waters. my husband is now able to breathe fully and deeply. His doctor reportedly says his liver is cancer free. That he does not seems to have a small amount of cancer in his liver and lungs again. The doctor is amazed at the effectiveness of the oil. my husband and I believe the major changes in his body. Of course we do notdeny the important role of dieting . my husband story is an ideal example of how oil healing miracles often have in the body.) We Thank fountain waters for his miraculous oil treatment. Email them with(fountainwatercoven@yahoo.com) or whatsapp on +2349054913842

Zorro

My humble advice to any prostate cancer patients is the following:
Dont go for a psa test if you dont have any symptoms of prostate cancer
Make very sure that a higher psa value is not because of prostatitis.Antibiotics do not always cure prostatitis.The treatment must be for at least 10 days.
Make sure that you get hold of your biopsy report.
Never panic and make sure what the urologist means if he tells you that you have cancer but it is very small.Sometimes small is neglectible. Make sure when it is the case.
Dont get anxious after 18 months of watchfull waiting
If your psa is more than 0.1 after a prostatectomy dont panic.
If the urologist had left residue prostate tissue behind you can still get prostatitis.
Read my story on YANA prostate cancer survivor stories by the name Zorro.This is the last story because of the alphabet.

Emily Luke

i am Emily Luke my heart is full of joy for what Dr Ogun Root and Herds the traditional healer has done for me, i was diagnose with cancer for the past four years, i thought my life was going to end like that, cause i thought there is no cure for this deadly disease, untHiil i came across a testimony of a young man who said that he was cure with the herbal medicine of Dr OGUN, initially i thought it was a scam testimony but i said i must also try this man to see if it true or false testimony. so i contacted this man through his email and he response to my emails and told me what to do, i kindly did what he ask me to do, and he sent me his herbal medicine and instructed me on how i will be taking them daily, i kindly follows the precaution and after some weeks i went for medical check up and my result came out with Negative.i want to use this medium to inform everyone living with cancer to stop wasting time on medical drugs and contact Dr OGUN the traditional healer for some herbal medicine that will cure you once and for all. Please contact him through his email:drogunrootherds@outlook.com please note that this man is 100% trusted and guarantee.

Tony Guille

I was diagnosed with Prostate Cancer some 7 years ago. after having regular checks over the previous 25 years with the symptoms although at the time I knew nothing about Prostate cancer.
Fortunately I had to see another GP because mine was on Holiday and he decide to ask for a P.S.I blood test.
This showed a figure of 551 which started a chain reaction of further tests under the auspices of a specialist. (needless to say I changed my surgery the next day.
My Gleeson was 9 with a T3 . after 4 years of hormone treatment my P.S.I leveled at 0.135. When a new specialist arrived, he decided I should have a ‘Holiday’ from treatment to allow my body to recover. After 22 months my P.S.I had risen to 18 and he put me back on one injection every 6 months but avoiding giving me the Bicalutamide. Now 12 months later I am back on the Bicalutamide and my P.S>I is at 47. still no side effects .
I am now 80 and play Golf 3 times a week and have always been fit. “Another day above ground is a bonus” Tony Guille,Guernsey

Dave P

In a follow up to my June 18th comments after my PSA rose to .1 two years after RPA, my doctor advised a new test due to the fact a different lab and PSA analysis were used.

Went to the same lab I have used for the past twenty years and my new result is .03

Micheal Anthony

Thank God Almighty that lead me to Dr Al-Jamali in Dubai. My brother lungs cancer has been cured by Dr Al-Jamali. My brother has been through chemo 3 times, but this time his condition was getting worse that I was afraid it will kill him. When a friend of mine directed me to Dr Al-Jamali at: (drjamaliremedycenter@gmail.com ) where I could buy the medication from, because the Dr Al-Jamali has help cured his own Brain tumor and he strongly recommend that he would helped me with my brother cancer and cure it completely, I never believed the story, but today, with thanks giving in my heart, My brother lungs cancer has been cured within the Dr Al-Jamali hemp oil and I want you all to join hands in appreciation of the great work that is been done by Dr Mahmood Al-Jamali , he is the man that saved the life of my brother with hemp oil, thanks to him. for all those who have problem relating to cancer and other diseases should contact him through his emai(drjamaliremedycenter@gmail.com) I’ll keep thanking him because his God sent to save my family that was at the stage of collapsing all because of my brother cancer, if you have cancer is time to save your life thanks everyone again bye.

Micheal Anthony

Thank God Almighty that lead me to Dr Al-Jamali in Dubai. My brother lungs cancer has been cured by Dr Al-Jamali. My brother has been through chemo 3 times, but this time his condition was getting worse that I was afraid it will kill him. When a friend of mine directed me to Dr Al-Jamali at: (drjamaliremedycenter@gmail.com ) where I could buy the medication from, because the Dr Al-Jamali has help cured his own Brain tumor and he strongly recommend that he would helped me with my brother cancer and cure it completely, I never believed the story, but today, with thanks giving in my heart, My brother lungs cancer has been cured within the Dr Al-Jamali hemp oil and I want you all to join hands in appreciation of the great work that is been done by Dr Mahmood Al-Jamali , he is the man that saved the life of my brother with hemp oil, thanks to him. for all those who have problem relating to cancer and other diseases should contact him through his emai(drjamaliremedycenter@gmail.com) I’ll keep thanking him because his God sent to save my family that was at the stage of collapsing all because of my brother cancer, if you have cancer is time to save your life thanks everyone again bye….

Sam

I had RP at August 2013 when I was 50 and PSA was 6.83 and with a Gleason 3+4=7.After surgery PSA was <0.01 ,than after 1 year it was 0.02 ,after 2 year 0.04 and it is in the 3rd year and PSA is 0.06.My doctor is suggesting to wait and do nothing untill it is 0.2.
Shall I wait or insist to have hormone or radiation theraphy?

Jack Plant

Jack Plant
My first check up 6 months after discontinuing my Lupron therapy both my PSA and Testosterone jumped from trace amounts to .138 and 195 respectively. My Gleason score was a 9 and I was treated with 9 weeks of external beam radiation followed by the Lupin injections every 4 months for 16 months. Now my urologist wants to see me in 4 months to see if there is another jump to decide if we need to reinitiate hormone therapy. I don’t feel too upset “yet”. Should I?
Jack

Nick Cardis

I had a Radical Prosectemy in May of 2014, with no follow up treatment, after surgery psa was <.04 for about a year. Then it went to <.05 for eight months , then went up to <.06 for a couple months, now it has gone up to <.08 after two years and two months. Had a CT and Bone Scan in Aug. 2016 that showed nothing.Just had blood drawn on 8/30/16 for PSA level. will find out my level now in a few days.
Doctor already mentioning of the possibility of Radiation treatment if PSA level continiues to rise to .2 . What is your thoughts?

Richard Michalowski

Dear Nick,

I was very happy to read your article for I had a Radical Prosectemy 4/2014. (Robotic Da Vinci). My doctor said cancer had spread to one lymph node and it was removed. I’m 70 now and walk 4 miles a day and swim, and drink and I ‘m having a ball. Anyway’s my PSA’s went from 0.01 to 0.12 after 2 years and my latest was 0.10. My surgeon recommended Proton Radiation Therapy. when I went to the Doctor to discuss this i was asking myself, why do I want to go thru this. I’m in great shape enjoying life, why put myself thru this. I felt if I die I want to go out as a man. I do have to wear pads 3 or 4 a day, sometime 5 or even six if I drink to much in fluids.. But I am now use to this and my loving wife is great about it. Here is the bottom line. I went to UC Irvine to another Doctor. He said that the would never go thru radiation himself, and would never recommend this to his relative’s. He said I am in great shape living life to the fullest why put myself thru this. I also asked him how to eat, and he recommeded a book called the China study. I am now kind of a Vegan. Not 100% but say 80% with no meat milk or cheese. Got lucky a few months ago PSA went to 0 but now back up to .10. The doctor watches every three months and he said unless it goes to .2 we will do nothing. I’m just so thankfull to be here. Do love happy hour at night not sure how great that is for me. We have a grandson that we love the heck out of only 19 months. We also love to travel a little and make trips to Vegas each 6 weeks. Life has no guarantees’ Did I make the right decision by not going thru radiation. I think so. The Doctor said the chances of not catching it were about 50%, and then if it was caught life expectancy was 10 years. What the heck is 10 years, i want to live to 100. Check out the China study and learn to smile a lot. I figure if they tell me I have a year to live, I then could go back to eating meat and cheese, and who knows even start smoking. Just kidding about the smoking. My theroy could be all wet, but it was my decision, hope this helps.

CHUNG HC

I am 55 and had my Radical Prostatectomy done May 2015. My PAS was 0.03 after surgery and now are back to 0.4. Should I consider Hormone and Radio Therapy?

jimmy wade

chung hc,,,,two hormone shots which cuts off the feeding of the cancer and than radio therapy….which with any luck kills it….keep fingers cross

Adel Ahmed

Adel Ahmed
I am 70 years old. a year and half before i performed a prostatectomy after a PSA level of 25. Unfortunately the PSA level didn’t drop to zero two months after the surgery. It dropped to 0.07 and started to raise, reached 0.2 a year after the surgery. Both MRI and biopsy assured an existence of a cancerous mass at the root of the penis and review of the MRI done before the surgery proved that this mass was there from the beginning and was overlooked both by the MRI report (it was seen in longitudinal sections and the axial sections didn’t go that below) and the surgeon. Now I finished a RT and would like to check with MRI if this mass is still have cancerous cells or not. It is not possible to have the PSA as indication to the treatment as the PSA is masked and will continue to be masked for another two months by Hormone therapy. What is the appropriate time to do MRI for follow up and check.?

MISS MARY

This is real take it serious, who will believe that a herb can cure ten
years HIV in my body, i navel believe that this will work i have spend a
lot when getting drugs from the hospital to keep me healthy, what i was
waiting for is death because i was broke, one day i hard about this great
man who is well know of HIV and cancer cure, i decided to email him,
unknowingly to me that this will be the end of the HIV aids in my body, he
prepare the herb for me, and give me instruction on how to take it, at the
end of the two week, he told me to go to the hospital for a check up, and i
went, surprisingly after the test the doctor confirm me negative, i thought
it was a joke, i went to other hospital was also negative, then i took my
friend who was also HIV positive to the Dr, after the treatment she was
also confirm negative . He also have the herb to cure cancer please i want
every one with this virus to be free, that is why am dropping his email
address, livingsotnetemple123gmail.com email him he isou
from any kind of diseases like Helps,Gonorrhea,Cardiac problem
Cancer
Watering sperm
Womb fertilization
Penis erection
Witch craft attack
S T D diseases
Internal heat
a great man.thank you for saving my life, and is also good in saving y
Rashes
Low sperm count
Dairy
long time sickness I promise I will always testify for your good work.

MISS MARY

This is real take it serious, who will believe that a herb can cure ten
years HIV in my body, i navel believe that this will work i have spend a
lot when getting drugs from the hospital to keep me healthy, what i was
waiting for is death because i was broke, one day i hard about this great
man who is well know of HIV and cancer cure, i decided to email him,
unknowingly to me that this will be the end of the HIV aids in my body, he
prepare the herb for me, and give me instruction on how to take it, at the
end of the two week, he told me to go to the hospital for a check up, and i
went, surprisingly after the test the doctor confirm me negative, i thought
it was a joke, i went to other hospital was also negative, then i took my
friend who was also HIV positive to the Dr, after the treatment she was
also confirm negative . He also have the herb to cure cancer please i want
every one with this virus to be free, that is why am dropping his email
address, livingsotnetemple123gmail.com email him he isou
from any kind of diseases like Helps,Gonorrhea,Cardiac problem
Cancer
Watering sperm
Womb fertilization
Penis erection
Witch craft attack
S T D diseases
Internal heat
a great man.thank you for saving my life, and is also good in saving y
Rashes
Low sperm count
Dairy
long time sickness I promise I will always testify for your good work.

Jerry diamond

I had an RP at 57 with a gleason score of 7 and a PSA of 4.5. all was good for 5 years and then my PSA started to jump and I was referred on to radiation which I did. 3 months after radiation my PSA dropped to undetectable. 7 years have passed since then and started checking once a year and just got the news that my PSA has gone to .27. I think I am back to square 1 and am now 70. My doctor says .27 is low not to panic. I say where there is smoke there is fire. I am taking 5000 units of vitamin D every day and 8 ozs of pure pomegranate juice every morning. Gone radical on sugar consumption 0 tolerance on sugar its a killer and as well no dairy or meat. Not sure where I am going with this but if the number does not hold I guess my next choice is chemical castration or bringing down the testosterone levels with Lupron. My dad had the same situation as I he died of heart failure, tough fighting those genes

Geoffrey Dodd

Geoffrey Dodd (UK )
Hello, I had a radical prostatectomy just over a year ago ( September ) 2016 six weeks later my PSA reading was 14 and continued rising and is now 18.75
I have just found out that I have abnormalities at the bladder and urethra area.
I am still incontinent and unsure of which way to go. As this blog suggests if I elect to have radio therapy this may become permanent.
Thank you for listening.

dave

Had protrate removed in January. 6psa going into surgery. Have had .008 psa since. Margins clear. Large tumor with one of nine lymph node cancer(small amount) Margins clear One DR. says I have 50% chance of it never coming back and one say 30%. Am on no treatment Any thoughts would be appreciated

Ray

Ray
Had a radical prostatectomy January 2014 .3 months later psa 0.05.stayed at that level for 18 months ,then rose to 0.055 then 3 months later went to 0.087 at this meeting with my consultant it was obvious that he wes convinced that my cancer was back and was preparing me for radiation and or hormone treatment ,getting an oncologist involved on the team. I read everything I could get my hands on looking for answers trying to understand read more books documents ,articles ,.Iam quite a sceptical person and didn’t believe I’d find any answers .I just wanted to understand what my chances were .
While reading some of the stuff I came across more than once references to. A book. Prostate Cancer understand, prevent and overcome. By Proffessor Jane Plant.
Anyway I sent of for a second hand copy of the book of Amazon, read it I can’t explain why but it made sense to me .
For me whose diet for 64 years had been pretty unhealthy ,the thought of following the recommendations in the book eg going totally non dairy lots of fruit and veg ,drinking green tea etc etc . I couldn’t see how that could defeat cancer although the arguments against eating dairy I found compelling .
After following Professor plants recommendations or doing what I could I was staggered when at my next psa test my psa dropped 15% to 0.074 .My consultant was staggered to after explaining what I’d done . He said there was a compelling amount of evidence to support what I was doing
But it wasn’t scientifically proven nevertheless he was keen for me to carry on has I had done.
Which is of course what I’m doing .Just had my latest psa test it’s now 0.07 ,just a slight drop 6%
But I’m so happy ,I really do believe that if I haven’t had come across other men’s references to Proffesor Plants book I’d now be in the process of having hormone or radiation treatment.
I don’t know what the future holds but I’ve got real hope regarding the future .
I’d just like other men to investigate .
Jane Plant and what she advocates is not an alternative to conventional treatment.
I’ve since purchased 4 copies of Jane plants book and gave them to my brothers and sons
Jane plant can be found readily on the net .

Ray sinfield

Ray
Had a radical prostatectomy January 2014 .3 months later psa 0.05.stayed at that level for 18 months ,then rose to 0.055 then 3 months later went to 0.087 at this meeting with my consultant it was obvious that he wes convinced that my cancer was back and was preparing me for radiation and or hormone treatment ,getting an oncologist involved on the team. I read everything I could get my hands on looking for answers trying to understand read more books documents ,articles ,.Iam quite a sceptical person and didn’t believe I’d find any answers .I just wanted to understand what my chances were .
While reading some of the stuff I came across more than once references to. A book. Prostate Cancer understand, prevent and overcome. By Proffessor Jane Plant.
Anyway I sent of for a second hand copy of the book of Amazon, read it I can’t explain why but it made sense to me .
For me whose diet for 64 years had been pretty unhealthy ,the thought of following the recommendations in the book eg going totally non dairy lots of fruit and veg ,drinking green tea etc etc . I couldn’t see how that could defeat cancer although the arguments against eating dairy I found compelling .
After following Professor plants recommendations or doing what I could I was staggered when at my next psa test my psa dropped 15% to 0.074 .My consultant was staggered to after explaining what I’d done . He said there was a compelling amount of evidence to support what I was doing
But it wasn’t scientifically proven nevertheless he was keen for me to carry on has I had done.
Which is of course what I’m doing .Just had my latest psa test it’s now 0.07 ,just a slight drop 6%
But I’m so happy ,I really do believe that if I haven’t had come across other men’s references to Proffesor Plants book I’d now be in the process of having hormone or radiation treatment.
I don’t know what the future holds but I’ve got real hope regarding the future .
I’d just like other men to investigate .
Jane Plant and what she advocates is not an alternative to conventional treatment.
I’ve since purchased 4 copies of Jane plants book and gave them to my brothers and sons
Jane plant can be found readily on the net .

John

Diagnosed with stage I PC at age 69. Primary care Mt Sinai Med Ctr in Miami Beach – interviewed every surgeon in Miami and Miami Beach – marginal intellectual honesty

My surgeon at Mt Sinai (the Best) discussed my options and my surgeon at Mt Sinai recommended low dose radiation – Mt Sinai is the only hospital with a clinical staff with both integrity and competency in the greater Miami area

My skepticism of the medical profession is based upon my 8 years as a research assistant at tge Harvard Medical School – without integrity there is no competency

The article was authored by the same caliber of the clinicians and researchers I worked for – integrity and honesty

The posts appearing above – with the exception of the Zorro post – are very disturbing – reflect inadequate counseling and knife happy quacks

M. Todd Miskel

Todd

Diagnosed Stage 4 locally advanced to a few lymph nodes and 1 small bone met to right hip femur in 2016 at age 55. Was referred to hormone therapy clinical trial at Huntsman Cancer Institute in Utah as I am not operable. PSA at diagnosis was 7.1 with a low free PSA. As of 10/12/16 PSA is down to 1.2 and I feel ok. Trial meds are Lupron with TAK-700 / Orteronel (experimental med) combo. Side effects of hot flashes and fatigue are moderate and annoying but I can still work and push thru the annoyance. Hoping for continued PSA drop or leveling off.

Zorro

It is to my mind very important that patients must take notice of the fact that the prostate sometimes enlarge into the bladder wall. Consequently it is possible that the urologist may overlook this part of the prostate during a Da Vince Robotic prostatectomy so that it can be left behind as prostate
residue tissue which is vunerable to prostatitis.This may lead to confusing psa results.If you have high psa values after a prostatectomy read my story at YANA prostate cancer survivor stories.It is the last one due to my name Zorro

gray marshall

Savvy blog post – I loved the points ! Does anyone know where my business could locate a template CT DRS CT-941 form to use ?

Joe Man

At age 51 I had a RP in Dec 1991 following a PSA of 6.4 and a positive biopsy which showed a totally embedded Adenocarcinoma, focal, grade 3+1.

Two weeks after surgery my PSA was .16 and stayed around this level for about 2 years. For the next 10+ years my PSA was always <.10 and then it started to rise: 2007=.13; 2008=.19; 2010=.43 (doubled); 2012=.87 (doubled); and 2016=2.30 (2.6X in 4 years). I am in a watch mode due to being on the low end of a doubling rate.

Why would my PSA start to rise after 16 years? And what is my best treatment option.

gerald diamond

Had a RP at 54 in 2004 PSA was 4 gleason score was 7. 3 months later had a PSA and was showing non detectable cancer after the RP. Five years later went in for my annual PSA jumped to .13. Had radiation for 3 months PSA dropped to undetecible after 6 months of the start of radiation. Now 7 years later or total of 12 years since my radical at age 70 now PSA showing .27. Decided to go radical no sugar whatsoever or anything relatex to sugar.,no honey no pasta no white rice no white bread no potatoes,no desserts of any kind, nothing in my coffee and definitely no red meat just fish and chicken and lots of Broccoli and spinach. I do get some sugar from apples and oranges as you need something for energy. I drink 8 ozs of pure pomegranate juice every day plus 5000 units of Vitamin D3 as well i take Curcumin 3 times a day and once a day i have tea made with fresh ginger steeped for 1/2 hour. Ive gone back 3 months later and my new PSA is exactly the same at .27. Not gone down but not risen . Im also going to add Lycopene along with the curcumin that im taking. Going in soon for another PSA and hoping to keep the PSA at .27 or less. Im going in as well for a CT scan next week and a bone scan. Will keep you posted. Good luck to all writing here

warren

Hi to all. I found all these comments very encouraging:)
I am 53 and two years ago I was diagnosed with stage 4 prostate cancer. It left the prostate and also went into one of my lymph nodes. I had radiation which never worked, and I have been on hormone therapy for two years. But recently my psa doubled, so I had the usual, a bone and ct scan, but they came back negative.
After much research, that’s still ongoing, I thought I would take an alternative route. So I take bicarb soda, laetril, b17, selenium, d3, cQ10, tumeric daily etc, I also watch my diet and try to eat plenty of brocolli, veg, smoothies, green teas, and I try to keep off dairy and meat so on.
After my psa doubled I was put on extra hormone therapy, but had bad side affects and came off them after consulting my consultant and because there we’re no evidence of cancer spreading.
I have had pain in my hips, groin and back occasionally, but I work outdoors as a builder and do lots of heavy work.
I Saw my consultant today and my psa has shot up in three months to 6.8 from 0.7, so more bone scans and ct and my consultant poo pooed that vitamins can help and told me I’m throwing my money down the drain and if these things worked he would send me to boots to get vits instead of giving me expensive drugs,and you can’t shut the gate when the horse has gone and he has given me an extra boost of hormone therapy and said the previous hormone tabs I were on brought my psa down and it looks like the cancer is trying to spread, but I have found your stories very, very encouraging and I will continue going down the natural route and see what my scans show.
Thanks everyone.

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