Lifestyle changes vs. Salvage Rad

gumbyrun

Greetings,

I had RP in Feb 2010 and my latest PSA numbers have gone from  0.03 to 0.12 in one year. Urologist recommends consultation with rad/oncologist. Here are my PSA numbers:

5/29/15 9:54A 5/29/15 0.12 FINAL
5/19/14 8:14A 5/19/14 0.03 FINAL
4/12/13 8:15A 4/12/13 <0.02 FINAL
4/13/12 7:49A 4/13/12 <0.02 FINAL
10/3/11 8:29A 10/3/11 <0.01 FINAL
2/28/11 8:31A 3/1/11 0.01 FINAL
11/1/10 8:50A 11/1/10 <0.01 FINAL
7/16/10 7:54A 7/16/10 <0.01 FINAL
4/13/10 10:19A 4/13/10 <0.01 FINAL

2/26/10 (Surgery)
2/4/10 9:01A 2/4/10 7.39* FINAL
10/21/09 9:07A 10/21/09 5.95* FINAL

Honestly, I thought this beast was behind me and had actually scheduled the appointment with the urologist to discuss a sling as I experience stress incontinence, especially when running. My solution to date? Quit running. The path report found negative margins.

I was really taken back when she said I had “slow biomechanical failure.” Her concerns are that 1) the doubling time  and 2) I will experience additional incontinence issues from the salvage radiation.

I’ve done additional research and found a lot of references to lifestyle changes which can halt and even reverse the growth of the cancer cells. I’d be glad to share some stuff I’ve found with interested parties.

 

Just looking for others experiences here. Thanks in advance.

VascodaGama

What's your Gleason score?

In your 5 years of survivorship not much has changed in terms of salvage therapies. The traditional is radiation of the prostate bed together with the localized lymph nodes. This can include a protocol of hormonal treatment that has shown better outcomes (25 to 35%). Some guys tried holistic approaches but they are just palliative as much as it would be taking the hormonal treatment alone.
Your age and life style as well as issues such as the incontinence problem or other health problem, must be considered in the decisions.

In any case, your PSA is low and it may stay like that during a long period before you start a salvage treatment. In guys with Gleason score of 6 and 7, typically recurrence is declared at a PSA level of 0.2, and salvage therapies start at PSA = 0.4. Aggressive types of cancer are recommended to start SRT the soonest after a neoadjuvant HT (plus RT) plus adjuvant HT. Surely anyone can start earlier but the outcomes seem not change much in terms of the length of the biochemical free period. The hormonal manipulations can be done itermittently in on/off periods controled with PSA and Testosterone thresholds.

Best wishes.

VG

gumbyrun

VascodaGama said:

What's your Gleason score?

In your 5 years of survivorship not much has changed in terms of salvage therapies. The traditional is radiation of the prostate bed together with the localized lymph nodes. This can include a protocol of hormonal treatment that has shown better outcomes (25 to 35%). Some guys tried holistic approaches but they are just palliative as much as it would be taking the hormonal treatment alone.
Your age and life style as well as issues such as the incontinence problem or other health problem, must be considered in the decisions.

In any case, your PSA is low and it may stay like that during a long period before you start a salvage treatment. In guys with Gleason score of 6 and 7, typically recurrence is declared at a PSA level of 0.2, and salvage therapies start at PSA = 0.4. Aggressive types of cancer are recommended to start SRT the soonest after a neoadjuvant HT (plus RT) plus adjuvant HT. Surely anyone can start earlier but the outcomes seem not change much in terms of the length of the biochemical free period. The hormonal manipulations can be done itermittently in on/off periods controled with PSA and Testosterone thresholds.

Best wishes.

VG

Gleason

First if all, thanks for the information.

My Gleason scores were 6-7. After reading your comments I realized I may be getting ahead of myself. There seems to be statistical evidence to support starting the rad at 0.2 vs later, especially after three years post-RP. I've heard more horror stories about the hirmone treatments then the rad. Not keen on either.

I'll post again after my appts on next Monday. 

Mike

Old-timer

Your "story" looks familiar

I undertand that no two cases are the same. However, your numbers look much like what I experienced several years ago. In case it may be helpful to you, following is an outline of my record:

 

July 1991, at age 65: PSA 4.0, biopsy Gleason 3+4 = 7.0.

 

September 1991: radical prostatectomy.

 

December 1991 through 2003: PSA .0.

 

Early 2004: PSA 0.2. Then at 3-month intervals my PSA rose: 0.39, 0.61, 1.11.

 

Feb.-Mar. 2004. Radiation sessions (35).

 

July 2004: PSA 1.20. (Informed that radiation was not successful.)

 

October 2004 to June 2008. PSA see-sawed a bit while gradually rising to 20.4.

 

June 2008. Began hormone therapy.

 

September 2008 to October 2014. PSA undetectable <0.1.

 

I am 89, feeling good, remaining relatively active, and enjoying life.

 

Feel free to ask questions.

 

Good luck to you.

 

Jerry (Old-timer)

gumbyrun

Old-timer said:

Your "story" looks familiar

I undertand that no two cases are the same. However, your numbers look much like what I experienced several years ago. In case it may be helpful to you, following is an outline of my record:

 

July 1991, at age 65: PSA 4.0, biopsy Gleason 3+4 = 7.0.

 

September 1991: radical prostatectomy.

 

December 1991 through 2003: PSA .0.

 

Early 2004: PSA 0.2. Then at 3-month intervals my PSA rose: 0.39, 0.61, 1.11.

 

Feb.-Mar. 2004. Radiation sessions (35).

 

July 2004: PSA 1.20. (Informed that radiation was not successful.)

 

October 2004 to June 2008. PSA see-sawed a bit while gradually rising to 20.4.

 

June 2008. Began hormone therapy.

 

September 2008 to October 2014. PSA undetectable <0.1.

 

I am 89, feeling good, remaining relatively active, and enjoying life.

 

Feel free to ask questions.

 

Good luck to you.

 

Jerry (Old-timer)

Long wait until Monday...

Thanks for sharing. Now we'll see what Monday brings and my appt with the rad/onc.