I am a new member of this forum and having recently read a lot of the threads really appreciate the participation and knowledge of all the contributors.
August 20, 2010 PSA Total 4.9 ug/L.
November 12, 2010 - Radical Prostatectomy (Da Vinci) followed by 5-units blood and 48-hours later open surgery to stop bleeding.
1. Tissue from left apical margin showing benign connective tissue, negative for malignancy.
2. Prostatectomy specimen showing:
a. Prostatic adenocarcinoma, Gleason grade 4 + 3 = 7 of 10.
b. Carcinoma involves both right and left lobes of prostate occupying approximately 10% of gland by volume.
c. Carcinoma reaches the resection margin of the left anterior quadrant of the gland. All other resection margins are negative for malignancy.
d. Positive for extracapsular extension by carcinoma.
e. Positive for perineural invasion by carcinoma.
f. Negative for lymphovascular invasion by carcinoma.
g. Seminal vesicles are negative for malignancy.
3. Right pelvic lymph nodes showing 2 benign lymph nodes, both negative for metastatic carcinoma.
4. Left pelvic lymph nodes showing 2 benign lymph nodes, both negative for metastatic carcinoma.
Recent PSA Total test results below indicate “recurrence”:
1. Aug 26, 2011 0.00 ug/L
2. Mar 21, 2012 0.06 ug/L
3. May 22, 2012 0.10 ug/L
4. July 22, 2012 will have another PSA test.
My Present Considerations:
1. Owing to cancer being exterior of capsule and extent of bleeding during following 48-hours is there an indication in the recent PSA Total tests above that the cancer is still in the prostate bed or elsewhere?
2. Should I, before starting the recommended regime of 2-months Hormone Therapy (HT) followed by 2-months Radiation Therapy (RT), receive tests to determine the location of the cancer?
3. Is the practice of following RT with 20-months of HT really necessary and beneficial or should I just do 2-months of each and rely on repeating HT and RT once the future PSA tests indicate close to 0.20 ug/L?
4. In my case for the RT could I consider Sterotactic Body Radiation Therapy (5 sessions, each about 40 minutes) or would the TomoRadiation (40 sessions, each about 5 minutes).
Good wishes to all and appreciate any replies to this thread.