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Cancer: Prostate Message Board


Cancer: Prostate Board Index


As a new participant on this board it was interesting to read the replies.

I knew right off that my case was challenging. I had a PSA of 113.6 (first ever at age 56 in December 1999) and a biopsy of all cores positive, most 100% cancer, GS 4+3=7, with perineural invasion; the stage was 3 with a "rock hard" prostate per the DRE. :confused: However, my CT and bone scans were negative, and I felt fine, with no symptoms except nocturia.

I did what I thought was adequate research, including reading ACS materials (bless them!) and the latest booklet from the National Comprehensive Cancer Network. With a lot of encouragement from well meaning but not so well informed friends, I took about two weeks to decide on surgery at a nearby world-class surgery institution, basing my decision primarily on the odds of success that I had read.

I was stunned and crestfallen when they told me I was not a surgery candidate! :( Of course, I soon learned they were right. They did offer radiation when I successfully hurdled a ProstaScint scan (then without fusion), and I prepared for that, having three preparatory consultations. However, I kept learning more about hormonal blockade, and a couple of weeks before starting the radiation, I first learned about tripple hormonal blockade. Concerned about the side effects of what would have involved a hefty pelvic dose, and encouraged by encouraging information about triple blockade, I decided to take my chances with blockade.

I have been awed and delighted with the results, though it has not been a cakewalk. :) My PSA dropped more slowly than for typical blockade patients with better case characteristics, but I was able to get it to below 0.05 for a year and reach a nadir of < 0.01 before starting my first off-therapy period after 31 months on full therapy, including Fosamax to protect bone density against that side effect of blockade. I was off full therapy for 34 months, regaining substantial testosterone in about three months, thereby recovering from most of the quality of life hit, which had been acceptable but not desirable. At the six months point my quality of life was virtually the same as before diagnosis.

While it now appears, based on slim but impressive evidence, that many low-risk patients apparently need only one round of about a year on full blockade to achieve excellent and long-term cancer control, I experienced a PSA rising well above that expected for a recovering prostate during off-therapy with predominantly normal tissue. As with a minority of higher risk patients, it was clear I needed to resume blockade. I stayed on full therapy for nineteen months, again achieving a nadir of < 0.01, and am now in my eleventh month "off therapy," with finasteride maintenance and Fosamax also in support. I don't know how many more months I can coast, but my quality of life is again excellent. :) I have learned that for most of us the side effects of blockade are tolerable and often largely manageable.

I have learned that low risk patients have a multitude of options that will probably be curative, but higher risk patients need to take care in tailoring therapy to the contours of their cases.

I did not expect to be on earth at this point, and I am profoundly grateful.





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