Post Prostrate Cancer

I am 48 years old my pre surgery PSA was 35...Thats right 35...I had had one done 4 yrs earlier that came back 3.9 but drs didn't say anything about it..Here I sit now, had surgery Jan. 21st this year...Got my results back on my first PSA yesterday and it was .33. I am extremely proud of that number but haven't talked to the dr yet to see what it means...My cancer had spread into my simila vessels but they did remove it. Dr told me even if my post PSA was zero that he would still do treatment..radiation.... I haven't found anyone  my age or even with a PSA that high.... I have just now began to feel like I will live...Its been a long road that I must still travel...Anyone out there close to this or have any words of encouragement...

 

On 3/12/2008 awgud wrote:

I am 48 years old my pre surgery PSA was 35...Thats right 35...I had had one done 4 yrs earlier that came back 3.9 but drs didn't say anything about it..Here I sit now, had surgery Jan. 21st this year...Got my results back on my first PSA yesterday and it was .33. I am extremely proud of that number but haven't talked to the dr yet to see what it means...My cancer had spread into my simila vessels but they did remove it. Dr told me even if my post PSA was zero that he would still do treatment..radiation.... I haven't found anyone  my age or even with a PSA that high.... I have just now began to feel like I will live...Its been a long road that I must still travel...Anyone out there close to this or have any words of encouragement...

Yes, PSA can go a lot higher: have two friends currently doing well on hormone treatment. One had a PSA of 58.

In an ideal world PSA should be undetectable or a very low figure often defined as under .1  six weeks after surgery, Anything  higher usually implies additional treatment, which your doctor has suggested in any event.

Dr Walsh used radiation and hormone treatment for his own high risk PC about 8 years ago, and has used it for many of his patients. With better treatment techniques and medications, many do well for a lot logner than used to be the case.  There's information of better prognosis when surgery has ben used in high risk situations.

 

Awgud:

Great attitude! Yes, you are still here with us! 

Oh, gosh, there are many with psa far higher than yours. If you go to yananow.net you will find Trueman Seamans from Maine, diagnosed 9 years ago with psa of 4,200. Still kicking high and hard.

 Mayo clinic has article on over 10,000 prostate cancer surgical patients over 15 years, and the youngest was 34. So you are much older and much better psa condition than those outliers.

Your surgeon is right to get on with radiation in your high risk case. See SWOG 8794 (google it) to find results of adjuvant (immediate) radiation in cases as yours seems to be.  

The big questions are what is your gleason scale? Did it extend outside of the margins. My husband (44) had a prostatectomy in July. He had 40 radiation treatments, started 6 weeks post op and ended on Thanksgiving. His PSA is <0.01. His PSA was only 3.7 or 3.9 (can't remember). when diagnosed. Continue to stay positive. If you need to talk more to people with this another website is yananow.net. It is also very helpful. Best wishes!

 

On 3/13/2008 Linb1414 wrote:

The big questions are what is your gleason scale? Did it extend outside of the margins. My husband (44) had a prostatectomy in July. He had 40 radiation treatments, started 6 weeks post op and ended on Thanksgiving. His PSA is <0.01. His PSA was only 3.7 or 3.9 (can't remember). when diagnosed. Continue to stay positive. If you need to talk more to people with this another website is yananow.net. It is also very helpful. Best wishes!

My gleason score was 8...Had surgery Jan 21st...They want to wait till June to do my treatments..Dr said he wanted me completely well before starting.

Awgud:

The radiation will increase any current issues with continence, erections, and perhaps bowel and bladder control. This depends on the kind of RT and the dose and number of sessions. Thus, doctors like to be certain of the best healing possible before beginning RT. Treatment is always a balance of risk and reward.

 

On 3/13/2008 Linb1414 wrote:

The big questions are what is your gleason scale? Did it extend outside of the margins. My husband (44) had a prostatectomy in July. He had 40 radiation treatments, started 6 weeks post op and ended on Thanksgiving. His PSA is <0.01. His PSA was only 3.7 or 3.9 (can't remember). when diagnosed. Continue to stay positive. If you need to talk more to people with this another website is yananow.net. It is also very helpful. Best wishes!

What has me puzzled is my PSA when I was 44 was 3.9 and my family dr said nothing to me....The I have a PSA of 35 at 48...When I ask him why he didn't say anything he said it was in normal limits...Now i'm reading about people with cancer under 4 PSA. I just wonder should a red flag started waving then...

Awgud:

I suffered from a similar situation. In the past, from the early 1980's when psa was being tested as a new marker, a level of 4 was considered the top of the "normal" scale. The problem is that at that time this included a significant number of older men, men with undiagnosed urinary and prostate conditions, men with benign prostate hyper plasia and other situations who had no cancer (so it was thought) because their DRE was unremarkable. PSA, though not perfect, has now clearly proven its usefulness. It is known that as a man ages his "normal" psa may rise with changes in the gland. Screening for men in their 30's to their 60's now has a limit of 2.8. We now know that delaying investigation until psa rises above 4 is an error. The best situation is to have a baseline psa from early thirties, and follow changes from that. Rate of increase and time to double are also significant factors in determining further investigation. 

My physician made the mistake of many others. He saw me as a vigorous and healthy 58 year old, DRE normal, and chose to discount a suspicious psa and/or  ignore my psa history and change. He also remembers only his training from years past with a psa "norm" of 4 and has not changed to the new lab limit in his clinical thinking and practice. 

Perhaps my sad experience has awakened him. 

i had the same unfortunate experience as "thoosier". my doc went by the psa 4 limit. for 6 years  he said, with my enlarged prostate ( but no difficulty in passing or holding urine flow) he said 'don't worry, you are ok.my psa ranged from 3 to 4  in those years.

in january 2007 when a severe backpain hit me and i had to be hospitalised and diagnosed, one test led to another and finally prostate and hip bone biopsies confimed cancer. note, that at that time my psa was only 2.8!!

recently my brother-in-law in australia , told me that many oncologists there set i.8 as the level of caution, where tey start going deeper into diagnosis. these psa numbers are still somewhat unclear, and only doctors who hve treated hundreds/thousands of patients in clinics where they work in teams and share in the diagnosis, can reasonably predict

cancer in their patients as related to specific psa numbers. pitchappan patient

My husband would have had the same situation as you. The only reason why he didn't was that his Dad died from PC 18 months before. His uncle also was diagnosed and died from kidney cancer. It moves fast in his family. The doctor smiled and said, "If you would feel better with a urological consult, I can refer you, but I'm sure that he is completely fine". I insisted. 6 months later, positive biopsies, 2 months later surgery.

It is incredibly irritating. Most people would never think to question their MD. Fortunately I work in health care and I tell every man that I see to keep a close eye on it. You can do the same.

As far as the radiation goes, other than being tired and an increase in urination, my husband had no problems. After going through the surgery, the radiation will be a piece of cake. 

Best wishes!

Lin