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Cancer: Prostate Message Board


Cancer: Prostate Board Index


[QUOTE=Dardanelle;3389332]I pulled my calander and these are my current dates tested.
My first PSA after surgery was on December 31,2007 results were .84ng
Next test is Feb 08, 2008.
My surgery date was November 27, 2007.
I may wait-and-see instead of treatment. I am not sure yet.
I am 61 Years old.
Great to talk about this.[/QUOTE]

Your PSA results give you another clue to be concerned about: you did not just have a fairly high post treatment PSA, but you had it virtually immediately after surgery. :( I like daff's point that you might not want to delay very long, at least not delay in researching your prospects and options, which you are doing now.

Did your doctors discuss any scans to figure out the location of the remaining cancer? If the cancer is beyond the range of the radiation, the value of a radiation program is doubtful - it certainly would not cure the cancer and it could add the burden of additional side effects and complications.

If the radiation has a good shot at success, then the risk can be worth the risk of the side effects. :) But what if the chance of success is low? Way back in 2000, when radiation technology was not as good as now, I had to make that decision for my own high risk case, which would have required a heavy dose of pelvic radiation and likely significant side effects, with a shot at a cure that was probably between 25% and 0%. :(

One scan that is relatively inexpensive and convenient is a check whether enough cancer has spread to the bones to be detectable. You may have already had that done, though it is so often negative, even if the case is intermediate risk, that it's initial value is questionable. However, after a surgery that does not virtually eliminate PSA, it's worth increases. It takes about 10% of cancer in a bone to show up as possible cancer on such a scan. There is an apparently more sensitive test for bone metastasis known as a special PET scan (Positron Emission Tomography) with an isotope known as 18 F-deoxyglucose. (It's not so hot for detecting spread to soft tissue unless the case is well advanced.) I had a bone scan in 2000 that was essentially negative. A bone check is often done first, because a positive result means you know the cancer is beyond the range of radiation so you don't have to do the other scans that are more expensive and less convenient.

Another scan that has come into its own is the fusion ProstaScint scan. It is great for detecting metastasis of tissue to soft tissue, even showing its location and shape. It is far superior to the CT scan, as the CT scan takes a pretty big tumor before it can indicate cancer. The fusion ProstaScint costs roughly $5,000 from what I've heard, but a good insurance policy will probably cover all of it for a very high risk patient pre-treatment (me) or for a patient with evidence of recurrence after treatment. Some doctors have not kept up-to-date about ProstaScint and still believe it results in too many false positives. (Actually, it was first measured against biopsies taken where the ProstaScint suggested cancer, and when the surgeon could not find cancer with the biopsy, the ProstaScint hit was considered a false positive. A few years later, cancer showed up at many of these spots, proving that the ProstaScint was simply a much better detector than the biopsy probe and decreasing the percentage of false positives.:))

There is another emerging scan that appears to have great potential for detecting metastasis in lymph nodes anywhere in the body, and it is less expensive than a fusion ProstaScint I believe. It is known under various names, such as USPIO, Combidex and Sinerem. The USPIO stands for "ultra small superparamagnetic iron oxide; it is special kind of CT scan. Unfortunately, doctors in the US have had trouble mastering the technology. There is at least one doctor in Europe considered an expert with that scan, and there is at least one US location that may now have mastered it.

My impression is that many doctors who advise patients on treating a recurrence after surgery favor jumping into treatment and judging whether the cancer has spread beyond the range of the treatment by whether the treatment is successful. The doctors I like are the ones that try to figure out whether the cancer has spread beyond the range of treatment first, and if it has, then moving straight to hormonal blockade therapy (or even such therapy with a short course of chemo) without burdening the patient with the effects of radiation therapy that is almost sure to fail.

Do you know about using diet/nutrition/supplements, exercise, stress reduction, and mild drugs to help combat your recurrence? Have you been advised about those tactics?

By the way, I decided to forego a shot at cure and went straight to relying on hormonal blockade, which has worked well for me. But it's a very individual decision. My case was very high risk, and yours is far lower in risk.

Jim





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