Originally Posted by johnblount
I had radical prostate surgery in 11/01 and was administered lupron for 18 months. My PSA test were always <.001 until 09/06 (almost 5 years later)when it rose to .1. In 8/07 it rose again to .2 and now in 1/08 it is .26. I have been advised to have radiation for the same 8 week period. I have read other research where PSA levels do sometimes rise after radiation. However, the research seemed to stop there and not explain how long must one go to see if it goes down or when to treat it with other remedies. Hopefully someone has an experience with this and can share it.
Before you try the radiation, you should at least seriously consider some more comfortable approaches, in my layman's opinion.
It looked like you had a PSA doubling time (PSADT) of about a year, and I just input your three test results into an online formula at a well-known site to check, assuming every test was done on the first of the month as you have to input the month, day and year; the result was a PSA doubling every 11.5 months, which is pretty good, especially when you had no sign of a recurrence until the five year point.
Johns Hopkins researched the seriousness of recurrences a couple of years ago, and they found three factors that clarified the picture. Some recurrences are so mild they are equivalent to a cure and require no additional treatment. In contrast, some are dangerous, and some are in between. By looking at your post-op Gleason Score (up to or greater than 8), time since what they consider to be a significant recurrence (up to or greater than 3 years since PSA rose to .2, and you were at five years - good), and PSADT of various numbers of months, they could predict a lot. They have that information at their website with nice tables, similar to the Partin tables, but you can also check for an abstract of the study at the free Government site [url]www.pubmed.gov[/url]. Just search for " freedland sj [au] AND humphreys [au] AND walsh p [au] AND 2005 [dp] " to see an abstract of the study. While they were studying survival after an RP, the vast majority of the patients were apparently not on hormonal blockade for recurrences until they were fairly late stage patients, which is a poor use of blockade from what I have studied. (Though I'm not medically trained.) The significance of the late use of hormonal blockade is that their patients would probably have done even much better with more timely blockade. Also, there have been other key improvements since the patients were treated in their study, such as improvements in maintaining bone density/minimizing bone metastases and in chemotherapy.
You have such a long PSADT that you might want to try some tactics that have a very low side effect profile and see what happens to your PSA. Age and other medical conditions obviously make a big difference. If you are around 85 with severe heart trouble, with that long PSADT you can pretty much forget about PC from what I've heard (but again, I'm not medically trained). But if you are much younger and/or healthier, then some kind of counter measures seem warranted.
Have you heard about pomegranate juice or pomegranate extract for recurring prostate cancer? In one study, a high quality (refrigerated, kept from light mostly) juice, 8 oz. per day, extended the PSADTs of recurring patients from about 15 months to about 54 months. For most patients, that would be all the help they would need to control the cancer without special major treatment.
Although the study was performed by a sterling set of researchers at an eminent nutrition and cancer institution (UCLA), it was funded by a pomegranate juice company, which raises at least the shadow of a doubt. However, some doctors are now reporting that their recurring patients are doing very well with the juice or extract.
I'm now taking two capsules a day myself, hoping to slow down my PSADT, enabling me to put off resuming hormonal blockade therapy. My next test will be toward the end of this month, and I should get an indication by then. (If you go to [url]www.pubmed.gov[/url], you can access a free abstract of the study by searching for " pomegranate AND heber [au] AND prostate cancer AND leppert jt [au] ". You can also click on an icon there to access a free copy of the whole study.)
As near as I can tell the juice and capsules have a pretty clean side effect profile, although you obviously get around 30 grams of sugar from 8 ounces of the juice - not so great for diabetics, and both the juice and extract act in an apparently much milder way that grapefruit juice does, reducing the breakdown of some medications and supplements, leading to effective larger doses, and potentially overdoses. It makes sense to me to bring this up to your doctor and see what he thinks about this and any other potential side effects.
The low key medications finasteride and Avodart might also be sufficient to slow your PSADT or even stop the rise or reverse it. There is some evidence for that.
(I've been on finasteride continuously for nearly eight years.) Again, these are pretty mild drugs, but something to discuss with a doctor. These drugs are lightweights - not good on their own for entrenched cases, but perhaps enough to knock back a lightweight recurrence.
Diet, nutrition, supplements, exercise and stress reduction tactics might also help. There are several good books. One of the best and most recent is "Beating Prostate Cancer: Hormonal Blockade and Diet," by Dr. Charles "Snuffy" Myers. There's evidence that food or supplements like vitamin D3 (from a good source), lycopene, and selenium, for instance, help control the cancer.
I hope you find something that works.