What are my odds for recurrence?
PSA 1/2013 was 3.6, DRE normal.
PSA 8/2014 was 5.5, DRE normal.
Was sent to Urologist for biopsy. Only thing we remember is the word “CANCER”.
Retropubic Prostatectomy 11/20/2014. My age 55.
On the table for approximately 5.5 hours. Came out with a scratched cornea from an eyelash being turned under during surgery. That was extra pain and suffering.
Pathology from surgery:
Gleason 3+4=7, Tertiary Pattern 5 (15%)
Tumor size: 30x 24x 12 mm
Extraprostatic extension present nonfocal (established, extensive) right and left posterior
Seminal vesicles present, bilateral
Positive margins, multifocal, Apical, Postero-lateral
Perineural invasion Yes
Lymphatic/vascular invasion, Not identified.
Lymph nodes, Negative, pN0
19 lymph nodes extracted were negative
Tumor t3b
PSA <.1
12/02/2014 Cystogram, JP and Foley removal. Free at last, free at last.
Cialis 5mg per day. ED not good. Incontinence mild.
External Beam Radiation 1/2015
We started this before any significant rise in PSA. “Just sanitizing the area”.
01/06 Targeting day
Going to work every day with trip to cancer center in the afternoon.
01/18 Peed a little blood today
01/27 Bladder Spasm. Started taking over-the counter “AZO”
02/02 Feel the burn
02/16 A--hole hurts. Felt like prolapse during a BM. Got suppositories for that.
02/22-26 Coughed and really hurt, Very tired all the time now.
03/01 Got Shingles on left buttocks. That stuff hurts. Got some capsules to take for it.
PSA .1
Viagra 100 mg as needed. Works adequately for ED. Incontinence, 1 pad per day
2017 Current PSA .1 Viagra still works. Stress incontinence, 1 pad per day. I sometimes lose a large load.
Do you think I am cured (most likely, not)? What are my chances of recurrence (pretty good)? Time till ADT?
I am questioning and answering myself. I always get jumpy around blood test time.
Comments
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So far zero Odds for recurrence
Welcome to the board. Thanks for sharing your story.
As you may expect nobody can tell you that you are free from another recurrence. In any case it makes already two years since SRT and the PSA still maintains the low profile of 0.1 ng/ml, since RP. I think that you should opt for ultra sensitive PSA tests of two decimal digits (0.XX ng/ml) because you have no prostate in place. Any tiny variation in the PSA would have significance and probably give you a better understanding of remission and surely, peace of mind.
In my case (not to be compared) of failed surgery (2000) plus failed SRT (2006), with a Gleason score 6 and apparent extraprostatic extensions, my doctor's PSA threshold to trigger ADT was PSA=1.0 ng/ml. That value was reached 4 years after SRT. The PSA pre RT was 3.6 and my nadir pos RT was 0.05, reached on the 13th month after the end of the IMRT. Recurrence was declared after three consecutive rises since nadir.
I started ADT in 2010 in a protocol of intermittent administration.I hope your PSA keeps the low profile forever as the means of cure.
Best wishes,
VG
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Thank You V.G.
I fear the start of ADT. I think it would be detrimental to the quality of life my wife and I have reestablished since surviving the surgery and radiation. I feel pretty good in my new normal except for a pinched nerve at the L5 spine.
Working, Loving and Living,
W.H.
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odds of recurrence
Weird Harold, you can probably use the Post- Radical Prostatectomy nomogram on the Memorial Sloan Kettering web site. It calculates the probability of recurrence using your demographics that you enter. These algorithms were developed using data from 1000's of patients and being a world class Cancer Research Center I would be inclined to put some credence in their predictions. It also gives you 15 yr survival rates.
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