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First follow-up after radiation treatments

Lynda4548
Posts: 1
Joined: Jul 2014

Hello,  my husband was diagnosed with PC last February. He gad a PSA of 6.8' Gleason 7, 4+ 3,  biopsy 7 of 12..Was told he was in the intermediate stage. They did not recommend surgery, because he is diabetic and has heart problems. He is 69 yrs old. This is all new to us.. He went thru the 37 treatments and ended April 17th.  He returned today for his first follow up. His PSA was down to 1.6 and testosterone at 14.  Oncologist told us, this is great, go enjoy life, and do not worry anymore.  We will see you in 4 months.  

 

Okay.. So does that mean the cancer us gone?..  Are these scores normal. We are thrilled but didn't get that much clarification.  Our fault, because we did not ask the questions.  What can we expect now?  If anyone has can help us see thru thus, I would appreciate your feedback.  Thank you

VascodaGama's picture
VascodaGama
Posts: 1711
Joined: Nov 2010

Lynda

Welcome to the board. Congratulations for the first response in the treatment with a lower PSA. I think that your testosterone unit of 14 is nmol/L which equals to 400 ng/dL or 4 ng/ml.
Many get confused with the units; however, if the above is your husband’s case, his T is within the normal range for his age.

In any case, the radiation therapy (RT) outcome is not verified through testosterone levels. The PSA is the marker you may use from now to look for successes. This marker may become erroneous going up and down and up again but it all signify good results. The fact is what we call PSA bounce, that may take two years till reaching nadir, the lowest reading, and becoming stable.

You can read about this phenomenon in these three links;
http://link.springer.com/chapter/10.1007%2F978-1-4471-2864-9_68
http://www.harvardprostateknowledge.org/what-is-a-psa-bounce
http://www.cancer.org/cancer/prostatecancer/detailedguide/prostate-cancer-treating-p-s-a-levels-after-treatment

Radiation therapy manages to “kill” all tissue in its path but benign “healthy” cells may survive or repair itself, continuing its life journey and produce PSA serum. Cancer cells see it more difficult of surviving but they may do such as well. The continuous several PSA tests will provide you with an answer regarding cure. Meanwhile you can enjoy the success of radiotherapy because it did not leave noticeable scars and it produced a strike on the bandit’s bull’s-eyes as represented in this successful PSA result.

You did not share his initial clinical stage or any info regarding an image study, which results may have help in deciding the surgery. Usually this procedure is done in guys diagnosed with contained localized cancer (negative for metastases), so that one may think that the drop in the PSA after RP is very significant that the cancer was concentrated and “hit” in the gland. Gleason score 7 and the 7 out of 12 positive needles are high in the intermediate risk for existing metastases (extracapsular extensions).

My lay opinion is that your husband needs more results to confirm the outcome. I would recommend he changes is diet and does some sort of physical fitness to improve is overall health issues. Here is a booklet which I recommend you to get;

http://cancer.ucsf.edu/_docs/crc/nutrition_prostate.pdf

 

You can always call the office of his doctor to ask the questions you wanted to do in your last meeting, in particular regarding any symptom or ways to counter the effects. Here are some ideas to help you in completing your list;

http://www.cancer.org/Cancer/ProstateCancer/DetailedGuide/prostate-cancer-talking-with-doctor

http://www.cancer.net/patient/All+About+Cancer/Newly+Diagnosed/Questions+to+Ask+the+Doctor

 

Best wishes for complete recovery from RT and luck in his journey.

VGama

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