It appears you have not yet Signed Up with our community. To Sign Up for free, please click here....



Cancer: Prostate Message Board
Post New Thread   Closed Thread
LinkBack Thread Tools
Old 08-09-2009, 08:18 AM   #1
Junior Member
(male)
 
Join Date: Jul 2009
Location: Lake Placid Fl USA
Posts: 12
SunnySace HB User
More- Post Op Radiotherapy

Along with so many other guys - I am looking at post RP radiation - only because my doc, Pow-Sang advised. I always said - if it comes down to radiation or chemo - I'll just do what I can with prayer, exercise and nutrition. Now that I'm in that square - I want to at least be more informed.
My surgery was 6/19/09. I feel it was a successful surgery and am pleased with recovery so far.
I am now 70 and otherwise quite healthy. I still own my own auto repair business and stay busy but know "busy" is not exercise. That I need to work on.
Although it will make this post quite lengthy - I am going to enter my original pre-op lab/biopsy findings and my post-surgical pathology in the hopes that the "new" guys joining "the club" may benefit.
Also - I plan to keep the group updated as my progress continues.
PRE-OP:
PSA went from 4.5 in '06 to 6.4 in Mar 09
Apr '09 DRE abnormal - hard mass on left side
Biopsy results:
a- Right Apex: benign prostatic tissue. mild acute inflammation
b- Right Mid: benign prostatic tissue
c- Right Base: benign prostatic tissue
d- Left Apex: Adenocarcinoma (Gleason Score 3+4=7) involving 30% of the specimen (2 of 2 cores contain cancer) Gleason pattern 4 comprises 20% of the cancer.
e- Left Mid: High-grade prostatic intraepithelial neoplasia.

Bostwick Labs has a staging system called UroPredict* for probability statistics -
Organ confined - 74%
Extraprostatic extension - 26%
Seminal vesicle invlvmt - 1%

Cinical Stage: T2
**************************************** *******************
POST-OP
Final Diagnosis (taken at time of surgery 6-19-09)
PSA 7.4
A. PROSTATE BASE MARGIN: Prostate tissue, no evidence of malignancy.
B. PROSTATE AND SEMINAL VESICLES, PROSTATECTOMY: Prostatic adenocarcinoma. Seminal vesicles, free of malignancy.
Pathologic stage: pT2c NX MX

Key Patholigical Findings
B. Prostate
Histologic Type: Prostatic adenocarcinoma
Histologic Grade: Primary Pattern: Grade 3
Secondary Pattern: Grade 4
Total Gleason Score: 7
Tumor Quantitation: Proportion (percent) of prostate involved by tumor:15%
Primary Tumor (pT): pT2c
Regional Lymph Nodes: pNX
Distant Metastasis (pM) : pMX
Tumor Location: Left apex
Right anterior apex
Right anterior mid
Right posterior mid
Right anterior base
Right posterior base
Right base
Left anterior apex
Left posterior apex
Left anterior mid
Left posterior mid
Left anterior base
Left posterior base
Margins: Margins involved by carcinoma:
Left apex (2.5mm linear extent involvement)
Right posterior mid
Right base
Extracapsular extension: not identified
Seminal Vesicle invasion: Left, free of malignancy
Right, free of malignancy
Perineural invasion: Present
Venous (Large Vessel) invasion (V): Absent
Lymphatic (Small Vessel) invasion (L): Absent
Additional pathologic findings:
High-grade prostatic intraepithelial neoplasia(PIN)
Glandular and stromal hyperplasia
(Partial) Gross Description:
The gland is serially sectioned from apex to base revealing a gray-white, slightly nodular appearance with yellow foci, which is suggestive of tumor diffused throughout the entire gland concentrated at the mid to basilar aspect................

Final Report:
Findings: Maximal preservation of the right neurovascular bundles. Posterior preservation of the left neurovascular bundles.




**************************************** *******************

There you go - the long and not so short of it...........
with all this given - we are thankful that we opted for the surgery

now I am leaning toward prayer, nutrition, supplements and exercise rather than radiation.......

I am now studying the various PSA tests - not having heard of the different types until I found this group - so - thanks guys! When I am more informed I'll be asking more questions - or if you have input.......let me have it!

 
Sponsors Lightbulb
   
Old 08-09-2009, 08:41 AM   #2
Member
(male)
 
Join Date: Jul 2009
Location: Greene, Rhode Island
Posts: 80
Red Nighthawk HB User
Re: More- Post Op Radiotherapy

That is one heck of a report Sunny. One thing I did learn from you is that my wife and I better keep excellent records through this nightmare. I'll ask for every report from every doctor I see. Thanks for the time and effort you gave to present this tremendously complete report of your journey. I wish you well with your strategy of prayer, nutrition, supplements, and exercise. Hopefully, radiation will not be needed for your complete cure. God bless you.
john

 
Old 08-10-2009, 03:12 PM   #3
Senior Veteran
(male)
 
Join Date: Nov 2007
Location: Annandale, VA, USA
Posts: 1,730
Blog Entries: 3
IADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB User
Re: More- Post Op Radiotherapy

Hi Jack,

I haven't yet had an opportunity to respond to one of your posts, but I've enjoyed reading them, and thanks for posting all the detail from your reports, especially the pathology report. I'm still curious about the look of those reports, and I learned from what you posted. I'll bet Dr. Pow-Sang, compared to other doctors, writes unusually detailed reports, packed with useful information. That's the kind of report I would have liked to have had if I had had surgery.

Thanks also for your kind comments about my posts.

I'll insert some thoughts in green. Jim


Quote:
Originally Posted by SunnySace View Post
Along with so many other guys - I am looking at post RP radiation - only because my doc, Pow-Sang advised. I always said - if it comes down to radiation or chemo - I'll just do what I can with prayer, exercise and nutrition. Now that I'm in that square - I want to at least be more informed.
My surgery was 6/19/09. I feel it was a successful surgery and am pleased with recovery so far.
I am now 70 and otherwise quite healthy.

Even if there is still cancer - not at all certain, you accomplished at least a couple of things with that RP. For one, at the very least you "debulked" the cancer. While it would be very early for some of those PC cells to mutate to something more aggressive and dangerous, debulking cuts down on the odds of that happening. For another, you got rid of all that was in the prostate, and that may have wiped out all of the Gleason 4 cancer you had, even if it did not get all the cancer.
...

now I am leaning toward prayer, nutrition, supplements and exercise rather than radiation.......

I'm going to copy and address your thought below the next one, as the PSA is really key here.

I am now studying the various PSA tests - not having heard of the different types until I found this group - so - thanks guys!

To me it makes great sense that all RP patients should be monitored for recurrence after their surgery with ultrasensitive PSA tests, and I'm interested whether Dr. Pow-Sang does that as a matter of course. But I think it is especially important in your case. Ultrasensitive testing gives much earlier warning if prostate cancer is still present and growing, and the trend in very low ultrasensitive test results, if there is cancer, is a good clue to aggressiveness of the cancer.

I would call the doctor and ask whether they intend to use an ultrasensitive test to check your status. Now is about the right length of time (with some margin) for a check. If they do intend to use an ultrasensitive tests, ask about its lower limit. That's because, if the limit is <0.01, you can tie in your result to research that has already been published that documents the predictive meaning of scores of <0.01, .01, .02, .03, .04, and .05 and higher, as well as trends with subsequent ultrasensitive results. Also, it is virtually certain that more research will be published on ultrasensitive monitoring of post-RP PSAs, and you will be able to tie into that in the future.

It's possible that Dr. Pow-Sang does not yet regularly use ultrasensitive post-RP monitoring. That would not be that unusual, as the American Urological Association has been luke-warm on the issue, which I think is regretable. If he plans to use a conventional test, or an ultrasensitive test with a lower limit that leaves the lowest values in the dark, I strongly recommend that you try to persuade him to test you with an ultrasensitive version with a lower limit of < 0.01. It's possible that there is now a version of the test with a practicial, clinical-use (as contrasted with an envelope stretching research-use) lower limit even lower than <0.01, but I'm not aware of any research showing that use of such results would have a useful advantage over a test sensitive to <0.01. (Of course, an advantage could become apparent in the future.)

I urge you not to settle for accepting convenience here. When my PSA is dropping to the .09 to .04 range on my triple blockade therapy, I and my doctor can get a quick result sensitive to <0.04 the next day and that's fine. But sometimes we want to know if I'm making it to <0.01 again, and we have to wait for 7 to 10 days for the out-of-state result. But that information is valuable to us, so we accept the delay. You only have this period to see how low your PSA dropped in the period shortly after your RP, so I recommend you go for it!

Now to repeat your thought from above -


now I am leaning toward prayer, nutrition, supplements and exercise rather than radiation.......

You can use the ultrasensitive results to help steer your course. If you get a PSA result in the range from <0.01 to .03, you've got a pretty good shot at not recurring, though the odds drop somewhat as you move from <0.01, to 0.01, to 0.02, to 0.03. At those levels, especially if the PSA does not start increasing on that tell-tale exponential upward trend as 2,000 cells all split to become 4,000, 4,000 all split to become 8,000, and so on, that program of prayer, nutrition, supplements and exercise looks highly appropriate to me. (I would add finasteride or Avodart, a statin drug, and stress reduction in addition to prayer, but you would already be doing a lot with what you mentioned.)

On the other hand, if your PSA score is 0.04 and it climbs, or much more so if it is 0.05 or higher and climbs, then it's time to start learning more about follow-up options. That lifestyle program would probably still be helpful in support, just not enough to do the whole job by itself. However, the medical world that treats prostate cancer is learning more all the time, and a block-buster lifestyle nutritional tactic or other lifestyle tactic may emerge as you monitor your PSA.

For instance, pomegranate juice or high quality capsules may prove to fill that bill for many patients; one high quality study showed they slowed the average PSA doubling time for recurring patients from about 15 months on average, which was troublesome, to about 51 months, which was quite reassuring. Vitamin D3 is also looking like a heavy hitter.

By the way, as you probably already realize, follow-up radiation is not the only option. Hormonal therapy alone, or radiation and hormonal therapy, are also excellent options.


When I am more informed I'll be asking more questions - or if you have input.......let me have it!

Here's hoping you will get a series of great ultrasensitive PSA results and will be able to relax.

Take care,

Jim


 
Old 08-11-2009, 10:21 AM   #4
Junior Member
(male)
 
Join Date: Jul 2009
Location: Lake Placid Fl USA
Posts: 12
SunnySace HB User
Re: More- Post Op Radiotherapy

Wow! Thanks for the input - now I have some understanding of the PSA testing and what to ask for. I've already started on the V D3 and pomegranate and scouring your posts for other needs.

Although I have an awesome doctor in Dr Pow-Sang - I still have to be informed and active in my treatment -
I'm going to step out and thank you for myself and so many of us that find your input so helpful! I appreciate the fact that you quote yourself as a layman - but my goodness - you are the most knowledgeable layman I've ever met. So, let us keep applauding your help!

Blessings!
Jack

 
Old 08-17-2009, 05:55 PM   #5
Senior Veteran
(male)
 
Join Date: Nov 2007
Location: Annandale, VA, USA
Posts: 1,730
Blog Entries: 3
IADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB UserIADT3since2000 HB User
Re: More- Post Op Radiotherapy

Hi Jack,

Thank you for your kind words. Comments like yours certainly encourage us frequent posters.


Quote:
Originally Posted by SunnySace View Post
... I appreciate the fact that you quote yourself as a layman - but my goodness - you are the most knowledgeable layman I've ever met. So, let us keep applauding your help!

That reminds me of a bumper sticker: "Good Judgement is Based on Experience; Experience is Based on Bad Judgment."

Blessings!
Jack
Blessings to you too!

Jim

 
Old 06-14-2011, 04:53 AM   #6
Newbie
(male)
 
Join Date: Jun 2011
Location: redwood,ny
Posts: 8
gordontoo HB User
Re: More- Post Op Radiotherapy

MY younger brother and Ihad the divinci method my following psa results have been .0042 or in that range my brothers whent up to 27.4 in15 months after surgery he then had radiation for 28 sessions no help from that now hes on luprtn shot and an oral pill.I believe in prayer nutrition and walking 2-4 miles per day. although my brother is 5 years younger he has had a terrible time his Dr. writes that my brothers condition is terminal he is 57 years old. The only difference between us is that he was on testosterone shots for about a year when he was 50 years old you have a lot to concider but make sure you enjoy today and not worry about tommorow. I wish you the very best

 
Closed Thread

Similar Threads
Thread Thread Starter Board Replies Last Post
should i get tested one more time? scaredscared HIV Prevention 5 04-21-2010 11:30 AM
Help!Lupus,Fibro,Heart SVT,IBS,Kidney&LiverProb,DDD,OA&more empressofq13 Lupus 2 07-10-2008 04:49 AM
One Struggle after another. I can't deal with much more. ILiveForMyKIDS Depression 8 01-08-2007 02:30 PM
What's next. How much more can I deal with? ILiveForMyKIDS Anxiety 3 01-03-2007 07:24 PM
Burning More Than You Consume Lizziegirl Exercise & Fitness 10 12-29-2005 08:31 AM




Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is Off
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off




Join Our Newsletter

Stay healthy through tips curated by our health experts.

Whoops,

There was a problem adding your email Try again

Thank You

Your email has been added




Top 10 Drugs Discussed on this Board.
(Go to DrugTalk.com for complete list)
Casodex
Cialis
Cipro
Flomax
Levaquin
  Levitra
Morphine
Proscar
Tylenol
Viagra




TOP THANKED CONTRIBUTORS



Tall Allen (174), IADT3since2000 (148), Baptista (97), Gleason9 (28), harpman (27), Johnt1 (22), honda50 (9), tumbleweed (6), flyfisher37 (6), GUAMJOHN (5)

Site Wide Totals

teteri66 (1136), MSJayhawk (941), Apollo123 (857), janewhite1 (823), Titchou (773), Gabriel (743), ladybud (667), sammy64 (666), midwest1 (655), BlueSkies14 (610)



All times are GMT -7. The time now is 01:25 AM.



Site owned and operated by HealthBoards.com™
Copyright and Terms of Use © 1998-2014 HealthBoards.comô All rights reserved.
Do not copy or redistribute in any form!