Any researcg on % of reoccurence of PC after RP?

mcin777

Well, it has been a long time since I visited this forum.

I was diagnosed back in Oct 2011 with PC.  I have been monitoring it since them.  I get periodic check ups by Urologist.  My last gleason score was 6 and my PSA has stayed in low 5 range for nearly a year.  In Jan of 2014 it was 5.0     However, I just had another PSA yesterday and found that it is now 6.0    So, I will now waste no more time getting the issue addressed.  

I seem to hear somewhat frequently of people who had robotic surgery who now have had to have radiation some time later.  My concern is that if this is a somewhat frequenty occurrence, why should I not just get radiated to begin with rather than end up having both procedures done?

Any advice?

 

Thanks,

Jim

hopeful and optimistic

First, here is a previous post that you made that provides more information about your case. I didn't check earlier thread that may also provide information.

http://csn.cancer.org/node/266087

 

When a man has an enlarged prostate, many times the prostate presses on the uretha and thus there is a higher PSA number. To be in an active surveillance protocol the relationship of psa/prostate size needs to be below 0.15

Also part of an active surveillance protocol, the psa needs to be less than 10.0

Remember that the PSA is an indicator only and every once in a while there are bumps. This is only one bump.  The Sloan Kettering web site has a nomogram that will calculate rate of change for you. 

The more critical information is results of the biopsy. 

In your previous thread, you gave information from a biospy done Jan 2013. I recommend that you have another biopsy now, an MRI guided one if possible. At any rate if you are seeking treatment I believe that it is important for you to have a Tesla 3.0 MRI to see if any extracapsular extension exists if any....click my name to see what I have been doing.

Swingshiftworker

Why Surgery if Radiation Needed Later Anyway?

Good question!

If you are a candidate for radiation treatment (usually T1c, Gleason 6-7 and PSA less than 10), IMO there really is no reason to subject yourself to the risk of surgery or the risk of recurrance given the effectiveness of the radiation treatment methods for PCa currently available. 

From my experience trolling the PCa boards (here and elsewhere), your risk of incontinence and ED are much higher w/surgery than radiation and you also are at risk for the "complications" of surgery, including infection, unintended collateral tissue damage (especially to the rectum and bladder) and simple negligence.

IMHO, the best methods of radiation treatment currently availabe (in order of priority) are: 1) CyberKnife (CK), 2) Proton Beam Therapy (PBT), 3) High Dose Rate Brachytherapy (HDR BT), 4) Intensity Modulated Radiation Therapy (IMRT) and 5) Low Dose Rate Brachytherapy (LDR BT).

If you are not familiar with these various methods of radiation treatment, I encourage you to research them and choose the one the you think best meets your needs.

Good luck!

BTW, I am a CK alumnus and PCa survivor just a month short of 4 years since I was treated w/CK. w/o any side effects.  It is the method I recommend.  Many men have arrived at the same choice w/the same results. 

Old Salt

You really need to be

You really need to be retested to see if your PSA is actually going up over time in a consistent way. A rise from 5 to 6 could be due to many factors.

It's my understanding, that salvage radiation is an option after surgery if the prostatectomy (surgical removal of the prostate) was less than 100% effective in getting rid of all cancer. Notice, that I used the word 'option'!

To answer your question (more) directly, there's a nomogram from Sloan-Kettering that one can use to address your question:

http://www.mskcc.org/cancer-care/adult/prostate/prediction-tools

 

 

mcin777

Swingshiftworker said:

Why Surgery if Radiation Needed Later Anyway?

Good question!

If you are a candidate for radiation treatment (usually T1c, Gleason 6-7 and PSA less than 10), IMO there really is no reason to subject yourself to the risk of surgery or the risk of recurrance given the effectiveness of the radiation treatment methods for PCa currently available. 

From my experience trolling the PCa boards (here and elsewhere), your risk of incontinence and ED are much higher w/surgery than radiation and you also are at risk for the "complications" of surgery, including infection, unintended collateral tissue damage (especially to the rectum and bladder) and simple negligence.

IMHO, the best methods of radiation treatment currently availabe (in order of priority) are: 1) CyberKnife (CK), 2) Proton Beam Therapy (PBT), 3) High Dose Rate Brachytherapy (HDR BT), 4) Intensity Modulated Radiation Therapy (IMRT) and 5) Low Dose Rate Brachytherapy (LDR BT).

If you are not familiar with these various methods of radiation treatment, I encourage you to research them and choose the one the you think best meets your needs.

Good luck!

BTW, I am a CK alumnus and PCa survivor just a month short of 4 years since I was treated w/CK. w/o any side effects.  It is the method I recommend.  Many men have arrived at the same choice w/the same results. 

Thank you for responding.  I

Thank you for responding.  I appreciate what you have to say and from this point forward I will aggressively seek answers.

mcin777

Old Salt said:

You really need to be

You really need to be retested to see if your PSA is actually going up over time in a consistent way. A rise from 5 to 6 could be due to many factors.

It's my understanding, that salvage radiation is an option after surgery if the prostatectomy (surgical removal of the prostate) was less than 100% effective in getting rid of all cancer. Notice, that I used the word 'option'!

To answer your question (more) directly, there's a nomogram from Sloan-Kettering that one can use to address your question:

http://www.mskcc.org/cancer-care/adult/prostate/prediction-tools

 

 

Thanks Old Salt.  I

Thanks Old Salt.  I appreciate your comments and referral.  Blessings!