PSA 150 - Are we looking at PC w Mets or is there a chance it’s something else?

LadyJaneK, With that high a PSA and being a G9, the probability of combotheraphy was probably about 80%. He is definitely a candidate for Adjuvant radiation rather than Salvage radiation and the long-term outcomes are better with Adjuvant.

https://www.cancernetwork.com/prostate-cancer/adjuvant-vs-salvage-radiotherapy-high-risk-prostate-cancer

Hello All,

I’m so happy to report my husband is doing great these days. Feeling more like himself every day & the incontinence is so much better, 1-2 nearly dry pads/day. Yeh!! However, the Casodex is making him pretty tired, couldn’t make it through a full work week. But he tried!

Thank you for your responses. I will definitely suggest the PET scan before radiating the area. I think that’s a reasonable request in his case. The cancer cells are likely coming from the prostate bed area, but they don’t know that for sure. We have PSA bloodwork this week & see the surgeon and RO at the end of August so we’ll be making treatment decisions soon, but who knows maybe that PSA will be so low w the Casodex we’ll just be able to coast on it for awhile. 🤷‍♀️

Hope everyone is enjoying their summer ☀️ . ~LjK

Hi Nytngale,

Good to hear from you. I agree this is a long road & not easy for any of us! Thanks for the prayers & your response. I continue to think of the two of you as well. Glad to hear your husband has stabilized following treatment & the nasty bowel issues are resolving. My husband and I seem to have fallen into an acceptance phase, just like everyone here predicted would happen. Sleepless nights are rare & it doesn’t consume our thoughts anymore, but there’s an underlying knowledge things could change at anytime depending on PSA results & how he responds to treatment.

Hopefully your husband’s PSA remains low on ADT therapy & good luck with the next phase of this road. Keep me posted. ~LjK

Good Morning ☀️.

Have to brag a little here. Our young Canadian tennis player did it!! We’ll take a training tip from her and visualize my husband cancer free by Jan 2020 😀.

My husband is back at work full time. He’s healed well from RP surgery in April. Down to 1 nearly dry pad/day & really doesn’t think about it much anymore; only wears a pad for occasional stress incontinence w heavy physical activity.

PSA August/19 .21 after Casodex for a month. We are so thankful numbers are moving in the right direction again. Our Urologist and RO recommend 33 back to back low dose IMRT at his time to start mid October. Apparently it works best when numbers are low & they feel we have a good chance of getting it all. We will certainly visualize this happening for him. Hopefully side effects will be minimal. A PET scan would be ordered but our province does not have the isotopes to identify PCa 😕. We’d have to go out of province or to California & foot the bill. Our RO said no matter what the scan revealed, he’d still recommend radiating the area, so treatments will be in the city M-F for 6&1/2 wks. That’s a daily 3hr commute for us. Yikes! Thankfully we have family in the city, so we’ll likely spend some nights.

Summer seems to have flown by; feels like fall around here. Any tips to prepare us for radiation beyond full bladder and empty bowel?? ~LjK

LadyJaneK said...
Our RO said no matter what the scan revealed, he’d still recommend radiating the area

I was told the opposite. Not to be downer but my RO sent me for a PET scan and found multiple mets. That absolutely changed the treatment protocol from radiation to systemic therapy (Lupron+Zytiga +prednisone). As he said, "why would I radiate your prostate bed when you need systemic treatment?" I certainly understand the cost/travel issue. But G9 cancer deserves a scan imho.

Is your RO planning prostate bed SRT, or whole pelvis SRT? A scan could help make that decision and is useful since you're still seeking a curative response.

I chose a prostate bed only SRT based on my low recurrent PSA value (0.08), but we really didn't know where the remaining cancer cells were. My RO's best guess was from remnants of my Seminal Vesicles (T3b with negative margins).

Wishing you a successful outcome.

We have our dates for radiation. Simulation Sept 27 and 33 low dose RT’s to start Oct 17/19 & another PSA prior to Tx.

He’s been doing well on 150mg of Casodex for the most part, but he’s developed some serious anxiety & mood swings. No other SE’s except a bit of breast tenderness. Had a panic attack at work. Not fun at all. Now that he knows what it is and that he will get through it ok, another one won’t be quite so overwhelming, at least I hope so for his sake. It really shook him up. The RO was thinking we should start Lupron shots, but now I’m not so sure. Will that make his symptoms even worse??

Those who’ve had these symptoms, let me know what worked for you. Would adding an anti-depressant or anti-anxiety at this stage help? ~LjK.

Merry Christmas 🎄 to you All!

I haven’t posted in awhile nor been online much lately. My husband just completed 33 rounds of radiation between Oct17-Dec04 w a daily commute of 4 hrs to the city and back. He tolerated IMRT and all the commuting really well. Some expected side effects intermittently like nausea and diarrhea which got a bit worse the week after completion but mostly just very tired. It has not affected his urinary continence level which is great. His PSA in the last week of treatment was 0.04. Yeh! The docs called it negligible. Compared to going up to 185 & 195 in Jan 2019 we couldn’t ask for a better Christmas Gift!! They’ll check it again in 2mo. We’re staying optimistic and hoping for the best. If all things remain the same he’ll stay on the Casodex 150mg daily till April and if his PSA continues to stabilize we’ll try going off. His treatment has been a bit unconventional, but he’s tolerating the higher dose of Casodex w very few side effects & we’re getting good results, so we’re sticking w it.

We’re taking One Day at a Time, and breathing easier; and like many of you told me in the beginning, we’d get used to living w Prostate Cancer, and it’s true. Our lives are not consumed by it, but I won’t lie, there’s still concern about his bone scan results and the sneaky castrate resistant cells that don’t register in the PSA. Unfortunately as recently as 2 wks ago I was told by a close relative that her father in law passed away; where this exact scenario took place. PSA was very low, but he was having symptoms. Found Mets to lungs in his back. It’s one thing reading about it, but it hit a bit too close to home. She happens to be a doctor so her advice was stay on top of those follow up scans no matter what the PSA says. Make sure the docs are doing them! We can do that!!

Our home Reno’s are coming along nicely and 2020 is looking brighter already. Thanks to those here on the forum who’ve followed my postings and been kind enough to respond. It’s been a great comfort this past year.

Wishing you all Happy Holidays from our house 🏡 to yours. May it bring quality time w friends and family 🙏.

Happy 2020. We’ll see you all in the New Year 😊.

LJK, thanks for the update. You are doing everything you should. Now most importantly enjoy the holidaysnwithnyournfamily and friends.

Best wishes.

It's been a tough year for you both. Hoping the coming one will be better!

Hello LadyJaneK ----

How are things going for you and your husband?

Last we heard from you, a series of proactive treatments had really knocked down the PSA levels, from its original level at diagnosis.

You have done tremendous work, in documenting the series of proactive steps you have taken in treatments.

We've got new readers out there who look to cases like yours for encouragement --- seeking hope and encouragement, when facing new treatments or a new diagnosis.

Here's hoping things are going well for you in Canada, and that you and your husband are looking forward to a great summer ahead!

Let us know how you're faring!

With my best, from here in the Midwest,
CYCLONE --- # Iowa State University