Prostatectomy + RT + ADT

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  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited March 2020 #62
    Texto

    Thanks everybody.
    I had a texto yesterday, the results for the blood glucose, HbAc1 and testosterone will be out next week.
    Maybe I will go and see Dr Tigger on the 2nd of April and maybe not, I will see what the coronavirus is doing.

  • Josephg
    Josephg Member Posts: 455 Member
    edited March 2020 #63
    Great News

    Great news, Georges!!!

    It is really good to read some great news in these generally bad news times.

    I will toast your good news this evening.

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited March 2020 #64
    Testosterone
    Hi there,

    Obviously they did not have a lot to do because they did my testosterone last night and sent me a copy today.
    Back on the 6 December 2018 it was below the limit of detection at < 12 ng/dL, < 41 nmol/dL
    Today it is up to 192 ng/L, 666 nmol/dL which is just below the normal range of 193 -740 ng/dL, 670 - 2568 nmol/dL
    Historically a level less than 50 ng/dL was viewed as subcastrate but the standard now is less than 20 ng/dL as the lower the amount of testosterone the better the therapeutic outcome.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2725306/
    So I am heading back towards normality, I think I will go for another test in September.
    So the question now is if the testosterone will tickle the PCa back into life or will I have an extended or life long period without it?

    Best wishes,

    Georges
  • SV
    SV Member Posts: 183 Member
    edited March 2020 #65
    Congratulations amigo!

    So nice to hear the good news. I am on tenth week of Lupron with Casodex added three weeks ago but all things considered, feeling great. Tons of short term energy that fizzles after a strong physical workout and no depression or anxiety. Erections are firm with Vitamin V with daily sexual intercourse to keep my girlfriend smiling. Unfortunately no orgasm for me though.

    The magic bullet here seems to be walking brisk for several miles every other day and heavy weightlifting with emphasis on core. It does require effort to get going but once warmed up my energy level rises. I am supposed to start proton therapy at MD Anderson in June. I've requested an earlier date so I can get this behind me.

  • hewhositsoncushions
    hewhositsoncushions Member Posts: 411 Member
    #66
    Georges Calvez said:

    Scores on the door

    Hi there,

    First up

    PSA < 0.05 aka under the limit of detection.

    Time for a celebration.

    Cheers,

    Georges

    Lucky man! Well done!

    Lucky man! Well done!

    I'm less hopeful about my next one as it was 0.09 :(

    EDIT: Sorry - that was grumpy and I have been a lot longer off of HT so my profile is different

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited March 2020 #67
    hewhositsoncushions said:

    Lucky man! Well done!

    Lucky man! Well done!

    I'm less hopeful about my next one as it was 0.09 :(

    EDIT: Sorry - that was grumpy and I have been a lot longer off of HT so my profile is different

    How low can you go?

    Hi Hew,

    A constant and low level of PSA is what you are looking for.
    Contrary to the received wisdom parroted by some PSA is not exclusively produced in the prostate.
    Some men that have had their bladder, prostate and all the associated gubbins hooked out because of bladder cancer continue to record low levels of PSA of the order of 0.1 ng/mL.
    If it sticks around the 0.1 ng/mL level, it may bounce around a bit as the assay is not totally reproducible, then you are bonza.
    We may be closer to the out door than some but it is still not that close.
    The time to worry is when the PSA comes back and there is a PSADT of around a few months.
    Then maybe you are looking at the one with your name on.

    Best wishes,

    Georges

  • hewhositsoncushions
    hewhositsoncushions Member Posts: 411 Member
    edited March 2020 #68
    Georges Calvez said:

    How low can you go?

    Hi Hew,

    A constant and low level of PSA is what you are looking for.
    Contrary to the received wisdom parroted by some PSA is not exclusively produced in the prostate.
    Some men that have had their bladder, prostate and all the associated gubbins hooked out because of bladder cancer continue to record low levels of PSA of the order of 0.1 ng/mL.
    If it sticks around the 0.1 ng/mL level, it may bounce around a bit as the assay is not totally reproducible, then you are bonza.
    We may be closer to the out door than some but it is still not that close.
    The time to worry is when the PSA comes back and there is a PSADT of around a few months.
    Then maybe you are looking at the one with your name on.

    Best wishes,

    Georges

    Yea. I know.

    Yea. I know.

    I'm just feeling gloomy as I have just lost my mum and uncle and there are no silver linings at the moment.

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited March 2020 #69
    hewhositsoncushions said:

    Yea. I know.

    Yea. I know.

    I'm just feeling gloomy as I have just lost my mum and uncle and there are no silver linings at the moment.

    Silver linings

    Hi Hew,

    You just have to keep on plugging on.
    There is a light at the end of tunnel, hopefully it is not the train coming the other way!

    Stay strong,

    Georges

  • hewhositsoncushions
    hewhositsoncushions Member Posts: 411 Member
    edited March 2020 #70
    Georges Calvez said:

    Silver linings

    Hi Hew,

    You just have to keep on plugging on.
    There is a light at the end of tunnel, hopefully it is not the train coming the other way!

    Stay strong,

    Georges

    Yea. I am playing Death

    Yea. I am playing Death Stranding at the moment. Sam Bridges has a refrain - "keep on keeping on"

    Its bloody hard though with all this loss and the death and chaos around.

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    #71
    Videoconference

    Hi All,

    Videoconference with Dr Tigger at 9am tomorrow morning.
    I have my papers ready!

    Best to all,

    Georges

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    #72
    Videoconference

    Hi All,

    That's the videoconference over.
    I have a prescription for three monthly PSA tests and some vitamin V in the post, hopefully I will see Tigger face to face in September.
    This assumes that we are both still alive and the sky has not fallen in!
    I will go and see Pooh for a chat when the emergency is over.

    Best wishes,

    Georges

  • VascodaGama
    VascodaGama Member Posts: 3,701 Member
    edited April 2020 #73
    Successful treatment

    You have a good reason to be positive. T is well above castration and the PSA maintained the remission levels. This is how we differentiate a successful treatment from the ones no so good.

     

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited April 2020 #74
    Quiet confidence
    Hi Vasco,

    I am moving round to a point of point of quiet confidence, if my PSA continues to remain under the limit of detection for a year
    with the testosterone flowing round then I think I will able to say confidently that I am in sustained remission.
    Obviously the beast can still jump out of the cupboard and get me later on but it will be good.
    If you look at the reference below you will see how lucky a bunny I am and may be.
    71% of men with a PSA level > 100 had a Gleason Score >8 and 93% of them had grade IV disease, etc, etc.
    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3285713/pdf/kju-53-82.pdf

    Best wishes,

    Georges
  • VascodaGama
    VascodaGama Member Posts: 3,701 Member
    edited April 2020 #75
    Jumpping out of the cupboard

    My lay opinion on your success as commented in above post is based on your informed initial diagnosis, the choice of treatment and the latest results, all reliable data.

    I wouldn't say that you are "a lucky bunny", as you comment, but that the treatment was chosen wisely and fit perfectly your PCa risky status. Not all G-rate 4 and seminal vesicle invasion cases manage the success as you did. There exists always the probability for recurrence which is a particular aspect of this PCa issue, independently of the type of Gleason or clinical stage. The medical community never uses the word "cured" after treatment for cancer exactly because the probability in recurrence is never zero.

    The link you posted does not identify you differently from what were the results of the biopsy of 2017. The study in the link identifies positive cases via the level of PSA serum providing probabilities of the level in Gleason grades. However, even if the Gleason grade in biopsies is flawed, the bandit will still jump out of the cupboard in guys like me with low G rates of 2 and 3.

    I like to know that your "quite confidence" involves being positive.

    Continue your good work in helping the many here and join me for a G&T before I get the covid-19.

    VGama

  • hewhositsoncushions
    hewhositsoncushions Member Posts: 411 Member
    #76
    VascodaGama said:

    Jumpping out of the cupboard

    My lay opinion on your success as commented in above post is based on your informed initial diagnosis, the choice of treatment and the latest results, all reliable data.

    I wouldn't say that you are "a lucky bunny", as you comment, but that the treatment was chosen wisely and fit perfectly your PCa risky status. Not all G-rate 4 and seminal vesicle invasion cases manage the success as you did. There exists always the probability for recurrence which is a particular aspect of this PCa issue, independently of the type of Gleason or clinical stage. The medical community never uses the word "cured" after treatment for cancer exactly because the probability in recurrence is never zero.

    The link you posted does not identify you differently from what were the results of the biopsy of 2017. The study in the link identifies positive cases via the level of PSA serum providing probabilities of the level in Gleason grades. However, even if the Gleason grade in biopsies is flawed, the bandit will still jump out of the cupboard in guys like me with low G rates of 2 and 3.

    I like to know that your "quite confidence" involves being positive.

    Continue your good work in helping the many here and join me for a G&T before I get the covid-19.

    VGama

    My next test is APRIL. I'm

    My next test is APRIL. I'm not thinking about it.... yet. Let's hope I keep up with George.

  • VascodaGama
    VascodaGama Member Posts: 3,701 Member
    #77
    Hi Cushions

    I hope the PSA comes at the levels of your wish. In any case, you know that there are always ways to handle things even if not as satisfactory. I know you are worried and the timing is not the best.

    Let's try being positive.

    VG

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited April 2020 #78
    PSA poker dice

    Hi Hew,


    Are we playing PSA poker dice? :-)
    Next test for me at the end of June if I have not died of COVID-19 or in a high speed Mini crash first!

    You will be fine,

    Georges

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited April 2020 #79
    Dr Pooh visit

    Hi there,

    So off I went to visit Pooh in the time of coronavirus.
    We agreed to continue with the cocktail of Irbesartan, Metformin, Amlodipine and Avorstatin that I am taking.
    I have another round of blood tests at the end of June for glucose, HbAc1, cholesterol and the dreaded PSA.
    My blood glucose in the morning is down to 1,16 g/L now, this is just above the normal range.
    I am taking a lot of walks and getting some gardening done as well.
    All in  all I feel fine.
    Here's to the middle of May and a paddle in the sea.

    Best wishes,

    Georges

  • VascodaGama
    VascodaGama Member Posts: 3,701 Member
    edited April 2020 #80
    Nice report

     

    This is an interesting cocktail. I got similar issues regarding high blood pressure and prevention of cardiovascular disease but have no diabetes (still). I hope the medication does work properly. Let7s hope for the good news on the PSA.

     Best wishes.

     VG

     

  • Georges Calvez
    Georges Calvez Member Posts: 547 Member
    edited April 2020 #81
    Cocktail

    Hi Vasco,

    I suspect that I could reduce the cocktail but I have ulterior motives in continuing to take it.
    Both ARB's like irbesartan and the metformin statin cocktail are suspected of reducing the activity of prostate cancer cells.
    So with the unwitting connivance of Pooh I am conducting my own one person trial of off label PCa treatment! :-)

    Best wishes,

    Georges

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