I am age 61. Prostate was surgically removed one year ago after biopsy showed early stage "malignant neoplasm" within the prostate.
Doctors were confident all cancer had been removed. This week, a PSA test indicated cancer is still present.
It seems nothing can be done now except hormonal or radiation therapy. Does anyone have experience with either of these therapies? Would you be kind enough to share your experience?
I am a former New Yorker so glad to give some feedback. Others will likely chime in, too.
First of all, just one PSA test may not be quite enough to go on. What was the score? If it is relatively low, I expect your doctor would get a couple more tests at 30-day intervals to check velocity, etc. Doubling time can be calculated and this provides some insight into how aggressive the cancer might be. That would help determine a course of action going forward. If it is high, they may want to do some other testing sooner to get a better idea if it is localized or if there has been some movement.
I had daVinci surgery in April 2011. Cancer appeared to be contained in the capsule and no lymph node involvment was indicated on final biopsy. Initial PSA tests at one and four months came back undetectable (<.05). In December, my PSA was .09 and rose about .02/month for the next several months.
For my situation, CT scans and other testing suggested that I likely had some residual cancer cells in the original area of the prostate but no metastasis to organs or bones. The amount of cells was low enough as to not show up on the PSA tests until some growth had taken place. The oncologist set up a plan to radiate the immediate field it not the whole pelvis.
I had 39 radiation treatments (IMRT) beginning this past April and ending in June. Monday thru Friday for about eight weeks.
From the cancer perspective, I was satisfied with the radiation treatment and outcome. My two PSA tests following treatment have both been undetectable. Of course, time will tell. Side effects vary by individual but I had only minor fatigue plus some burning with urination and increased urgency. Still have some rectal and urinary irritation but it's manageable.
I was given the option of possibly doing hormone treatment in addition to radiation as part of a randomized clinical study but turned it down. Some of the guys I talked to during radiation had gone through hormone therapy and it was helpful to them. However, most of them had really high PSAs and the hormone deprivation knocked it way down. Some of the other guys on here can fill you in on that aspect.
At some point, you need to have a talk with an oncologist - either a medical oncologist or radiation oncologist. (A medical oncologist would have less treatment bias than a radiologist.) That will give you a much better perspective than just talking with the urologist.
John
Last edited by JohninDallas; 09-21-2012 at 07:40 PM.
fractious,
I had Proton Beam Therapy in 2009 after a failed Radical Prostatectomy and recommend that you research it. A good place to start is the Proton Bob Newsletter. The September issue deals with statistics and myths concerning proton treatment which are frequently referred to by supporters of other treatments. It is important to your quality of life that you throughly research salvage treatments. I was treated at Loma Linda but there are 10 treatment facilities currently operating and 9 more under construction in the US. I am satisfied that I am cured with no side effects such as impotence, incontinence, or toxic bowel problems which are common with other treatments.
Best of luck.
