Newbie From Taiwan - Cancer: Prostate Message Board

greggeva · 10-02-2008, 07:26 AM

Just wanted to introduce myself a bit ... and take this first step in getting on the board. My name's Gregg, I'm 51 years old, and have been living in Taiwan for 20 years now. Last November, I went for a physical exam and found out I had prostate cancer. Initial PSA was 66.04, Gleason = 7 (3+4) and 5 (3+2), and it had invaded the seminal vessicles and a nearby lymph node. I went on hormonal therapy (Zoladex) and then, eight weeks of radiotherapy starting in March of this year. My subsequent PSA results were 3.90, 1.73, and in September, .59.

I thought the .59 was great, but my doctor doesn't seem so happy about it. He said he'd like for it to get below .1 ... and feels like it should have already done so. In fact, he said if it doesn't go below .5 at the next testing, he would start me on something else. Does this sound right to you guys? There are not a lot of treatment options over here, but this doctor (and hospital) have a reputation as being the best on the island. That said, there's not as much experience in dealing with prostate cancer in Taiwan. Guess I'm a bit insecure in where I'm going in this. Thanks for any feedback you might have!

Gregg

daff · 10-02-2008, 03:26 PM

Glad you found the board- sorry you had to. One of the most knowledgeable persons I've ever come across is Jim (IADT3since2000). While he is not a medical doctor, his own personal experiences along with his considerable in-depth research has led to many posts dealing with issues similar to yours. When he comes across your post, I'm sure he will provide some specific thoughts. In the meantime you might want to search through some of his prior postings.

dale2035 · 10-03-2008, 12:57 PM

Quote:

Originally Posted by greggeva

Just wanted to introduce myself a bit ... and take this first step in getting on the board. My name's Gregg, I'm 51 years old, and have been living in Taiwan for 20 years now. Last November, I went for a physical exam and found out I had prostate cancer. Initial PSA was 66.04, Gleason = 7 (3+4) and 5 (3+2), and it had invaded the seminal vessicles and a nearby lymph node. I went on hormonal therapy (Zoladex) and then, eight weeks of radiotherapy starting in March of this year. My subsequent PSA results were 3.90, 1.73, and in September, .59.

I thought the .59 was great, but my doctor doesn't seem so happy about it. He said he'd like for it to get below .1 ... and feels like it should have already done so. In fact, he said if it doesn't go below .5 at the next testing, he would start me on something else. Does this sound right to you guys? There are not a lot of treatment options over here, but this doctor (and hospital) have a reputation as being the best on the island. That said, there's not as much experience in dealing with prostate cancer in Taiwan. Guess I'm a bit insecure in where I'm going in this. Thanks for any feedback you might have!

Gregg

Hi, Gregg,
I am new to this. I am in the process of getting information. It seems, even when a person has the best provider on his island, he has to work to supplement his understanding. It would be nice to totally trust the expert...and you may be closer to being able to trust your specialist than I have been so far (although I have been very impressed with the urologist who diagnosed my PCa and the radiologist recommended by the family doctor). I am guessing your medical team is more thorough than most. With a Gleason score of only 7 and the primary pattern only a 3, I was wondering about the cancer being a little bit outside the organ. I wonder what test was used to give you the specific location of the cancer outside the capsule.
Not knowing anything about your question, as an uniformed Newbie, I would be encouraged by the impatience of the doctor who is getting a steady drop in the PSA, but is eager to get more of a drop...and will utilize new procedures &/or medications to promote that continued decline.
Good luck with your treatment. I have found Daff and Jim very helpful. They seem to have a handle on most questions...or find out the answers...and are very generous and patient passing on that information. Jim has been away for a few weeks as part of a "think tank" of experts in the field and informed patients. He is back now helping us out.
Dale

greggeva · 10-03-2008, 02:17 PM

Hi Dale and Daff,

Thanks for your replies. It means a lot to me to hear back from you guys in this. You (Dale) asked what tests they used to figure out where the cancer was outside the prostate. I'm pretty sure they saw all this on an MRI they gave me. The doctor pointed it all out to me on the computer, including the enlarged (2.2 cm) lymph node. Other than a couple of bone scans (negative) and the CT scan associated with my radiotherapy, I can't think of any other diagnostic tests I've had done.

Thanks again, guys, for your feedback!

Gregg

daff · 10-03-2008, 02:33 PM

Quote:

Originally Posted by greggeva

I'm pretty sure they saw all this on an MRI they gave me. The doctor pointed it all out to me on the computer, including the enlarged (2.2 cm) lymph node.

Gregg-
It must have been a pretty conclusive MRI, as they are not always easy to read. I initially had a standard MRI and there were conflicting opinions as to whether the cancer had gone into the margin. I later received a more advanced endorectal spectroscopic MRI, and the conclusion from that was that it was contained within the prostate. You might want to ask again if there can be any doubt at all about the reading of your MRI.