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WHICH COMES FIRST WHEN PROSTATE CANCER HAS SPREAD ?

DIPSTICK
Posts: 4
Joined: Apr 2014

Which usually comes first when prostate cancer has spread: a fast, high-rising PSA or pain at the site where the cancer has spread?

VascodaGama's picture
VascodaGama
Posts: 2987
Joined: Nov 2010

There is no proper answer for your question. Each PCa case is different and the advancement of the disease may have different conclusions. Some cancers produce lesser PSA serum even in low Gleason and some patients are lesser sensitive to pain. Cancer in bone does usually cause pain very nasty in some but this occurs in advanced cases when cells are of greater Gleason patterns, less diferenciated and therefore producing lesser PSA.

best

VG

 

rdw453
Posts: 2
Joined: Aug 2018

i had radical robotic prostatectomy on 8/21/18 along with removal or two lymph nodes for pathology. i recieved the report today { not good} gleason score of 9.  my question is, what can i expect next. i see my urologist on the 30th. thanks for any info

 

CBHowry's picture
CBHowry
Posts: 6
Joined: Apr 2018

I had similar post op pathogy, Gleason 9, Lymph negative, positive margins, +SVI. My doctor refered me to an oncologist and she but me on 37 days of radiadtion 90 days after my surgery. This was not Salvage RT. I finished RT on 7/20/2018 and my next PSA test is next week, I'm keeping my fingers crossed. Good Luck!

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3274
Joined: May 2012

CB,

It sounds like your RT was an additional therapy "toward curative effect," or to cure/completely eradicate the disease.

As you note, this is not regarded as salvage therapy, which has differing outcome probabilities.  I hope for great news in your case,

graycloud
Posts: 34
Joined: Jan 2018

I don't know where you had your surgery, and who read your pathology report.  I would seek 2nd and 3rd opinions from prostate cancer experts to see what the best treatment options are.  John Epstein at Johns Hopkins is the top prostate pathologist in the nation.  Get your oncologist to have him read your reports and do his own testing.   My husband had his robotic surgery 1/30/18.   He was originally diagnosed with Gleason 9 (started at 7 on local level -then  John Hopkins, Memorial Sloan Kettering, and Mayo both staged at Gleason 9 pre surgery).  He was downgraded post surgery to Gleason 7.    We made the decision early on to seek advise from many of the top notch prostate centers in the US/World.  We chose Memorial Sloan Kettering in NYC to work with my husband because we knew we had more options for cutting edge treaetment if he came out a 9 post surgery.  Good luck.  I tell everyone knowledge is power.  Get to the experts in the field to help you make decisions.  Love and prayers. 

CBHowry's picture
CBHowry
Posts: 6
Joined: Apr 2018

I had the exact same post op pathology: Gleason 5+4, lymph nodes not involved. My urologist refered me to an oncologist and she put me on 37 days of ART (Adjuvant Radiation Therapy) Completed ART on 7/20/18. Waiting till next week for my next PSA test.

Old Salt
Posts: 720
Joined: Aug 2014

You can ask him about margins, complications, and what else he saw.

Your next PSA test result will suggest what needs to be done. Some doctors ask for this early on, others wait for tissues to heal. Whatever, hopefully, your post op PSA  will be very low or 'undetectable'.

It would be infomative if you posted the complete pathology report.

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3274
Joined: May 2012

Dipstick,

Two friends of mine died with PCa in the last 7 years.  Both had PCa over 13 years.  Neither of them had ANY PCa-related pain for over 12 of those years.  As Vasco wrote, pain is usually a latecomer in the process, and is usually from advanced bone involvement.

So, even men with metastatic disease need not have any worries regarding pain, at least not for a long, long time after diagnosis.  Usually.

max

red2dog
Posts: 3
Joined: Nov 2011

Looking for others who have started this same course. Question is what was you sequencing of adminstration of the drugs ? 

Old Salt
Posts: 720
Joined: Aug 2014

But in the meantime, let me assure you that Casodex is commonly prescribed to prevent 'Lupron flare'. Hence, Casodex first and then Lupron.

dthehill
Posts: 2
Joined: May 2019

I had my prostate removed three monthas ago and my last P.S.a test was high I am going to start two months of hormon therapy and  Six weeks of radiation treatments thats the plan any way the doctor told me by doing the radiation it would weaken the cancer by basically starving it,

Georges Calvez
Posts: 242
Joined: Sep 2018

Hi lads,

Start a new thread, give us lots of details about your case eg PSA levels, date of diagnosis, etc.
Lay out a timeline with all relevant details and I will bet that one of us has experienced it and has some helpful and relevant comments to make.
It is easy!

Best wishes,

Georges

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