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PSA LEVELS

concernedson
Posts: 23
Joined: Dec 2006

My father was diagnosed with PC on Dec. 6, 2006. In 2001 my father had a biopsy done and came back negative. Since then he has been keeping a close eye on his PSA LEVELS which were ranging from 2-3. In 2005 he had a surgery to shrink his prostate. Now In 2006 his PSA level has jumped to 6. The doctor recommeded a biopsy, which came back positive for PC. The family is shocked and now we are in the begining stages of finding out the details. So far we have learned that his Gleason Score was 3 + 3 = 6. I did some research and found that 6 is usually the average. The doctor has indicated that the tumor is deep inside one of the tubes and appears to be moderate level and slow growing. They rated the tumor as T1 indicated that it was undetectable by scan or physical exam. The only symtoms my father has had in the past weeks is hip pain. The next step is going for a bone scan and other tests to see if it has spread beyond the prostate. This is very new to me and if any one could shed some light on the results we have received so far it would be greatful. Does the information so far indicate that it has remained in the prostate or does it indicate that it has spread. I am not a doctor so any help would be great. Thanks.

2ndBase's picture
2ndBase
Posts: 220
Joined: Mar 2004

I have metastisized prostate cancer and given the info you have I would say that there is almost no chance that this cancer has spread and a bone scan is not very effective in finding a tumor unless it is the size of a nickel or so. There is a test where isotope tracers are injected and gamma rays are used to find really small tumors but I would not think this necessary and the costs are outrageous. Mine led to filing bankruptcy as I did not have insurance. The pain in the hips is very common and most doctors will say it is not due to the cancer but then they have not ever had it like your dad and I. My psa was 24 and gleason of 9 and yes it had left the prostate, however in your dad's case it would be unlikey that this has happened. If he is 65 years or older I would think that using radiation may be enough to prevent future problems. I took 40 rad treatments and Lupron and am surviving 3 years. My psa is rising again and more treatment is coming if I choose to accept it. Really the best treatment is to get rid of all his stress as this is what kills more people than any cancer. His cancer is not likely to ever cause his death and any qualified doctor should confirm this. Best wishes

concernedson
Posts: 23
Joined: Dec 2006

Thank you for your quick response. My father is 60 years old and besides the PC is a very healthy man. He is concerned that it went undeteced since the last biopsy. Could the cancer have been growing since 2001. Your comments have calmed my nerves. He is scheduled for blood tests and bone scan and MRI. If these come back negative then we would assume its only in the prostate. Do you have any other recommendations. I also worry if it could have traveled to other organs in the body. Sorry for asking you so many questions but this is very scary for us and any guidance would help. You are a great inspiration. Thanks again and happy holidays.

shipjim's picture
shipjim
Posts: 130
Joined: Apr 2006

I'm 60, had a psa of about 6, had the biopsy due to family history and was diagnosed in late Jan 2006, met with a surgeon on Feb2, got bone scan, xrays etc and ekg on Feb3 and was operated on Feb 7. Used the da vinci robotic with virtually no pain or down time was a 23 hr hospital visit.

If caught early should be no problem, any cancer could spread so take the tests, do the surgery, he's young enough not to use rad or other chemo and seeds. If they are used first, surgery is almost always not a future option. DON"T let them cut him find a Doc that will do the robot.
Check it out online under Da Vinci Robotics. Cost effective, my ins paid regular rates and I know medicare also pays for it.

Will have some incontinence for a while, tell him to do the kegel excercises just like for pregnancy, get good pads, to wear and don't lift or ride bikes or horses (really that's what they told me, like I'm going horseback riding after surgery!!! or at all for that matter). Incontinence will clear up, I'm dry except when I drink wine or play golf without stopping enough then it's only a dribble.
Sexual ability may be more difficult, as of now 10 months later no luck but there's more to life than that, I can do any and everything I want and did before the surgery.

Get informed and don't let the surgeon push you until you check out all the options.

What part of the country do you live in? There are great surgeons in Detroit, Sloan-Kettering, St David's in Austin and many others. If he had to fly or drive somewhere for this, it's only a couple of days out of the home and should't be a concern. Only the exams and tests read by the docs can tell you the next step.

Good luck, take care. jj

concernedson
Posts: 23
Joined: Dec 2006

ShipJim thank you for you advise. Im glad to see your feeling better and I think you have a great outlook on life. We live in New York and the two places that we are thinking about is Sloan or Columbia. If you don't mind me asking was your cancer localized in the prostate or did it spread. Secondly, as all readings are different through your experience how does my fathers numbers appear regarding the severity of the disease. Thanks and happy holidays.

shipjim's picture
shipjim
Posts: 130
Joined: Apr 2006

I was 3+3 and was localized. Each case is different with a 3+3 it's about as good as you can get. If a man has to get cancer this is the "best" it can be and the most treatable. Don't fret too much, survival is huge in the early stages. Either hospital you mentioned is great probably I'd go to Sloan for reputation, make sure you surgeon has lots of these behind (no pun) him. My guy does 25-30 per month for the last 5 yrs. You also want them to have the old style experience in case they need to open up but unlikely.

Again, be calm, get information from your docs before you get too worked up. Speculation only creates stress and fear, go slow, the cancer usually does. Anytime you need to write, let me know via private message and I'll send my email etc. jj

concernedson
Posts: 23
Joined: Dec 2006

We made appoinments with two doctors that we feel are the most qualfied. Ash Tewari and David Samadi. Let me know what you think. Both doctors are pretty impressive.

concernedson
Posts: 23
Joined: Dec 2006

shipjim you have been very helpful. I dont know how to reach you through private e-mail can you please instruct me I would love for you to speak with my father. Thanks again

Tasch
Posts: 18
Joined: Sep 2006

Concernedson,
I am 45 and had a gleason of 7 (4+3) in August.
I had the Da vinci method done at Weill Cornell med center ( I live on LI).
You should have your dad call Dr Ash Tewari ( or at least google him-you'll be quite impressed). He is a pioneer in the robotic field and I can assure you, he will have your dad back to 100% in 4-6 weeks.
I had 100% continence the minute the catheter came out. Its going to take a while on the erectile issue, but like shipjim said, there are MUCH more important issues in life than that.
It sounds like your dads cancer is confined to the prostate (as was mine) so everything should be just fine. Dr Tewari takes inter operational biopsies so he makes sure he gets all of the cancer prior to closing a patient up.
I would be very happy to speak with your dad about the procedure as well as Dr Tewari.
Let me know and I'll send you my #.
So far, everything you have mentioned is SOP prior to RP.

Best of luck to your dad.
He is in my thoughts and prayers as you go through this!!!!

Tom

concernedson
Posts: 23
Joined: Dec 2006

Do you know anything about James Eastham, MD
Memorial Sloan-Kettering Cancer Center
or David B. Samadi, MD atColumbia Presbyterian Medical Center. If any one knows of these doctors please let me know.

purplebook
Posts: 2
Joined: Dec 2006

If you decide open surgery, Jim Eastham is one of the best, if you decide on robotic surgery and need someone who is also trained in open surgery as well as laparoscopy, I would go with Dr. David Samadi

concernedson
Posts: 23
Joined: Dec 2006

Tasch can you send me your number the surgeon you used is one that we are interested in. Thanks.

Tasch
Posts: 18
Joined: Sep 2006

Concerned- feel free to call me anytime-516 795-5642H/516 242-0654C.
I opted for Dr Tewari instead of Dr Peter Scardino who is the head of Urology at Memorial Sloan kettering.
I look forward to hearing from you.
Tom

stuart
Posts: 88
Joined: Dec 2001

You are getting a lot of advise...Regarding surgery or radiation, the ten year studies indicate that on average the outcomes are the same...I think your dad may wish to get more than one opinion ie. a surgeon and a radiologist...Six years ago at the age of 53 I was diagnosed with prostate cancer..I decided on radiation both external beam and seeds..There is no right or wrong...It depends on your dad's personal preference...Surgery takes about 2-3 hours with a 2- day hospital stay and about 2-4 weeks recovery time...Radiation is about a month every day except weekends...It takes about 10 minutes each day...There is no pain but radiation does cause fatigue...It sounds like your dad was diagnosed early on which is always more hopefull...Best to you and your dad...

purplebook
Posts: 2
Joined: Dec 2006

It is not so much important what technique you would use. It is the experience of your surgeon that counts. I had consulted with Dr. David Samadi in the past and had a very successful outcome with him. He is the dirctor of robotic surgery at Columbia Presbyterian and performs 7-10 robotic prostatectomy a week and has one of the largest volume of prostate cancer in NY. I chose him because he had worked with Peter Scardino and he is also a competent laparoscopic surgeon. To me it was important to have all three skills in the operating room. Cancer is gone, contienence and potency returned very quickly. He is very compassionate about his work. I would recommend him to anyone with prostate cancer. You can find his information on his website roboticoncology.com Good luck

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