Five years after IMRT

G.L.M_61
G.L.M_61 Member Posts: 30
edited March 2014 in Prostate Cancer #1
In 2005 I had a PSA level of 4.0. In 2006 I had the same and a biopsy was recommended. I had this done, 1 out of 12 samples showed cancer. I choose 8 weeks of IMRT theropy, nothing else. About 6 to 8 months after the original treatment, my PSA decreased to about .90 or maybe less. A year ago my PSA was 1.9 and on this past Monday, my PSA was 2.2. Both my family doctor and my previous Oncologist recomended and scheduled a bone scan for 9/22/2010. I also have had burning during urination since the treatment in 2006, and sex feels like fire. I have had a colonoscopy about two years ago and three polops were removed in my lower intestine as there was red blood in my stool. I was taken by surprise at this first diagnosis in 2006 and even more so now at age 61. Doctors to not say much until they have the facts. After reading many posts it is my 99.9% feeling that my cancer has returned, or is someplace else lurking. Is there anyone out there that has had any similar situation and can be honest with me of what I might expect shortly down this road? Am I correct to assume that my prostrate or some other form a cancer has developed since my IMRT treatment 5 years ago? Thank you for the truth, which only God knows anyway.
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Comments

  • Trew
    Trew Member Posts: 931 Member
    Sounds like maybe you might
    Sounds like maybe you might be getting a hormone shot soon. Just my guess. Rising PSA doesn't sound good but then not evrey one of our fears materizies. Take a deep breath and wait and see what the docs find.

    I wish you well.
  • Kongo
    Kongo Member Posts: 1,166 Member
    Welcome
    G.L.M.

    Welcome to the forum. There are many men here who have gone through similar situations as yourself and will provide you lots of advice and commentary.

    I am sure your doctors told you that the theory behind radiation treatment is that ionizing radiation kills cancer cells by releasing free radicals within the cancerous cell that attack the DNA and prevent the cell from multiplying and spreading. As you probably recall from research you did at your initial diagnosis, prostate cancer is very slow growing and by the time it is detected through a PSA test and biopsy, there are millions and millions of cancer cells in the prostate. When you received IMRT treatment, the drop in PSA you experienced indicates that many, if not most, of the cancer cells in your prostate died off as a result of the radiation. Unfortunately, because there are so many cancer cells and all of them are in different stages of development, it is inevitable that some of the cells were not sufficiently damaged to trigger apoptosis (cell suicide) and these cells will start multiplying again.

    Most radiation oncologists consider that three consecutive increases in PSA indicate a biochemical recurrence and from what you describe in your post that seems to be the case here. The big question, of course, is where is the cancer? Is it still within the prostate or has it spread to surrounding areas? The type of treatment and its efficacy of whatever course you and your doctors decide upon now depends on where the cancer is located.

    I would encourage you to seek multiple second opinions from the most experienced specialists in your area on this. Your family doctor is probably not equipped to address this and his knowledge of the latest research and options is likely to be limited, dated, or both. There are several methods that can help determine where the cancer is. A test known as a ProstaScint Monoclonal Antibody Scan takes about five days to complete but can pinpoint where the cancer is. Color MRIs and some advanced CT technology are also available. I would have your medical team explain the purposes of these tests to you in detail and what can be accomplished with them. All are painless.

    Treatment choices serve mainlky to delay the growth of this cancer. When it was first detected in you in had probably been growing for 10 or 15 years and had only just reached the level where it could be detected through the techniques we have today. After radiation, it most likely never completely went away, but enough of it was destroyed so that it remained basically undetectable until it grew enough to be noticed through increasing PSA testing.

    Of course, since you still have a prostate, there may be other causes for the rise in PSA such as prostatitus which can cause PSA to rise and can still occur after radiation. Only advanced testing can determine exactly what is going on. The doctors should also be doing DREs and may want to consider another biopsy.

    Hormone treatment has been shown to be effective in delaying (not curing) the growth of PCa. There are also other radiation options to kill the remaining cancer, particularly if the doctors can determine that it is still confined to the prostate.

    Many advances continue to be made with IMRT. In 2006, the technology was not available to fully compensate for the movement of the prostate on a normal basis and the rectal toxicity you describe may well be correlated to radiation spillover to the wall of the colon as there is a very tiny separation from the prostate and the rectum. More modern techniques with IMRT today and other forms of radiation like SBRT now prevent much of the radiation damage to surrounding tissue. Late stage rectal toxicity occurs in about 3% of patients treated with IMRT and the treatment is pretty much what they did in your case.

    There’s still a lot about your situation that you just don’t know yet. Other types of cancer would not cause the PSA to rise. But the PSA rise may not be associated with PCa although I would be surprised if there wasn’t at least some microscopic PCa remaining.

    Please get yourself some expert consultations on your condition and keep us posted on your progress.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    Trew said:

    Sounds like maybe you might
    Sounds like maybe you might be getting a hormone shot soon. Just my guess. Rising PSA doesn't sound good but then not evrey one of our fears materizies. Take a deep breath and wait and see what the docs find.

    I wish you well.

    Rising PSA
    Trew;
    I agree with all of your comments and pray for the best. Thank you.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    Kongo said:

    Welcome
    G.L.M.

    Welcome to the forum. There are many men here who have gone through similar situations as yourself and will provide you lots of advice and commentary.

    I am sure your doctors told you that the theory behind radiation treatment is that ionizing radiation kills cancer cells by releasing free radicals within the cancerous cell that attack the DNA and prevent the cell from multiplying and spreading. As you probably recall from research you did at your initial diagnosis, prostate cancer is very slow growing and by the time it is detected through a PSA test and biopsy, there are millions and millions of cancer cells in the prostate. When you received IMRT treatment, the drop in PSA you experienced indicates that many, if not most, of the cancer cells in your prostate died off as a result of the radiation. Unfortunately, because there are so many cancer cells and all of them are in different stages of development, it is inevitable that some of the cells were not sufficiently damaged to trigger apoptosis (cell suicide) and these cells will start multiplying again.

    Most radiation oncologists consider that three consecutive increases in PSA indicate a biochemical recurrence and from what you describe in your post that seems to be the case here. The big question, of course, is where is the cancer? Is it still within the prostate or has it spread to surrounding areas? The type of treatment and its efficacy of whatever course you and your doctors decide upon now depends on where the cancer is located.

    I would encourage you to seek multiple second opinions from the most experienced specialists in your area on this. Your family doctor is probably not equipped to address this and his knowledge of the latest research and options is likely to be limited, dated, or both. There are several methods that can help determine where the cancer is. A test known as a ProstaScint Monoclonal Antibody Scan takes about five days to complete but can pinpoint where the cancer is. Color MRIs and some advanced CT technology are also available. I would have your medical team explain the purposes of these tests to you in detail and what can be accomplished with them. All are painless.

    Treatment choices serve mainlky to delay the growth of this cancer. When it was first detected in you in had probably been growing for 10 or 15 years and had only just reached the level where it could be detected through the techniques we have today. After radiation, it most likely never completely went away, but enough of it was destroyed so that it remained basically undetectable until it grew enough to be noticed through increasing PSA testing.

    Of course, since you still have a prostate, there may be other causes for the rise in PSA such as prostatitus which can cause PSA to rise and can still occur after radiation. Only advanced testing can determine exactly what is going on. The doctors should also be doing DREs and may want to consider another biopsy.

    Hormone treatment has been shown to be effective in delaying (not curing) the growth of PCa. There are also other radiation options to kill the remaining cancer, particularly if the doctors can determine that it is still confined to the prostate.

    Many advances continue to be made with IMRT. In 2006, the technology was not available to fully compensate for the movement of the prostate on a normal basis and the rectal toxicity you describe may well be correlated to radiation spillover to the wall of the colon as there is a very tiny separation from the prostate and the rectum. More modern techniques with IMRT today and other forms of radiation like SBRT now prevent much of the radiation damage to surrounding tissue. Late stage rectal toxicity occurs in about 3% of patients treated with IMRT and the treatment is pretty much what they did in your case.

    There’s still a lot about your situation that you just don’t know yet. Other types of cancer would not cause the PSA to rise. But the PSA rise may not be associated with PCa although I would be surprised if there wasn’t at least some microscopic PCa remaining.

    Please get yourself some expert consultations on your condition and keep us posted on your progress.

    Rising PSA
    Dear Kongo;
    So far you have explained more to me that both my doctors in 5 years. Thank you. I just cannot figure out why this situation happened as my original cancer was ver small, and I had 48 treatments of IMRT. Some people said they gave me too much radiation to begin with. I did print out your kind reply and will study it very closely. You are a good man to spend so much time helping others. Have a great weekend as my wife and I are watching our second Grandson for the night. He is 3 months old.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    Kongo said:

    Welcome
    G.L.M.

    Welcome to the forum. There are many men here who have gone through similar situations as yourself and will provide you lots of advice and commentary.

    I am sure your doctors told you that the theory behind radiation treatment is that ionizing radiation kills cancer cells by releasing free radicals within the cancerous cell that attack the DNA and prevent the cell from multiplying and spreading. As you probably recall from research you did at your initial diagnosis, prostate cancer is very slow growing and by the time it is detected through a PSA test and biopsy, there are millions and millions of cancer cells in the prostate. When you received IMRT treatment, the drop in PSA you experienced indicates that many, if not most, of the cancer cells in your prostate died off as a result of the radiation. Unfortunately, because there are so many cancer cells and all of them are in different stages of development, it is inevitable that some of the cells were not sufficiently damaged to trigger apoptosis (cell suicide) and these cells will start multiplying again.

    Most radiation oncologists consider that three consecutive increases in PSA indicate a biochemical recurrence and from what you describe in your post that seems to be the case here. The big question, of course, is where is the cancer? Is it still within the prostate or has it spread to surrounding areas? The type of treatment and its efficacy of whatever course you and your doctors decide upon now depends on where the cancer is located.

    I would encourage you to seek multiple second opinions from the most experienced specialists in your area on this. Your family doctor is probably not equipped to address this and his knowledge of the latest research and options is likely to be limited, dated, or both. There are several methods that can help determine where the cancer is. A test known as a ProstaScint Monoclonal Antibody Scan takes about five days to complete but can pinpoint where the cancer is. Color MRIs and some advanced CT technology are also available. I would have your medical team explain the purposes of these tests to you in detail and what can be accomplished with them. All are painless.

    Treatment choices serve mainlky to delay the growth of this cancer. When it was first detected in you in had probably been growing for 10 or 15 years and had only just reached the level where it could be detected through the techniques we have today. After radiation, it most likely never completely went away, but enough of it was destroyed so that it remained basically undetectable until it grew enough to be noticed through increasing PSA testing.

    Of course, since you still have a prostate, there may be other causes for the rise in PSA such as prostatitus which can cause PSA to rise and can still occur after radiation. Only advanced testing can determine exactly what is going on. The doctors should also be doing DREs and may want to consider another biopsy.

    Hormone treatment has been shown to be effective in delaying (not curing) the growth of PCa. There are also other radiation options to kill the remaining cancer, particularly if the doctors can determine that it is still confined to the prostate.

    Many advances continue to be made with IMRT. In 2006, the technology was not available to fully compensate for the movement of the prostate on a normal basis and the rectal toxicity you describe may well be correlated to radiation spillover to the wall of the colon as there is a very tiny separation from the prostate and the rectum. More modern techniques with IMRT today and other forms of radiation like SBRT now prevent much of the radiation damage to surrounding tissue. Late stage rectal toxicity occurs in about 3% of patients treated with IMRT and the treatment is pretty much what they did in your case.

    There’s still a lot about your situation that you just don’t know yet. Other types of cancer would not cause the PSA to rise. But the PSA rise may not be associated with PCa although I would be surprised if there wasn’t at least some microscopic PCa remaining.

    Please get yourself some expert consultations on your condition and keep us posted on your progress.

    Rising PSA
    This is a follow up question if I may please. Both my family doctor and former Oncologist want me to have a bone scan ASAP as it is already sceduled for next wednesday, 9/22/10. Do you believe or have heard that this is the best, next step to take in order to determiine a "game plan? Thank you so much for your time.
  • mrspjd
    mrspjd Member Posts: 694 Member
    G.L.M_61 said:

    Rising PSA
    This is a follow up question if I may please. Both my family doctor and former Oncologist want me to have a bone scan ASAP as it is already sceduled for next wednesday, 9/22/10. Do you believe or have heard that this is the best, next step to take in order to determiine a "game plan? Thank you so much for your time.

    absolutely
    GLM,
    Not only a bone scan, but also a pelvic CT with contrast. Although no test currently can detect microscopic PCa cells, these two tests are important in helping your doctor determine if the PCa has metastasized. Also, an endorectal MRI w/Spectoscopy, preferably with Tesla 3 MRI equipment, may be appropriate and can indicate if the PCa is in the seminal vesicles and nodes. The Tesla 3 MRI is a newer version of the imaging with clearer, higher def images, & is limited in use, mostly found at a few of the larger well-known teaching hospitals in the country. Be your own advocate and insist on these tests after you have done your own research.
    Best,
    mrs pjd
  • Kongo
    Kongo Member Posts: 1,166 Member
    mrspjd said:

    absolutely
    GLM,
    Not only a bone scan, but also a pelvic CT with contrast. Although no test currently can detect microscopic PCa cells, these two tests are important in helping your doctor determine if the PCa has metastasized. Also, an endorectal MRI w/Spectoscopy, preferably with Tesla 3 MRI equipment, may be appropriate and can indicate if the PCa is in the seminal vesicles and nodes. The Tesla 3 MRI is a newer version of the imaging with clearer, higher def images, & is limited in use, mostly found at a few of the larger well-known teaching hospitals in the country. Be your own advocate and insist on these tests after you have done your own research.
    Best,
    mrs pjd

    Bone Scan
    I second mrs pjd's comments. Frankly, I doubt the bone scan is going to show anything at all. Bone metastasis large enough to be seen in a bone scan occvur in the later stages of prostate cancer and from what you have described, you certainly don't seem to be there. Doctors continue to prescribe this test at inappropriate times to avoid lawsuits and to "rule out" certain conditions that seem rather obvious to not be in play given the description of your situation. In any event, it's not going to do any harm given the amount of radiation you have already received.

    Keep in mind that if anything is detected in a bone scan, it is a strong indication that the prostate cancer is probably also in lymph nodes, seminal vesicules, and may have also moved to the liver.

    I would expect that in addition to the bone scan that they would also do a full blood panel to look at liver functions.

    As mrs pjd points out we generally do not have testing today that can detect microscopic PCa but there are tests that can give your medical teams clues and include the procedures she highlighted. And I suggest you ask them about the ProstaScint test in my earlier post.

    You may also wish to talk to your doctors about a bone marrow aspiration test that may detect potential metastases in the bone much earlier than a bone scan.

    I appreciate your kind words but if in five years your medical team couldn't make clear to you what was going on and give you a likely prognosis, I would think it is time that you consider recruiting another set of doctors. In my own case, I learned to be a much stronger advocate for myself as I learned more. In the begining, I went along with everything that was recommended, biopsies, bone scans, chest x-rays...all of which may not have been necessary. Hindsight is always 20-20 in these cases and I know telling your doctors "no way!" and walking is difficult for us to do. But think about it and make sure they answer all your questions.

    Enjoy playing with the new baby grandson. Those are precious times.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    mrspjd said:

    absolutely
    GLM,
    Not only a bone scan, but also a pelvic CT with contrast. Although no test currently can detect microscopic PCa cells, these two tests are important in helping your doctor determine if the PCa has metastasized. Also, an endorectal MRI w/Spectoscopy, preferably with Tesla 3 MRI equipment, may be appropriate and can indicate if the PCa is in the seminal vesicles and nodes. The Tesla 3 MRI is a newer version of the imaging with clearer, higher def images, & is limited in use, mostly found at a few of the larger well-known teaching hospitals in the country. Be your own advocate and insist on these tests after you have done your own research.
    Best,
    mrs pjd

    rising PSA
    Mrs pjd;
    Thank you for your rely as this is the first time I have ever been on a discussion forum or any Internet group such as this. You have ben very kind and helpful with your time. Have a good Sunday. I just always seem to feel that doctors rush into tests, and more test without giving the patient time to think.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    Kongo said:

    Bone Scan
    I second mrs pjd's comments. Frankly, I doubt the bone scan is going to show anything at all. Bone metastasis large enough to be seen in a bone scan occvur in the later stages of prostate cancer and from what you have described, you certainly don't seem to be there. Doctors continue to prescribe this test at inappropriate times to avoid lawsuits and to "rule out" certain conditions that seem rather obvious to not be in play given the description of your situation. In any event, it's not going to do any harm given the amount of radiation you have already received.

    Keep in mind that if anything is detected in a bone scan, it is a strong indication that the prostate cancer is probably also in lymph nodes, seminal vesicules, and may have also moved to the liver.

    I would expect that in addition to the bone scan that they would also do a full blood panel to look at liver functions.

    As mrs pjd points out we generally do not have testing today that can detect microscopic PCa but there are tests that can give your medical teams clues and include the procedures she highlighted. And I suggest you ask them about the ProstaScint test in my earlier post.

    You may also wish to talk to your doctors about a bone marrow aspiration test that may detect potential metastases in the bone much earlier than a bone scan.

    I appreciate your kind words but if in five years your medical team couldn't make clear to you what was going on and give you a likely prognosis, I would think it is time that you consider recruiting another set of doctors. In my own case, I learned to be a much stronger advocate for myself as I learned more. In the begining, I went along with everything that was recommended, biopsies, bone scans, chest x-rays...all of which may not have been necessary. Hindsight is always 20-20 in these cases and I know telling your doctors "no way!" and walking is difficult for us to do. But think about it and make sure they answer all your questions.

    Enjoy playing with the new baby grandson. Those are precious times.

    Bone scan , too much radiation?
    I was the one who suggested the bone scan before any treatment. My Oncologist told me my Pca was so minute, that we never even do them in cases like mine. I insisted and got the test anyway. I was also reading about a mans PSA lever can fluctuate during certain times by quiite abit. My blood work was sent to me but not my PSA level on the same report. This causes me concern. I feel like asking for another PSA level next week and wait for the results in the office to see. I always feel that most doctors seem to rush patients into any test and for different reasons.
    I will most likely go ahead with this bone scan as my doctor already told me that most likely, nothing will show up to do with Ca. Originally my Pca was quite minute so after radiation , 48 cessions, I was told my cancer was gone as it was caught early. I was never told that someday my cancer might return. I went to Texas Oncology Center on Preston Rd. and George Bush Tollway in Plano, TX. It is supposed to be the best in the state, however everyone claims to be the best, do they not? :-). Thak you again for your kind thoughts, and yes, our new grandson only work up once last night, so it was a double blessing. God bless you all for taking your time in answering my questions.
  • Kongo
    Kongo Member Posts: 1,166 Member
    G.L.M_61 said:

    Bone scan , too much radiation?
    I was the one who suggested the bone scan before any treatment. My Oncologist told me my Pca was so minute, that we never even do them in cases like mine. I insisted and got the test anyway. I was also reading about a mans PSA lever can fluctuate during certain times by quiite abit. My blood work was sent to me but not my PSA level on the same report. This causes me concern. I feel like asking for another PSA level next week and wait for the results in the office to see. I always feel that most doctors seem to rush patients into any test and for different reasons.
    I will most likely go ahead with this bone scan as my doctor already told me that most likely, nothing will show up to do with Ca. Originally my Pca was quite minute so after radiation , 48 cessions, I was told my cancer was gone as it was caught early. I was never told that someday my cancer might return. I went to Texas Oncology Center on Preston Rd. and George Bush Tollway in Plano, TX. It is supposed to be the best in the state, however everyone claims to be the best, do they not? :-). Thak you again for your kind thoughts, and yes, our new grandson only work up once last night, so it was a double blessing. God bless you all for taking your time in answering my questions.

    PSA
    G.L.M.

    The bone scan certainly can't hurt but it's just one of several tests you and your medical team ought to consider to assess your existing condition so that you can intelligently weigh future options.

    As you said, many things can cause PSA to vary and PSA increases is not specific for PCa as long as you have a prostate. Considering the amount of radiation the prostate receives during treatments such as IMRT, BPH is probably a remote possibility but many patients develop prostatitus after radiation that can cause PSA to increase. Also, as I am sure you read in your research, PSA is given off with ejaculate so you will want to avoid sex for a few days prior to having your blood drawn to get an unbiased level. In my own case I found that eliminating dairy lowered my PSA significantly (it went from 4.3 to 2.8 in about 8 weeks). With radiation, almost 50% of patients experience what is known as a "PSA bounce" but it usually occurs at the 1 to 2 year point so I don't think what you are seeing correlates to a harmless bounce effect, but I would ask the doctors about it anyway.

    One of the great misrepresentations about prostate cancer, in my opinion, is that doctors lead willing patients to believe that there is a "cure" if it is caught early enough. In a true sense of the word, cure means that you will never, ever have a recurrence and that "they got it all." The more I learn about prostate cancer (and I am just a novice...six months ago I barely knew where the prostate was even located) the more I suspect that there is no such thing as a true cure. Prostate cancer is a inexorable metatastic disease that follows a fairly predictable pattern of growth and cell multiplication. Usually it takes more than 50 years for prostate cancer to go from a single rogue cell to enough mass that it is a killer. When it grows to a detectable level, taking early treatment basically resets the clock back quite a bit but it is still there and it will still grow. In a sense, we are "cured" of prostate cancer when we get hit by a bus or a heart attack kills us. Of course there are some variants of this cancer that are much more virulent and kill fairly quickly, within a few years of detection, and treatment methods today have little effect on the outcome outside of statistically extending your likely lifetime by a few months. Fortunately for most of us, this only happens to a very, very small minority of patients with prostate cancer.

    G.M.T., one of the predictors of how your disease is progressing is the velocity of how quickly the PSA is increasing and the PSA doubling time. If you go back and look at all the PSA readings since your IMRT treatment, you will be able to calculate this yourself and you should have it with you when you discuss your case with your doctors. There are some nomograms on the web that enable you to plug in the PSA reading and the date and it calculates these numbers for you automaticaly. One site I have used can be found at http://www.doubling-time.com/compute-PSA-doubling-time.php. For men who have had treatment, a PSA doubling time greater than 1 year is generally considered good. Obviously, the more data points you have the more accurate the curve fitting equation used to calculate the PSADT and velocity are. Just making a SWAG at the numbers posted, I suspect you have a low PSA velocity.

    One of the dangers we patients face when looking at a potential recurrence is that additional treatments increase the liklihood of negative side effects. In your own case you have already experienced some late stage rectal toxcicity. Additional treatment increases the risk of more of the same along with potential incontinence issues and erectile dysfuction. There is always a trade off to consider, so being well informed and strong advocate for yourself is the only way we can navigate these muddy waters.
  • mrspjd
    mrspjd Member Posts: 694 Member
    G.L.M_61 said:

    rising PSA
    Mrs pjd;
    Thank you for your rely as this is the first time I have ever been on a discussion forum or any Internet group such as this. You have ben very kind and helpful with your time. Have a good Sunday. I just always seem to feel that doctors rush into tests, and more test without giving the patient time to think.

    agreed
    GLM,
    Agree with you wholeheartedly that many doctors tend to "rush" to add'l (at times unnecessary) tests/testing, (perhaps motiviated by $$)...that is why it is sooo important for one to be an informed and educated patient and your own advocate for what it is you may or may not need, re testing, treatment, and over-treatment. It can't be said too many times--do your own homework and thorough research prior to agreeing to what a doctor recommends...you should never feel rushed or pushed into any kind of tx or testing by a doctor. In addition, always obtain several 2nd opinions.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    Kongo said:

    PSA
    G.L.M.

    The bone scan certainly can't hurt but it's just one of several tests you and your medical team ought to consider to assess your existing condition so that you can intelligently weigh future options.

    As you said, many things can cause PSA to vary and PSA increases is not specific for PCa as long as you have a prostate. Considering the amount of radiation the prostate receives during treatments such as IMRT, BPH is probably a remote possibility but many patients develop prostatitus after radiation that can cause PSA to increase. Also, as I am sure you read in your research, PSA is given off with ejaculate so you will want to avoid sex for a few days prior to having your blood drawn to get an unbiased level. In my own case I found that eliminating dairy lowered my PSA significantly (it went from 4.3 to 2.8 in about 8 weeks). With radiation, almost 50% of patients experience what is known as a "PSA bounce" but it usually occurs at the 1 to 2 year point so I don't think what you are seeing correlates to a harmless bounce effect, but I would ask the doctors about it anyway.

    One of the great misrepresentations about prostate cancer, in my opinion, is that doctors lead willing patients to believe that there is a "cure" if it is caught early enough. In a true sense of the word, cure means that you will never, ever have a recurrence and that "they got it all." The more I learn about prostate cancer (and I am just a novice...six months ago I barely knew where the prostate was even located) the more I suspect that there is no such thing as a true cure. Prostate cancer is a inexorable metatastic disease that follows a fairly predictable pattern of growth and cell multiplication. Usually it takes more than 50 years for prostate cancer to go from a single rogue cell to enough mass that it is a killer. When it grows to a detectable level, taking early treatment basically resets the clock back quite a bit but it is still there and it will still grow. In a sense, we are "cured" of prostate cancer when we get hit by a bus or a heart attack kills us. Of course there are some variants of this cancer that are much more virulent and kill fairly quickly, within a few years of detection, and treatment methods today have little effect on the outcome outside of statistically extending your likely lifetime by a few months. Fortunately for most of us, this only happens to a very, very small minority of patients with prostate cancer.

    G.M.T., one of the predictors of how your disease is progressing is the velocity of how quickly the PSA is increasing and the PSA doubling time. If you go back and look at all the PSA readings since your IMRT treatment, you will be able to calculate this yourself and you should have it with you when you discuss your case with your doctors. There are some nomograms on the web that enable you to plug in the PSA reading and the date and it calculates these numbers for you automaticaly. One site I have used can be found at http://www.doubling-time.com/compute-PSA-doubling-time.php. For men who have had treatment, a PSA doubling time greater than 1 year is generally considered good. Obviously, the more data points you have the more accurate the curve fitting equation used to calculate the PSADT and velocity are. Just making a SWAG at the numbers posted, I suspect you have a low PSA velocity.

    One of the dangers we patients face when looking at a potential recurrence is that additional treatments increase the liklihood of negative side effects. In your own case you have already experienced some late stage rectal toxcicity. Additional treatment increases the risk of more of the same along with potential incontinence issues and erectile dysfuction. There is always a trade off to consider, so being well informed and strong advocate for yourself is the only way we can navigate these muddy waters.

    PSA Rising
    For you participating in this for about six months, you sure seem like an encyclopedia of knowlege. Something you said about dairy products really hit home very hard when I read your latest reply to me. I saw my family doctor on Monday,9/13/2010. My PB was good, Bad cholesterol was under normal level, my bad cholesterol was 150 and he would like to see it under 100. My triglicerides were 4 points over nornal which is good. I am 61 years young, 5 ft. 9 in and weighed 174 on 9/13/2010. I told my doctor that my weight was most likely higher which it was, and my cholestorol would most likely be high, which it was. I told my doctor this as I had been eating a quart of ice cream everynight all summer when I knew it was wrong as my son works for Whole Foods CO. I still smoke which also makes me an idiot also. I stopped eating ice cream since and in 5 days I lost over 3 pounds as I am fairly active also. Your statment about "dairy" makes me wonder now if this is why my PSA was high ?. Right now, being my own advocate so to speak, I wonder if I should stay on my current diet which is good as my wife does not really buy any junk food and reads every label, then have another PSA level done in a week rather than that bone scan right away as my doctors want. I am a retired master residential remodeler of 42 years in business which tell you something. I like everything as perfect as can be...........so do doctors and in the trades, we feed our friends and other trades work to keep the work coming. I know this is what the medical profession has been all about and is getting worse, heck, dentists, Lawyers, eveyone does the same. It seems to be all about the "almighty dollar" as the "love" of money is one of the 7 deadly sins. Now I off on a tangent and I am getting tired and confused. So I will thank you now and mentally digest all of this. As I mentioned before, I feel like watching another PSA level test and then if it is still high, get the bone scan. Thank you again and please feel free to respond and even ask me questions if you wish. I have always been told I an too honest for my own good most of the time,LOL.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    mrspjd said:

    agreed
    GLM,
    Agree with you wholeheartedly that many doctors tend to "rush" to add'l (at times unnecessary) tests/testing, (perhaps motiviated by $$)...that is why it is sooo important for one to be an informed and educated patient and your own advocate for what it is you may or may not need, re testing, treatment, and over-treatment. It can't be said too many times--do your own homework and thorough research prior to agreeing to what a doctor recommends...you should never feel rushed or pushed into any kind of tx or testing by a doctor. In addition, always obtain several 2nd opinions.

    Rising PSA / agreed
    Mrspjd;
    "Perhaps motivated by money?" this is an understatement in my book and many others. Doctors are humans, not Gods as many people seem to think. Now a days, if one's cholestorol is 2 points over normal, your doctor tells you that you are a diabetic, and he wants to put you on a pill. If you can read the reply I just posted to "Kongo", it will tell you more about me and about my "ice cream" addiction so to speak. :-). The more I read from all the kind people on this site makes me feel better that others care, however I do not feel that competant to help others, at least not in this subject matter right now. I am going to talk with my doctors ASAP in a very diplomatic way, ask more questions, and be my own advocate which is a word I had never used before. I just feel like a victum of the system right now and that I had been lied to way back in 2006 and just last Monday. I am a human being, not a piece of paper with the word, "NEXT" on it. I worked in a hospital for three years in my early twenties. I was in the x-ray and recovery room departments. People just become numbers at times. Thank you again...........with the help of God and what gray matter he gave me, along with my lovely wife, we will get through this.
  • Kongo
    Kongo Member Posts: 1,166 Member
    G.L.M_61 said:

    PSA Rising
    For you participating in this for about six months, you sure seem like an encyclopedia of knowlege. Something you said about dairy products really hit home very hard when I read your latest reply to me. I saw my family doctor on Monday,9/13/2010. My PB was good, Bad cholesterol was under normal level, my bad cholesterol was 150 and he would like to see it under 100. My triglicerides were 4 points over nornal which is good. I am 61 years young, 5 ft. 9 in and weighed 174 on 9/13/2010. I told my doctor that my weight was most likely higher which it was, and my cholestorol would most likely be high, which it was. I told my doctor this as I had been eating a quart of ice cream everynight all summer when I knew it was wrong as my son works for Whole Foods CO. I still smoke which also makes me an idiot also. I stopped eating ice cream since and in 5 days I lost over 3 pounds as I am fairly active also. Your statment about "dairy" makes me wonder now if this is why my PSA was high ?. Right now, being my own advocate so to speak, I wonder if I should stay on my current diet which is good as my wife does not really buy any junk food and reads every label, then have another PSA level done in a week rather than that bone scan right away as my doctors want. I am a retired master residential remodeler of 42 years in business which tell you something. I like everything as perfect as can be...........so do doctors and in the trades, we feed our friends and other trades work to keep the work coming. I know this is what the medical profession has been all about and is getting worse, heck, dentists, Lawyers, eveyone does the same. It seems to be all about the "almighty dollar" as the "love" of money is one of the 7 deadly sins. Now I off on a tangent and I am getting tired and confused. So I will thank you now and mentally digest all of this. As I mentioned before, I feel like watching another PSA level test and then if it is still high, get the bone scan. Thank you again and please feel free to respond and even ask me questions if you wish. I have always been told I an too honest for my own good most of the time,LOL.

    Dairy
    I don’t know whether or not binging on ice cream would have caused your PSA to spike but in my own case, the complete elimination of dairy did serve to dramatically lower my PSAs in about an eight week period. The biggest problems with dairy and red meat today, in my opinion, are the growth hormones given to so much of the product that reaches our grocery stores amplifies the IGFs already present. These IGFs (insulin growth factors) have the effect of giving candy to cancer.

    While many men eat dairy and red meat in large quantities and never develop cancer, the statistics worldwide should give you pause. In China, for example, prostate cancer is a rare disease, affecting about 1 in 100,000 men compared to the 1 in 6 that will get it in Western nations. When Chinese immigrate to the West and adopt western diets, their cancer rates equal white males within a generation. There is essentially no dairy in China (considered baby food) and people quit milk intake after weaning. Similar statistics hold for breast cancer which is like a sister disease to prostate cancer. Humans are the only mammals that knowingly drink the milk of another species and we don’t need milk after weaning. Humans did just fine before cattle were domesticated about 7,000 years ago. The dairy industry will undoubtedly take exception to this position.

    Personally, I don’t think it’s enough to just “read the labels.” I think that if you’re going to pursue a cancer healthy diet that you must eliminate ALL dairy and significantly cut back on red meat to a few servings a month. I replaced my dairy with soy milk and use other soy products as a source of protein in place of red meat whenever possible. Although I was initially quite leery, I found soy to be quite tasty and after a day or so you won’t miss milk at all. Soy milk is also supplemented with calcium and Vitamin D. You will be pleasantly surprised to learn that they have delicious soy ice cream, yogurts, and cheeses and you can pretty much replace milk in cooking with soy. Rice milk is another product I use a lot, particularly on cereal. I travel a lot and it’s hard to find dairy free products on the road, but if you are persistent you can usually find something good to eat that doesn’t involve dairy.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    Kongo said:

    Dairy
    I don’t know whether or not binging on ice cream would have caused your PSA to spike but in my own case, the complete elimination of dairy did serve to dramatically lower my PSAs in about an eight week period. The biggest problems with dairy and red meat today, in my opinion, are the growth hormones given to so much of the product that reaches our grocery stores amplifies the IGFs already present. These IGFs (insulin growth factors) have the effect of giving candy to cancer.

    While many men eat dairy and red meat in large quantities and never develop cancer, the statistics worldwide should give you pause. In China, for example, prostate cancer is a rare disease, affecting about 1 in 100,000 men compared to the 1 in 6 that will get it in Western nations. When Chinese immigrate to the West and adopt western diets, their cancer rates equal white males within a generation. There is essentially no dairy in China (considered baby food) and people quit milk intake after weaning. Similar statistics hold for breast cancer which is like a sister disease to prostate cancer. Humans are the only mammals that knowingly drink the milk of another species and we don’t need milk after weaning. Humans did just fine before cattle were domesticated about 7,000 years ago. The dairy industry will undoubtedly take exception to this position.

    Personally, I don’t think it’s enough to just “read the labels.” I think that if you’re going to pursue a cancer healthy diet that you must eliminate ALL dairy and significantly cut back on red meat to a few servings a month. I replaced my dairy with soy milk and use other soy products as a source of protein in place of red meat whenever possible. Although I was initially quite leery, I found soy to be quite tasty and after a day or so you won’t miss milk at all. Soy milk is also supplemented with calcium and Vitamin D. You will be pleasantly surprised to learn that they have delicious soy ice cream, yogurts, and cheeses and you can pretty much replace milk in cooking with soy. Rice milk is another product I use a lot, particularly on cereal. I travel a lot and it’s hard to find dairy free products on the road, but if you are persistent you can usually find something good to eat that doesn’t involve dairy.

    Dairy
    I use soy coffee cramer and eat cereal woth 2% milk once or twice a week. You are correct that I cannot tell the differnece in between the two. Candy was my downfall until ice cream took over, that that is gone also. I talked to my older sister last night who has much exoerience with taking care of the elderly and has worked for many doctors. I told her I feel rushed again into all of these tests, so she said than study a little more. then make your decision. Just now I got off the phone and cancelled my bone scan as I want to get another PSA level done in about one week or two. I am going to start taking Omega 3 fish oil today also for the first time. My sis ter in florida is absolutely livid about what the doctors do to the elderly as they do not have the strength nor the help they need, so when the doctor says, "do it now", they do it. It is also a money game for sure.
    When I got my blood work back from last Monday, only 50% of the numbers were there, so I am going to investigatge also. I hope they are not overcharging my Medicare for tests that were not even done. One of my good friends is Korean and about 65 years old, he tells me what he eats, etc. Yes, one does not see any animals drinking beer or milk after weaning, even though cats love it, it is not good for them. Do you live in Texas by chance, just a persoal quesion with no obligation to answer. Thank you so much for all your help and advice as you actually sound better than a licenced MD. :-)
  • Kongo
    Kongo Member Posts: 1,166 Member
    G.L.M_61 said:

    Dairy
    I use soy coffee cramer and eat cereal woth 2% milk once or twice a week. You are correct that I cannot tell the differnece in between the two. Candy was my downfall until ice cream took over, that that is gone also. I talked to my older sister last night who has much exoerience with taking care of the elderly and has worked for many doctors. I told her I feel rushed again into all of these tests, so she said than study a little more. then make your decision. Just now I got off the phone and cancelled my bone scan as I want to get another PSA level done in about one week or two. I am going to start taking Omega 3 fish oil today also for the first time. My sis ter in florida is absolutely livid about what the doctors do to the elderly as they do not have the strength nor the help they need, so when the doctor says, "do it now", they do it. It is also a money game for sure.
    When I got my blood work back from last Monday, only 50% of the numbers were there, so I am going to investigatge also. I hope they are not overcharging my Medicare for tests that were not even done. One of my good friends is Korean and about 65 years old, he tells me what he eats, etc. Yes, one does not see any animals drinking beer or milk after weaning, even though cats love it, it is not good for them. Do you live in Texas by chance, just a persoal quesion with no obligation to answer. Thank you so much for all your help and advice as you actually sound better than a licenced MD. :-)

    Location
    GLM,

    I'm in Southern California. And regarding the percent fat in milk, it really doesn't make any difference whether its skim milk, low fat, whole milk, or raw milk. They all have the same level of IGFs.

    I agree with you that many of of the elderly, particularly those without children to help them through the process, are led blindly into procedures and tests that aren't necessary. Part of it is probably to blunt the possibility of litigation if a condition was overlooked, but I agree that a lot of it, particularly with the way Medicare is set up to pay, is done just for money.

    Even in the case of men who are diagnosed with PCa in their 50s or 60s, too young to really be considered "elderly," we are frequently led to slaughter like sheep. We get diagnosed and told we have cancer, the big C, and we are keenly anxious, most of us don't know anything about long term statistics, treatment options, or even the rudimentals of the anatomy surrounding the prostate or even what the prostate does in the body. Most lay men, particularly when they are newly diagnosed, do not have the background to fully understand what they are being told. Doctors tell us they can "cure" it and even though we have to give "informed consent" prior to treatment, most men really have no idea what they are signing up for. I think there is an epidemic of overtreatment for prostate cancer in this country and a lot of doctors are making a lot of money on it. On the other hand, I don't think we can completely blame the doctors or Medicare. We each have our own responsibilty to be an informed patient. I think the most successful outcomes occur when the patient and doctor form an equal partnership, with the majority vote going to the patient. Fortunately, there is an abundance of information available today for men to study and learn enough to make intelligent decisions. For many, unfortunately, that learning process too often happens only after something goes wrong.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    Kongo said:

    Location
    GLM,

    I'm in Southern California. And regarding the percent fat in milk, it really doesn't make any difference whether its skim milk, low fat, whole milk, or raw milk. They all have the same level of IGFs.

    I agree with you that many of of the elderly, particularly those without children to help them through the process, are led blindly into procedures and tests that aren't necessary. Part of it is probably to blunt the possibility of litigation if a condition was overlooked, but I agree that a lot of it, particularly with the way Medicare is set up to pay, is done just for money.

    Even in the case of men who are diagnosed with PCa in their 50s or 60s, too young to really be considered "elderly," we are frequently led to slaughter like sheep. We get diagnosed and told we have cancer, the big C, and we are keenly anxious, most of us don't know anything about long term statistics, treatment options, or even the rudimentals of the anatomy surrounding the prostate or even what the prostate does in the body. Most lay men, particularly when they are newly diagnosed, do not have the background to fully understand what they are being told. Doctors tell us they can "cure" it and even though we have to give "informed consent" prior to treatment, most men really have no idea what they are signing up for. I think there is an epidemic of overtreatment for prostate cancer in this country and a lot of doctors are making a lot of money on it. On the other hand, I don't think we can completely blame the doctors or Medicare. We each have our own responsibilty to be an informed patient. I think the most successful outcomes occur when the patient and doctor form an equal partnership, with the majority vote going to the patient. Fortunately, there is an abundance of information available today for men to study and learn enough to make intelligent decisions. For many, unfortunately, that learning process too often happens only after something goes wrong.

    Location / Kongo
    I am from N.J. orginally, then Texas twice, and Lake Elsinore in S.Ca. for 5 years. You may live in San Diego or Temecula and your diction reminds me of either an attorney or a doctor. I know about the milk contents as it is basically all the same.
    My 68 year old sister from Boca Roton, Fl. stressed that fact about the Elderly are being run over like a steam roller by the medical profession.
    All your comments make perfect sence to me however all of us are not Oncologist as most of the time I wish I was a dentist rather than a retired house doctor. This being said, I changed my diet a week ago and NO ice cream for 7 days now. I lost 4 lbs. already and started Omega 3 fish oil yesterday. I faxed a cover sheet, an introductory letter and this entire 5 page discussion to my family doctor. He called me and very politley knew the message I was sending. He had no issue with this so I am getting my PSA lever retaken in 9/27/2010. I cancelled the bone scan for now, and then take it from there. He belives his lab results of 2.2 on my current PSA, so I asked him what if come back 1.0? He sort of laughed and said, " I would not belive or trust those results. LOL. He would also strongly recommend the bone scan would be an almost necessary test because of my back problems which I had long before the cancer. So from 2009 to 2010 my PSA went from 1.9 to 2.2 and all of a sudden after he talked to my Oncologist, all these test are "recomended and necessary" now. So now in one week after my new PSA is read, I am back to square one. This, needless to say is blowing my mind. BTW: My father did die of prostate cancer at age 80 as it metatised to his liver. He was taking some kind of shots to lower his testoserone I imagine, however his PSA was 9. I can only guess that that Pa. horse doctor assumed my dad would die before the cancer killed him. It was an awful death when the liver is shot. Thank you as you keep me leaning. Most od the time I do not know whether to shake the doctors' hand, or punch him in the nose.
  • Kongo
    Kongo Member Posts: 1,166 Member
    G.L.M_61 said:

    Location / Kongo
    I am from N.J. orginally, then Texas twice, and Lake Elsinore in S.Ca. for 5 years. You may live in San Diego or Temecula and your diction reminds me of either an attorney or a doctor. I know about the milk contents as it is basically all the same.
    My 68 year old sister from Boca Roton, Fl. stressed that fact about the Elderly are being run over like a steam roller by the medical profession.
    All your comments make perfect sence to me however all of us are not Oncologist as most of the time I wish I was a dentist rather than a retired house doctor. This being said, I changed my diet a week ago and NO ice cream for 7 days now. I lost 4 lbs. already and started Omega 3 fish oil yesterday. I faxed a cover sheet, an introductory letter and this entire 5 page discussion to my family doctor. He called me and very politley knew the message I was sending. He had no issue with this so I am getting my PSA lever retaken in 9/27/2010. I cancelled the bone scan for now, and then take it from there. He belives his lab results of 2.2 on my current PSA, so I asked him what if come back 1.0? He sort of laughed and said, " I would not belive or trust those results. LOL. He would also strongly recommend the bone scan would be an almost necessary test because of my back problems which I had long before the cancer. So from 2009 to 2010 my PSA went from 1.9 to 2.2 and all of a sudden after he talked to my Oncologist, all these test are "recomended and necessary" now. So now in one week after my new PSA is read, I am back to square one. This, needless to say is blowing my mind. BTW: My father did die of prostate cancer at age 80 as it metatised to his liver. He was taking some kind of shots to lower his testoserone I imagine, however his PSA was 9. I can only guess that that Pa. horse doctor assumed my dad would die before the cancer killed him. It was an awful death when the liver is shot. Thank you as you keep me leaning. Most od the time I do not know whether to shake the doctors' hand, or punch him in the nose.

    GLM
    I do live in San Diego but am not a doctor or lawyer. Just a retired navy guy who is still working because its more fun than playing golf all the time and I still have a mortgage to pay off (thanks to a counterpart of yours...a whole home remodel a few years ago). If you click on my information I've posted a few blog entries about my background and how I came to where I am today with respect to prostate cancer.

    When I knocked off dairy and cut way back on the red meat my weight dropped about 10 pounds in a few weeks then it pretty much stabilized. It's still going down but at a slower rate and if I were more diligent about regular exercise I am sure the pounds would go off quicker. This is important as there is a strong relationship between higher body mass and several types of cancer, including PCa.

    There is a lot of skepticism in the medical community about dietary supplements or "no dairy" approaches. I believe the general feeling is that if they're not cutting or radiating you or prescribing a drug then it won't work. My feeling is that there is enough information out there about dairy that has strong correlation to both breast and prostate cancer that it should be taken seriously. Eliminating dairy won't hurt you as long as you ensure your calcium and vitamin D levels are within acceptable ranges, and you certainly don't need dairy to get those. (Although the American Dairy Industry would say otherwise). There are other things that have shown to reduce PCa too...and I am a big fan of pomegranate juice although if you're taking a statin like crestor you should check with your doctor and there is some indication that they may interfere with each other.

    Of course, if your PSA does not come down you will want to consider other courses of action but it just makes common sense that if you can control your PSA with diet why subject yourself to more treatment or drugs that will block testosterone and potentially cause some rather severe side effects.

    With your father's history, you and your own experience with PCa you know you have a predispositon for this disease and it is something that you will need to monitor closely for the rest of your life.

    And don't forget...no sex for 48 hours before your next blood test for PSA. Having an orgasm before a PSA test will temorarily increase your reading by 1 to 2 points. You don't want to find yourself in more treatment just because you got lucky!
  • ob66
    ob66 Member Posts: 227 Member
    Kongo said:

    GLM
    I do live in San Diego but am not a doctor or lawyer. Just a retired navy guy who is still working because its more fun than playing golf all the time and I still have a mortgage to pay off (thanks to a counterpart of yours...a whole home remodel a few years ago). If you click on my information I've posted a few blog entries about my background and how I came to where I am today with respect to prostate cancer.

    When I knocked off dairy and cut way back on the red meat my weight dropped about 10 pounds in a few weeks then it pretty much stabilized. It's still going down but at a slower rate and if I were more diligent about regular exercise I am sure the pounds would go off quicker. This is important as there is a strong relationship between higher body mass and several types of cancer, including PCa.

    There is a lot of skepticism in the medical community about dietary supplements or "no dairy" approaches. I believe the general feeling is that if they're not cutting or radiating you or prescribing a drug then it won't work. My feeling is that there is enough information out there about dairy that has strong correlation to both breast and prostate cancer that it should be taken seriously. Eliminating dairy won't hurt you as long as you ensure your calcium and vitamin D levels are within acceptable ranges, and you certainly don't need dairy to get those. (Although the American Dairy Industry would say otherwise). There are other things that have shown to reduce PCa too...and I am a big fan of pomegranate juice although if you're taking a statin like crestor you should check with your doctor and there is some indication that they may interfere with each other.

    Of course, if your PSA does not come down you will want to consider other courses of action but it just makes common sense that if you can control your PSA with diet why subject yourself to more treatment or drugs that will block testosterone and potentially cause some rather severe side effects.

    With your father's history, you and your own experience with PCa you know you have a predispositon for this disease and it is something that you will need to monitor closely for the rest of your life.

    And don't forget...no sex for 48 hours before your next blood test for PSA. Having an orgasm before a PSA test will temorarily increase your reading by 1 to 2 points. You don't want to find yourself in more treatment just because you got lucky!

    Doctor/Lawyer Kongo
    It is so interesting that GLM brought up the doctor/lawyer thing, for my wife and I have enjoyed Kongo's well informed and written posts for as long as we have visited this site, and both of us had conjured that you were a doctor, Kongo. I think it is the way you give your advice with such authority that gave us that impression along with you knowledge of some not too widely used terminology. Well, we were wrong. One question I have Kongo, is that you emphasize the non dairy, non red meat dietary approach and seem to espouse it very strongly. You do so to the point that any dairy or red meat usage I entertain is done with guilt. Yet, at the same time, you are somewhat casual about exercise. Since I am much the reverse, I wonder why someone who is so committed to diet, is not so much so to exercise??? Answer only if you care to, for it is really none of my business, but I would have guessed a stronger exercise program from someone so committed to diet. Wondering minds can be dangerous.
  • G.L.M_61
    G.L.M_61 Member Posts: 30
    Kongo said:

    GLM
    I do live in San Diego but am not a doctor or lawyer. Just a retired navy guy who is still working because its more fun than playing golf all the time and I still have a mortgage to pay off (thanks to a counterpart of yours...a whole home remodel a few years ago). If you click on my information I've posted a few blog entries about my background and how I came to where I am today with respect to prostate cancer.

    When I knocked off dairy and cut way back on the red meat my weight dropped about 10 pounds in a few weeks then it pretty much stabilized. It's still going down but at a slower rate and if I were more diligent about regular exercise I am sure the pounds would go off quicker. This is important as there is a strong relationship between higher body mass and several types of cancer, including PCa.

    There is a lot of skepticism in the medical community about dietary supplements or "no dairy" approaches. I believe the general feeling is that if they're not cutting or radiating you or prescribing a drug then it won't work. My feeling is that there is enough information out there about dairy that has strong correlation to both breast and prostate cancer that it should be taken seriously. Eliminating dairy won't hurt you as long as you ensure your calcium and vitamin D levels are within acceptable ranges, and you certainly don't need dairy to get those. (Although the American Dairy Industry would say otherwise). There are other things that have shown to reduce PCa too...and I am a big fan of pomegranate juice although if you're taking a statin like crestor you should check with your doctor and there is some indication that they may interfere with each other.

    Of course, if your PSA does not come down you will want to consider other courses of action but it just makes common sense that if you can control your PSA with diet why subject yourself to more treatment or drugs that will block testosterone and potentially cause some rather severe side effects.

    With your father's history, you and your own experience with PCa you know you have a predispositon for this disease and it is something that you will need to monitor closely for the rest of your life.

    And don't forget...no sex for 48 hours before your next blood test for PSA. Having an orgasm before a PSA test will temorarily increase your reading by 1 to 2 points. You don't want to find yourself in more treatment just because you got lucky!

    GLM / Kongo
    I have often wanted to be a private detective or an FBI profiler as I love to watch " criminal minds" and "without a trace" each night. :-). The part of your home that shows, your attire, and Palm tree leaves spells "success" is why I guessed San Diego.
    Well a quick update is that I am getting a repeat PSA next Monday, however in the meantime today I received, at my request, a detailed print out of my lab work that was done on the 13th of this month. My FREE PSA is "10" which by their standards and others, It appears to me that I have a 56% rate that my cancer has returned. Of course I am not happy about this, feel I was lied to in 2006, and would like to put my Oncologist head under that linier excellerator for 8 weeks............then just say when it is all over and he asked why the side effects, I will just say as he did, "I am sorry".
    However we are not the judge in this crazy world, as only God is and has a plan for everyone before they are even born. "He preparest a table before me in the presence of mine enimies". When I learned what this meant, I was quit taken by it, as many people do not.
    As for your remodeling job, it is just business as ladies shoes have a mark up of about 90%. LOL. If one has the tools and the ability to use them well with experience and is also a transplanted Yankee,:-), Remodeling was my "bag" and I loved it. We just loved smaller jobs and meeting people and have finsined projects from coast to coast that may last 100 years after we are gone. We offered 70 differnet services and for the last 12 years out of 42, my wife and I were a team, like a surgeon and a great surgical nurse.
    I know about the "sex" thing also. My wife is a georgeous Sicilian woman 10 years younger than me, and we have been married for 30 years, YIKES. Just remember what Dr. Phill McGraw says, " Sometimes it takes all night, to do what we used to do all night."