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Finally, the PSA I've been looking for
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LeeLiam
May 3, 2012, 7:12:32 PM5/3/12
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Since I haven't posted much for a while, a little background. I was diagnosed in 06/06 with PSA 13.8 and Gleason 7.4 (that's my way of saying Gleason 3+4 with 40% 4's).
I had seeds in 10/06, with IMRT through that December. My onc had an enormous amount of experience at RCOG, but had left there and was working on his own. He had a system where he put in three gold seeds along with the radiation seeds. At each IMRT session, they x-rayed me and, based on the location of the gold seeds, the computer moved the bed in all three dimensions to insure the beam hit the prostate and only the prostate. I think that is the main reason why I have had absolutely no side effects. I could not have been more pleased with the treatment.
I sorta expected a bounce, but not two of them and not to the extreme mine reached. Here is my PSA history:
PSA dx 13.8
seeds 10/06
3.2 (1/23/07)
2.2 (4/23/07)
2.5 (10/23/07)
3.2 (1/23/08) My onc said not a problem, we expect a bounce.
3.5 (4/23/08)
5.6 (6/26/08)
7.5 (10/23/08) My onc seemed very worried at this point, but I kept the faith.
6.0 (11/23/08)
3.7 (3/15/09)
3.4 (7/23/09)
2.3 (11/6/09) I'm feeling pretty good about here.
2.7 (3/23/10) Now, not so much.
3.7 (7/25/10) Now, I'm scared.
2.4 (10/16/10) This is better.
0.8 (2/22/11) Way better.
0.5 (10/17/11) Better still.
0.2 (5/3/12) The best.
I think they say if you hit 0.2 around the five year mark, its a pretty good sign. But, just to be on the safe side, I'll keep taking the curcumin, milk thistle, Pecta-Sol and fish oil.
I had seeds in 10/06, with IMRT through that December. My onc had an enormous amount of experience at RCOG, but had left there and was working on his own. He had a system where he put in three gold seeds along with the radiation seeds. At each IMRT session, they x-rayed me and, based on the location of the gold seeds, the computer moved the bed in all three dimensions to insure the beam hit the prostate and only the prostate. I think that is the main reason why I have had absolutely no side effects. I could not have been more pleased with the treatment.
I sorta expected a bounce, but not two of them and not to the extreme mine reached. Here is my PSA history:
PSA dx 13.8
seeds 10/06
3.2 (1/23/07)
2.2 (4/23/07)
2.5 (10/23/07)
3.2 (1/23/08) My onc said not a problem, we expect a bounce.
3.5 (4/23/08)
5.6 (6/26/08)
7.5 (10/23/08) My onc seemed very worried at this point, but I kept the faith.
6.0 (11/23/08)
3.7 (3/15/09)
3.4 (7/23/09)
2.3 (11/6/09) I'm feeling pretty good about here.
2.7 (3/23/10) Now, not so much.
3.7 (7/25/10) Now, I'm scared.
2.4 (10/16/10) This is better.
0.8 (2/22/11) Way better.
0.5 (10/17/11) Better still.
0.2 (5/3/12) The best.
I think they say if you hit 0.2 around the five year mark, its a pretty good sign. But, just to be on the safe side, I'll keep taking the curcumin, milk thistle, Pecta-Sol and fish oil.
Steve Kramer
May 3, 2012, 9:56:22 PM5/3/12
to
That's GREAT, John!!
I'm glad you came back to tell us.
PSA OCT 2000 @ 46
Biopsy NOV 2000 3+4=7, T2c
RRP DEC 2000 3+4=7), T3cN0M0, SVI, Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT MAY - JULY 2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron started JULY 2003 @ 48
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added JUL 2006 @ 51
Last PSA <0.05 Next draw AUG 2012 @ 57
Illegitimati non carborundum
"LeeLiam" wrote in message
news:9998106.53.1336086752534.JavaMail.geo-discussion-forums@ynll26...
I'm glad you came back to tell us.
PSA OCT 2000 @ 46
Biopsy NOV 2000 3+4=7, T2c
RRP DEC 2000 3+4=7), T3cN0M0, SVI, Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT MAY - JULY 2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD 0.56 years
Lupron started JULY 2003 @ 48
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.40 years
Casodex added JUL 2006 @ 51
Last PSA <0.05 Next draw AUG 2012 @ 57
Illegitimati non carborundum
"LeeLiam" wrote in message
news:9998106.53.1336086752534.JavaMail.geo-discussion-forums@ynll26...
Alan Meyer
May 3, 2012, 11:30:40 PM5/3/12
to
On 5/3/2012 7:12 PM, LeeLiam wrote:
...
five years to reach PSA nadir after HDR brachytherapy + 3DCRT + ADT, but
the highest PSA I recorded was 1.8.
As you say, the statistics show that the longer you take to reach a low
PSA value the more likely you are to be completely cured. It's
counter-intuitive to be sure, but apparently the studies show that it's
true.
Interestingly, one of the standard measures of recurrence is three
straight rises in PSA, measured at least months apart. You had *FIVE*
straight rises in PSA, measured three months apart! That must have been
scary as hell.
Your experience is important for other men. Some men probably go on ADT
who don't really need to do so. Seeing a PSA of 7.5 21 months after
treatment with five straight rises shows that big bounces are indeed
possible and yet still result in what we hope to call a cure.
Alan
...
> PSA dx 13.8
> seeds 10/06
> 3.2 (1/23/07)
> 2.2 (4/23/07)
> 2.5 (10/23/07)
> 3.2 (1/23/08) My onc said not a problem, we expect a bounce.
> 3.5 (4/23/08)
> 5.6 (6/26/08)
> 7.5 (10/23/08) My onc seemed very worried at this point, but I kept the faith.
> 6.0 (11/23/08)
> 3.7 (3/15/09)
> 3.4 (7/23/09)
> 2.3 (11/6/09) I'm feeling pretty good about here.
> 2.7 (3/23/10) Now, not so much.
> 3.7 (7/25/10) Now, I'm scared.
> 2.4 (10/16/10) This is better.
> 0.8 (2/22/11) Way better.
> 0.5 (10/17/11) Better still.
> 0.2 (5/3/12) The best.
>
> I think they say if you hit 0.2 around the five year mark, its a pretty good sign. But, just to be on the safe side, I'll keep taking the curcumin, milk thistle, Pecta-Sol and fish oil.
That's was a big bounce indeed. I also had several bounces and took
> seeds 10/06
> 3.2 (1/23/07)
> 2.2 (4/23/07)
> 2.5 (10/23/07)
> 3.2 (1/23/08) My onc said not a problem, we expect a bounce.
> 3.5 (4/23/08)
> 5.6 (6/26/08)
> 7.5 (10/23/08) My onc seemed very worried at this point, but I kept the faith.
> 6.0 (11/23/08)
> 3.7 (3/15/09)
> 3.4 (7/23/09)
> 2.3 (11/6/09) I'm feeling pretty good about here.
> 2.7 (3/23/10) Now, not so much.
> 3.7 (7/25/10) Now, I'm scared.
> 2.4 (10/16/10) This is better.
> 0.8 (2/22/11) Way better.
> 0.5 (10/17/11) Better still.
> 0.2 (5/3/12) The best.
>
> I think they say if you hit 0.2 around the five year mark, its a pretty good sign. But, just to be on the safe side, I'll keep taking the curcumin, milk thistle, Pecta-Sol and fish oil.
five years to reach PSA nadir after HDR brachytherapy + 3DCRT + ADT, but
the highest PSA I recorded was 1.8.
As you say, the statistics show that the longer you take to reach a low
PSA value the more likely you are to be completely cured. It's
counter-intuitive to be sure, but apparently the studies show that it's
true.
Interestingly, one of the standard measures of recurrence is three
straight rises in PSA, measured at least months apart. You had *FIVE*
straight rises in PSA, measured three months apart! That must have been
scary as hell.
Your experience is important for other men. Some men probably go on ADT
who don't really need to do so. Seeing a PSA of 7.5 21 months after
treatment with five straight rises shows that big bounces are indeed
possible and yet still result in what we hope to call a cure.
Alan
LeeLiam
May 9, 2012, 11:24:20 AM5/9/12
to
On Thursday, May 3, 2012 11:30:40 PM UTC-4, Alan Meyer wrote:
> As you say, the statistics show that the longer you take to reach a low
> PSA value the more likely you are to be completely cured. It's
> counter-intuitive to be sure, but apparently the studies show that it's
> true.
>
Alan,
> As you say, the statistics show that the longer you take to reach a low
> PSA value the more likely you are to be completely cured. It's
> counter-intuitive to be sure, but apparently the studies show that it's
> true.
>
It may not be as counter-intuitive as you might first think. The way my very limited understanding of the way radiation works, it seems the radiation damages the DNA in the cancer cells. It does not kill the cells. It is not until the cells split (mitosis) that they actually die. Therefore, if a person has rapidly splitting cells (hence, a more aggressive cancer) his cells will die quicker and he will reach nadir faster.
For someone with cells splitting more slowly (a less aggressive cancer), it takes longer for the cell population to die off and nadir to be reached.
If all cancer is killed, it doesn't matter in either event. But, if any cells remain, obviously the less aggressive variety is preferable. So, a man with a longer time to nadir may be more likely to die with the disease than to die of the disease.
> Interestingly, one of the standard measures of recurrence is three
> straight rises in PSA, measured at least months apart. You had *FIVE*
> straight rises in PSA, measured three months apart! That must have been
> scary as hell.
>
Even though I was not treated at RCOG, my doc used the same protocol. So, I joined an RCOG group on Yahoo. They have a database where about 60 men have recorded their PSA readings from 6 months out to as much as 12 years. This was incredibly helpful to me to see the wide variety and magnitudes of bounces. It really helped me make a couple of good decisions. It is a shame data like this isn't available in everyone's circumstances.
> Your experience is important for other men. Some men probably go on ADT
> who don't really need to do so. Seeing a PSA of 7.5 21 months after
> treatment with five straight rises shows that big bounces are indeed
> possible and yet still result in what we hope to call a cure.
Finally, let me say that, while I haven't written very much here over the last five years, I have read almost everything you and others have written and I really appreciate everything you all contribute. It is amazingly helpful.
John
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