Post Op PSA

randy_in_indy said:

Nicole
Many times the biopsy gleason score raises with post op pathology. Mine did. I have a question for you though....you say you are getting the 3 month PSA results now...10 months after the operation you stated he had in April of 2009. Can you please elaborate on that before I give my take?

Thanks

randy in indy

WHW said:

I Had Surgery and Then Radiation
Nicole,

As you can see from my signature line, I was Gleason 7 (3+4) at diagnosis and changed to Gleason 7 (4+3) at path report. A 4+3 is a more aggressive cancer than the 3+4. I had positive margins and extraprostatic extension. All not really good signs. I have however talked with guys who had worse post-path reports and are still pulling zeroes years later. They never had the need to follow up the surgery with anything else.

There has been a lot of discussion about when to pull the trigger on following surgery with radiation. Numbers are thrown around like .1, .4, .5, 1.0, you name it and someone's doctor uses that number as guideline.

My thirty day test was .4, followed by a .53 and .6 very closely thereafter. I talked it over with my Radiation Oncologist at MD Anderson Cancer Center in Orlando, and he said it was my call. He did not have a magic number and had started radiation anywhere from .2 to 2.0.

Personally, I think your dad's doctor is being a little bit on the aggressive side. You don't say whether the doctor was the surgeon, is your dad's Uro or what. That info would be helpful to us in evaluating your situation. Whatever the case is, your dad needs to consult with a Radiation Oncologist that is well versed in dealing with PCa. That is where you will find the true guidance and evaluation of your dad's situation.

Your dad has just barely healed from the surgery, it might be a little early to jump in the Radiation pool. You say your dad is recovering well with minimal side effects. Is he fully continent? Most ROs won't start rad until the patient is continent. The rad can worsen the situation if the patient is incontinent. My RO asked that right up front and told me that he would not start the rad until I had regained continence.

I did elect to go with the rad and fairly soon too. I started at 74 days post surgery. But my numbers were climbing much more rapidly that your fathers. I didn't suffer many side effects during the treatments, but did go through a spell for the 3 weeks following. The build up of the rad takes it's toll on the urinary tract and the bladder. I experienced extreme urgency and frequency just short of the point of incontinence. I can see where an incontinent person would have had great difficulties.

Today I am 5 weeks post treatment and everything is back to normal as far as urinary issues. I am still dealing with the ED from the surgery, but things are improving. I know that in time the effect of the rad may cause further ED issues, but we'll just wait and see.

I hope this info has been helpful. Bless you for being there for your dad,

Sonny

60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
Gleason Score (3+4) 7 in all positive cores
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5%
positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy