Latest Check-up Results
I had my 3 month checkup today, and the good news is that my PSA is still undetectable, but my Testosterone has only risen to 26. But, by far, the most important test result is that my PSA is still undetectable. Life is good.
My Related History and Data:
Post-Robotic Prostate Removal Surgery Pathology Report
A. Lymph nodes, right pelvic: Two (2) lymph nodes; negative for metastasis.
B. Lymph nodes, left pelvic: Two (2) lymph nodes; negative for metastasis.
C. Prostate, radical resection:
1. Prostatic adenocarcinoma, Gleason grade 4+3=7, involving both lobes, at least 2.1cm and occupying 15% of the prostate by volume.
2. No lymphatic/vascular invasion is present.
3. Perineural invasion is present.
4. Invasive carcinoma focally extends into extraprostatic soft tissue adjacent to the left posterior prostate (C20).
5. The Seminal vesicles are free of carcinoma.
6. The inked margins are free of carcinoma.
7. High-grade PIN is present.
8. Necrotizing granulomas are present within the prostate parenchyma; stains for microorganisms will be performed and reported in an addendum.
D. Left mid margin: Fibrovascular tissue; negative for tumor.
Diagnosis Comment: AJCC: pT3a NO
Da Vinci Robotic Prostate Removal Surgery
11/21/2011
AMS 800 Artificial Sphincter Implant Surgery
1/9/2013 - Original implant
9/28/2019 - Replacement implant (original implant failed, due to leakage)
First Hormone Therapy (Lupron tri-monthly and Casodex daily)
Started 5/4/2013
Stopped 11/6/2013 (2nd and last 3-month dosage shot given on 8/6/2013)
Second Hormone Therapy (Lupron tri-monthly and Zytiga/Prednisone daily)
Started 1/29/2021
Stopped 1/14/2023
First Radiation Therapy IMRT (38 visits, 68 Grays)
Started 6/4/2013
Stopped 8/9/2013
Second Radiation Therapy SBRT (3 visits, 30 Grays)
Started 2/17/2021
Stopped 2/22/2021
PET Scan Report - 1/21/2021
Technique: Radiopharmaceutical: F-18-fluciclovine. Dose: 10.87 mCi.
Image acquisition: Approximately 3-5 minutes following IV tracer administration via a right antecubital fossa vein, positron emission tomography was performed from the vertex through the mid thigh. Non-contrast low-dose helical CT imaging was performed over the same range without breath-hold for attenuation correction of PET images and anatomic correlation.
Results: There is focal mildly increased radiotracer uptake within a sclerotic lesion in the left inferior pubic ramus, most likely representing an osseous metastasis.
MRI – 6/21/2021
To assess the initial results of the SBRT radiation therapy to my left hip. This will also serve as a baseline for future imaging assessments in this area.
First Bone Density Scan – 8/4/2021
Baseline for future scans, to identify any changes in bone density, due to long term hormone treatment
Second Bone Density Scan – 9/21/2023
- Bone Density -
BMD BMD Change BMD Change
Site (g/cm2) T-score Z-score Since (Baseline) Since (Prior Scan)
--------- ------- ------- ------- ------------------- -------------------
AP Spine
L1 L3 L4 1.026 -0.6 0.3 -3.6% (08/04/2021) -3.6% (08/04/2021)
Left Hip
Fem Neck 0.769 -1.2 0.0 -4.8% (08/04/2021) -4.8% (08/04/2021)
Total 0.889 -1.0 -0.3 -3.1% (08/04/2021) -3.1% (08/04/2021)
--------- ------- ------- ------- ------------------- -------------------
Interpretation: Osteopenia (low bone mass).
CT Scan and First Bone Scan – 10/7/2022
Both scans were to determine if any signs of existing PCa were visible. No visible signs of PCa in either scan.
PSA History
5.22 - 6/28/2011 (59 years old)
0.05 - 12/22/2011
0.05 - 3/25/2012
0.05 - 6/22/2012
0.06 - 10/13/2012
0.08 - 12/31/2012
0.11 - 3/30/2013
0.13 - 4/23/2013
0.02 - 8/6/2013
0.02 - 11/26/2013
<0.015 - 7/28/2014
<0.015 - 1/3/2015
<0.015 - 7/7/2015
0.02 - 1/15/2016
0.05 - 8/23/2016
0.07 - 2/21/2017
0.10 - 8/22/2017
0.13 - 12/29/2017
0.19 - 6/18/2018
0.26 - 10/15/2018
0.29 – 2/11/2019
0.41 - 5/20/2019
0.43 - 9/13/2019
0.46 - 1/17/2020
0.65 - 5/22/2020
0.97 - 9/25/2020
0.98 - 1/11/2021
0.25 - 3/4/2021
0.05 - 4/28/2021
<0.02 - 8/4/2021
<0.02 - 1/19/2022
<0.02 – 4/20/2022
<0.02 – 7/13/2022
<0.02 – 10/17/2022
<0.02 – 1/11/2023
<0.02 – 4/12/2023
<0.02 – 7/12/2023
<0.02 – 10/11/2023
<0.02 – 1/17/2024
Related Permanent Side Effects
Complete Incontinence - Prostate removal surgery (had to remove the left side nerve bundle)
ED - Prostate removal surgery (had to remove the left side nerve bundle)
Gynecomastia (benign breast tissue growth) - Hormone treatments of Lupron and/or Casodex
Hyperhidrosis (excessive sweating every time performing very minor physical activity) - Hormone treatments of Lupron and/or Casodex.
Hematuria (abundant blood in urine) - Radiation treatments caused recurring instances of bladder wall inflammation. Biopsy negative.
Osteopenia (low bone mass) – Hormone treatments of Lupron and/or Zytiga
Comments
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Hi,
Good news on your PSA reports, sounds like you have been through a lot. Keep your spirits up.
Dave 3+4
0 -
Old Salt, my last Lupron shot was on 1/14/2023, just over a year ago. But, I had been on the Lupron/Zytiga/Prednisone cocktail for 2 years. My Oncologist said that it is not unusual for Testosterone to take well over a year to recover, if at all, for the length of time that I've been on that cocktail. So, I will just wait and see.
PSA is not detectable, so life is good.
1 -
I had my 3 month checkup yesterday, and my PSA was <0.02, which is good news to me. My Testosterone was only 27, 1 point up from 26, 3 months ago. While the Testosterone number was not what I had hoped for, my PSA remains undetectable, which is by for the most important measure. I have now been off of the Lupron/ Arbiraterone/Prednisone cocktail since January 2023 (after a 2 year therapy regimen), and I'm still having all of the symptoms of ADT, due to the lagging Testosterone measure. Annoying to some extent, but well within my desired quality of life status. So, life goes on for the next 3 months, until my next checkup.
0 -
I had my 3 month check-up yesterday, and it was a mixed bag of results. On the positive side, my PSA is still undetectable at <0.02, which is the most important test result to me. This test result coincides with my being 18 months since the end of my 2 year hormone cocktail treatment protocol, and I will celebrate this milestone.
On the less positive side, my Testosterone level remains at 27, the same as it was 3 months ago. This now documents a history of 9 months in a row with my Testosterone level being between 26 and 27, and basically no change in the upward direction. My Oncologist believes that my Testosterone level has reached its new peak, and will unlikely increase significantly in the future (a direct result of my 2 year hormone cocktail treatment protocol). Thus, I will continue to have the hot flashes and inherently lower level of energy for the foreseeable future, an outcome that I would have preferred to avoid. This will be one more permanent side effect that I can add to my personal permanent side effect list associated with my PCa journey.
I remain very much satisfied that my PCa is still in remission, and I still enjoy an acceptable quality of life on my PCa journey.
0 -
Yes, my Oncologist and I discussed potential alternatives for Testosterone increases, but that would only be suggested (and not necessarily recommended) after 5 full years of remission. Otherwise, the belief is that it is simply too risky for fueling recurrence.
My exercise regimen is not what it used to be, or how I would like it to be, as I was recently diagnosed with Arterial Fibrillation and Flutter, and this is further impacting my overall energy level and exercise strategy.
0 -
Hi @Josephg, I have a suggestion for you regarding the hot flashes that are due to your low hormone levels.
Firstly though, I can understand why you want to explore ways of increasing your T level. No doubt you already know that a higher T level would also result in a more normal estrogen level as well through the aromatization process, thus eliminating the hot flashes.
So, consider using low dose estradiol patches, just like some menopausal women use, for exactly the same reasons. This might not solve your energy level issues, but it should make you feel better by not having to suffer those pesky and potentially debilitating hot flash episodes. It will also negate osteoporosis which you would now be prone to, and possibly even improve cognitive function.
1
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