RRP followed by PSA Rise

Motivation has to be self actualized. It's up to you. 

You can create an environment that is healthy...for example no bad food at home....the same for booze.

As far as exercise, I simply do it every morning; it's a routine for me.

.....................

Make believe that your life depends on a heart healthy life style....................It really does.

best

cushions, I also block out the Pca but I think it's made me stronger in helping me deal with life. My perspective  is a lot different these days. Situations that might have seemed insurmountable  in the past now seem relatively insignificant. I just don't worry about petty bull s...it  anymore. I think the threatening  concern of the Pca gave me , what I consider, strength. I have to say that about 2 weeks or so prior to my 6 month psa check I'm somewhat of a mess. I just had mine a few weeks ago and I was good.
Hope yours turns out good as well. --contento 

I would become somewhat introverted and cranky for about a month before my recurring PSA tests.  It kind of grew like a slowly developing toothache, until I recognized what it was, and I made a conscious and concerted effort to subdue it, at least in the compny of other people.  I found that it was the worst, during the period of time that my PSA was still undetectible.  Strangely, once my PSA started to rise again, the amount of pre-PSA test anxiety and mood swings have reduced dramatically.

Very sorry to hear of your PSA result, hewho.  You are correct: With your biopsy and later, with your pathology results, this possible (not yet confirmed) relapse is impossible to reason out.

You studied much longer than most here, so you have the mantle of knowledge with you already.

If confirmed, salvage radiation toward cure is still very much a way to eradicate the disease fully, even with this latest result.

max

I would recommend you to wait for the next PSA to draw conclusions. In any case, before any decision you need to check other health issues that could interfere with an additional therapy. Radiation is linked to colitis and hormonal therapies are linked to bone health. NHS doctors will only check the matters of PCa if you do not inquire on the other issues. I wonder if you still trust the GP attending you. It has been totally unreliable in dealing your case.

Best wiches and luck in the next meeting.

VG

hewhositsoncushions said:

Vasco

Vasco

I hsve a blood draw on Monday to see what the numbers are on a second try and a consult on the 20th.

I don't think I have any other health issues to worry about as I am fit for my age, no diabetes, only slightly overweight. I'll take what they throw at me treatment wise - I have a family I need to live for.

As for the treatment so far, to be honest, the main issue was the transition from the GP to the hospital as there were drop offs that I had to pick up on. In terms of actual treatment, I have no complaints apart from it being very clinical (i.e. not mental health friendly).

Where I am in the NHS pathway, the consultant steps back anyway and hands over the specialist nurses as I was on maintenance PSA tests whereby they test and call and only take action if there is a concern. In this case, they were on the ball so I cannot complain.

My main concern oddly enough is to persuade them to start SRT early as I have read that hitting it hard whilst under 0.2 and with adjuvant therapy is far more effective than waiting until 0.2 and following sequential treatment.

Just have to wait and see.

C

He who,

I have read similiar studies, that beginning RT sooner is better than later (intuitive enough) in effecting cure of moderate relapse.   An aside, my Urology Group (in the Southeastern US, at a teaching hospital) also uses .2 as the threshold in defining relapse post RP.

HT of course is never curative, but is of assistance to the RT when added, and is not an uncommon combination. And HT has given many a man here an additional 15 years of life,

max

Yes, ADT improves the outcome of SRT and so it does the radiation administered earlier, however, this claim is only expected if the field of radiation contains the whole cancer. One needs to be sure that the targets were properly identified, which as we know is a difficult task with present available means.

The doctors at NHS will spend little time reviewing in detail your past and present history. You need to collect this info and summarize it into the important subjects that can influence their judgments. At least copy of the biopsy report, the MRI, the pathological report on RP specimens and the PSA histology.
Without details the doctors will follow the typical protocol in SRT with a predefined field of attack. They will radiate the bed of the prostate (the fossa) and localized lymph nodes (?).

This kind of protocol is different from a treatment that includes surgery plus adjuvant radiation, which I think being your comment above. Typically the series of nodes involved is vast depending on the location of the cancer found in the biopsy. Inguinal, the iliac and pararectal at the pelvic area (anterior and posterior) may or may not be part of the protocol.

My experience with the NHS procedures is that the urologist continues to be the prime doctor providing the forms (request sheets) for other specialties under his own responsibility. Those services can be requested at an inner department or at an outsider. The scope of attack is planned by the radiologist but this guy will not go further than what has been requested or established in the urologist’s form. In such regard we may help the urologist to avoid missing any probable area. One needs to investigate about those areas that could be the cause for later recurrences.
The risk from a SRT done on guessing is if this does not cover the whole affected area which could become in fact a worse case in need of “rads over rads”.

If recurrence becomes apparent in your case (not yet verified), you are confronting a similar occurrence as that of mine in 2000. I was 50 at RP, saw biochemical failure and six month later were declared with recurrence. Everything was confusing to me and I believed in the doctor blindly. He was my god and savior from a death that did not exist.

Let us know the developments . We will try helping you.

Be the force with you.

Best wishes,

VGama