Where Am I Going?

I am a brand new member today. I had a Da Venci robotic prostatectomy Jan 05. Post op PSA started with a .06 now 3 years later I am at .43. My former Dr. moved to Florida. I really liked and trusted this guy. Now I have a new Dr.

T-3 Gleason 6

I need advice. Where am I going from here? What type of radiation is effective/recomended, or is harmone therepy worthwhile. Anyone please advise. Anyone gone through Ablatherm? Thank you and May God Bless us all with healing.

Sted

Sted:

Sorry to hear of this news. By "T-3" I assume that the pathology at surgery indicated some factor outside the prostate gland itself. This is highly suspicious as a source of your current psa.  It appears you may not have a clinical recurrence because your psa never went to zero, though it was close. Pathologic G-6 is a sign that the disease may remain loco-regional. Treatment before psa reaches 1.0 is recommended, and generally the lower the psa the better. This translates to sooner rather than later. A consultation with a radiologist and oncologist is highly recommended. A urologist is now out of the picture as his work is done at this point, unless you have other uro issues that need attention.

Some men have success slowing their disease with diet, supplements and lifestyle changes. With a doubling time crudely calculated as ~14 months, this could also be of benefit to you, though I would not suggest this as an alternative to salvage therapy, only as an additional consideration.

I am not aware of HIFU (Ablatherm) used for post surgery recurrence, unless there is a specific target that can be identified with imaging. If your recurrence is microscopic, unable to be seen with any technology and recognized with psa alone, some type of conventional radiation rather than ultrasound will be your option. 

Sted:

Just saw your response to first poster. Vitamin D-3 (cholecalciferol) and pomegranate (juice or extract) have both had clinical trials with success for men similar to you. Both are currently in additional trials, Pomegranate Juice in phase III.

Vitamin D-3 should be maintained at 50-80 ng and a physician's supervision is strongly suggested if you pursue this path.  

Hi Sted,

 I had a radical in Jan 04. My first PSA was 0.008. I was found to have a positive margin, and after almost 4 years my PSA a month a half ago was 0.33. The cancer clinic told me they would put me on hormones and radiate when I got to point 0.5. Well, in the past month it went from 0.33 to 0.45; then in a week it went to 0.53.

I have been put on Lupron and Casodex.........with a tentative radiation date of Aug 12th.

Be careful with your PSA. It can really ramp up unexpectedly; the Cancer Clinic had warned me about this.......and it came true.

 I agree with the previous comments.......radiation should begin before the PSA reaches 1. The purpose of the Lupron and Casodex is to shrink the tumor and put it into remission before radiation.

Good luck to you..........Stan.

Thanks Stan

Pray for a cure for all!

Sted