What are my odds for recurrence?

Weird Harold

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.

VascodaGama

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   

Weird Harold

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.

contento

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.

GeorgeG

Other world class

Other world class institutions like JH use the MSK formulas.

 

George