On 12/17/2007
jwb187 wrote:
Hi Rose,
In reply to your question.....I had davinci surgery April 24 after a biopsy indicating that I had 12 of 24 probes containing adenocarcinoma a psa score of 4.62 and had a gleason score of 8. (High Grade). After surgery the pathology was even worse, gleason 9 (4+5), positive surgical margin and seminal vesicle involvement. I had my first post op psa test in early June which was .62 which came as no surprise to me or my surgeon. Another test about three weeks later indicated a psa of .59. I was referred to a radiation oncologist and also a medical oncologist for further consultation. It was decided that I would start on ADTherapy immediately (lupron) a shot every three months which would continue for two years and as soon as I was reasonably continent would start IMRT radiation treatments. I started IMRT on September 13 and had my next psa checked September 26 which resulted in a reading of .08. This was after three months of hormone therapy and just a few days of rad treatment. As of today I have had very few side effects from either rad or ht therapys. I do have hot flashes but they are what I consider to be minor and short lived. I apparently suffered no ill effects from the radiation treatments. I am scheduled for my next psa in early January and hope that it will be undetectable. I hope this dialog of my course of treatment will give you some guidance of what to expect and maybe what medical regimen to follow. JMHO.....jwb.
Dear jwb ---
Thanks so much for giving your history. I also had prostate surgery, mine 4 years ago and conventional RP done. Prior PSA was 14, only one biopsy stick of ultimately 16 done showed cancer, but high grade 8-9. My PSA readings have been modest BUT rising last two years from 0.09 to 0.16 most recently over those two years. So now considering radiation while chance for salvage therapy cure is still maybe decent (20-30% ?).
My concerns are : (a) side effects of radiation - rectal bleeding, urinary tract pain, etc. Also likely to do concurrent hormone therapy as you to somewhat improve the odds. (b) If I do nothing, will I see my PSA spread to bones and kill me in 5, 10, 15 years ? (Now age 68, age 64 at cancer diagnosis...) Any thoughts ? THANK YOU ! Dick