What's Next (radiation and recurrence)?

whom

My brother was diagnosed with prostate cancer about 3 years ago - psa around 13 and Gleason 7 at the time. There was no evidence of cancer beyond the prostate. He was in early 60s. He could have had radiation or surgery and got mixed advice, but went for the radiation thinking it would have fewer side effects. He Had 3d conformal radiation (maximum dose) plus Lupron. Psa went down to below one but has now climbed to about 4. On last DRE, doctor found recurrence of the cancer. So far doc just said wait another few months and have another psa test. Just wondering what's likely to be next. Anyone been in this situation? My brother is convinced this is the "beginning of the end" - that all he can do is have some more hormone blocking drugs, but eventually they will wear off and he will die. Seems to me there might be reason for more hope than that. I mentioned salvage surgery and cryosurgery, but he said those are very difficult, unlikely to work , and have terrible side effects. Any thoughts or experiences?

kaiepooh

sorry to hear about your brother. my husband has prostate cancer and it has spread to the bones. he is a patient at memorial sloan kettering cancer center in nyc. he had radio active seed implant in 95 and reoccurence in dec 97. we went to sloan. they are the reason he is still here. they gave him a experimental vac that kept it at bay till last nov. when it spread to his bones. he had a rough year but is still here and fighting he is 59 and now he gets chemo. there is a dr. there named scardino who also specializes in reoccurence and surg. there are a lot of treatments still left so please don't give up. get another opinion. 3 if need be. i hope this helped. good luck i will prayer for him. keep pushing for answers. also see if he will talk to someone to.

Karen

tpelle

My brother is 87. First discovered capsule- contained prostate cancer about 15 years ago and had external radiation. For the past five or so years has been on Lupron. During the past year his psa jumped from under 4.0 to 7.0, recently was over 14.0; but there is no evidence of cancer spread to the bones. He is now on Cassodex. During this entire period there have been no outward signs of physical health deterioration. He walks up to five miles per day.

Benji48

Hi,
My first comment towards your statement of "no evidence of cancer beyond the prostate" based on the values of psa 13, Gleason 7 according to the least tumor of T1C the probabilities are as follows
Ogan confined 37%
Extraprostatic extension 43%
Seminal Vesicle invasion 12%
Lymphnode invasion 8%

Raising the level to a T2a yields
confined 20%
outside 49%
Seminal 16%
Lymphs 14%
Not very good odds to say the least,roughly 50/50, BUTTT with that said ANDDD we're all going to die someday, I don't mean to be too blunt here but there is life after cancer! I've got it & been on Lupron now for a couple of years following surgery, radiation, & now hormone shots and live it to the fullest each day! Tell your brother he MUST also. Don't give up. It, by itself is not a death sentence. My last psa was .04 & I'm fine. If I didn't tell you I had cancer, you would never know it.I do everything I did B4 just a little slower, heh,heh. Be sure & take Tpelle's post to heart also & don't let it get him down.
Best Wishes & take care Benji

russwhot

I have had radiation and am investigating cryology as the possible next step. I have "heard" that freezing the prostate is the next option after a failed radiation therapy. My understanding is that it does not require invasive surgery. I have just begun my investigation. I will post my findings as soon as I can get more information. As you can read from the other replies, a higher psa does not necessarily mean rapid invasion of the bones and then death. The best of luck to your brother. rwhot