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Husband with prostate cancer

ginnygingin
Posts: 3
Joined: Mar 2013

Hi:  My husband is the cancer survivor.  Pretty much still in denial - so this is why I'm writing.  I need some advice.  He is 59.  Diagnosed last year:  PSA 6.6, Gleason score was 7 (3+4), biopsy 7 out of 12 positive for cancer.  Underwent Robotic Surgery 8 months ago with two positive margins near apex; seminal vesicles - left and right both negative.  He did not do lymph node biopsy as pre-surgery CT scan was negative for lymph node invasion and lymph nodes appeared negative.   Due to having two positive margins, we went ahead with adjuvant radiation therapy three months after his surgery.  His postop PSA (at 3 months) was 0.1 and again at 6 months was the same 0.1 (two months after completion of radiation).  So, my question is should he be seeing an Oncologist at this point?  Probably too soon to start any other treatment.  He feels great.  Very minimal side effects from both surgery and radiation.  Thanks for all your replies.  

ralph.townsend1's picture
ralph.townsend1
Posts: 354
Joined: Feb 2012

With the psa staying at 0.1 is good, but psa should be at 0.001, that's a real zero. Maybe another test from a new location or if it is the same location and it comes back at psa 0.1 again.

If the same, I would not look for a Oncologist yet. If It gets to 0.3 or 0.4 in about 2-3 months and when look at getting a Oncologist.

So for right now injoy life and pray!

God Bless

ginnygingin
Posts: 3
Joined: Mar 2013

Ralph:

 

Thanks for your comment.  Will try not to worry.  He did start adjuvant radiation 2 weeks before the 1st (about 3 1/2 months postop) PSA was drawn.  Don't know if that influenced the PSA or not.  We will watch it closely.  

VascodaGama's picture
VascodaGama
Posts: 1637
Joined: Nov 2010

Ginny

Your worries may be for nothing. It is too early to make any conclusion on the success of the treatment. I agree with your husband’s denial and would suggest you to believe in it too.

The first PSA surely has been influenced by the radiation so that the latest becomes the marker for future reference in the prognosis.

I also think that PSA=0.1 is high but the number seems more to refer to the particulars of the assay, more specifically to the LLD (low level of detection) used in that laboratory.
I would recommend your husband to request tests done with higher sensitive specifics on the two decimal places (0.XX ng/ml). This is more proper to judge progression on cases of RP plus RT.
Remission levels in patients of prostatectomy are usually considered below 0.03 ng/ml. That could well be the result of the last PSA if the lower limit of the assay was just 0.1.

You may wait for the next test to draw conclusions but you could repeat the test now in sensitive assays to have a more reliable starting marker. In any case, your husband should get tested every three months during the follow up period of the treatment (approximately two years under remission).

No analysis has been done on lymph nodes but the radiation field may have included those areas of the prostate bed and iliac where cancer usually spreads when positive margins are apparent. You can consult with the radiologist about what they have radiated. It is important to have a copy of the RT protocol for future reference, should recurrence occur.

Your husband would need an oncologist only if recurrence becomes apparent. For the moment just celebrate the success of the treatment for the minimal side effects he is experiencing.

Believe in cure.

 

Peace of mind to you and best wishes for total recovery for your husband.

VGama

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