YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

SILVER

Russ D and E live in Ontario, Canada. He was 58 when he was diagnosed in July 2005. His initial PSA was 7.12 ng/ml, his Gleason Score was 3+4 = 7 and he was staged T1c. His choice of treatment was radical prostatectomy. Here is his story.

After annual physicals through '03 to '05 that showed a creeping PSA from 5 to 7.1, my doctor referred me to a urologist to investigate rising PSA but showing nothing on DRE (Digital Rectal Examination). By July 2005 the PSA was up to 7.12, a slight increase from Feb 05 reading. Prostate biopsy was done in August, 2005 - 10 cores with one +, 5% of core adenocarcinoma GL 3+4 or 7, percentages not stated.

After consultations with urologist and radiation oncologist, I chose to have a nerve-sparing RRP (Retropubic Radical Prostatectomy) in December, 2005 and received the pathology results in late January 2006. Pathology reported pT3, GL 3+4 20% bilateral prostate volume adenocarcinoma, High grade PIN (Prostatic Intraepithelial Neoplasia) present, extraprostatic extension present, 4 bilateral positive resection margins, no seminal vesicle involvement, lymph nodes not tested. First PSA test post RRP 0.87, March 06. Referred to radiation oncologist whom I saw May 06. PSA now 1.1, PSADT (PSA Doubling Time) less than 4 months.

I had 36 treatments 3D Conformal Photon Radiation, 64 Grey total to the prostate bed with intention to still seek cure starting in June 06 after I got my continence back after the RRP. Also had two weeks of daily 50mg Casodex and then monthly 7.5 Lupron injections beginning June 06.

PSA and Testosterone (T) was measured every 4 months since November 06. PSA <0.1 (lowest limit on my assay), and T <0.4 (also lowest limit on my assay) or <11 USA measure).

In December, 2007 it was decided to go intermittent, stopping the monthly Lupron Depot after the November 07 injection. The intention was to let the T recover to the expected 80% of original level (375) and see what the PSA does in response. My hope of course is that the PSA stays undetectable, indicating that the radiation did what it was hoped to do - destroy any remaining PCa.

I will update as I get information.

 

UPDATED

January 2009

 

 

After the RP and then the 36 treatments (64 Gy) 3D conformal photon radiation and 18 months of Lupron injected once a month, I am now not using any drugs at all.

My PSA, checked every 6 months by my radiation oncologist has continued to be <0.1 using the same non-ultrasensitive test at the same lab as when I had my first done by my uro before my RRP.

My testosterone once <0.4 or 11 US measure (or castrate) has slowly recovered and, at last reading was 2.8 or about 81 in US measure. I continue to have ED issues but I was told that before I chose to have the radiation and the Lupron. Overall, I otherwise feel fine.

My next PSA and T check will be in May.

 

UPDATED

June 2010

 

 

Since I had my prostatectomy (December 2005) and it failed (post PSA 0.83 and then 1.1, 5 weeks later)I had 36 treatments of conformal 3D radiation in 2006 and 18 months of Lupron to suppress the Testosterone.

My PSAs since radiation have always been undetectable, including my last in May 2010. My radiation oncologist has indicated that I no longer have to come to see him but has given me an invitation to do so if my PSA checks start to rise. :).


Russ' e-mail address is: daviesr@cogeco.ca