NolaKevin said...
My urologist mentioned the gene analysis and, obviously, if I can do anything to help them out down the road,

I am not trying to be pessimistic but the genetic analysis I am talking about would be for you, in case the initial treatments fail. It seems that there is alot of research around targeted treatments based on the genetics of the tumor. This mutation. That mutation. Its a place I hope I never have to go, but my renegade prostate is sitting in a freezer at Fox Chase in case they need a sample.

halbert said...
Your G 3+4 places you in "low intermediate risk", and your odds are very good that your treatment--whichever you choose--will be once and done. Particularly if it is organ confined.

Absolutely!

Jim and all,
Thank you for the feedback. What you are saying makes a great deal of sense. I was definitely confused about what the urologist was telling me about the genetic testing. But, he had just told me I had cancer so not sure I heard a lot after that anyway.

Tudpock18 said...
I think that “genetic” testing as a reason to get prostate surgery is a red herring.

Well maybe “genetic” was the wrong word but this article was really interesting. It describes the experience of a guy who had his prostate cancer genetically sequenced from his previously removed prostate.

https://www.wired.com/story/one-mans-search-for-dna-data-that-could-save-his-life/

“ Oregon Health & Science pathologist Christopher Corless analyzed Olson’s walnut-sized prostate gland that had been excised and embedded in wax. Corless cut the tissue into thin wafers using a device that looked like a deli pastrami slicer.

After the tissue was stained to identify the cancer under a microscope, the malignant areas were placed in a test tube and mixed with an enzyme to free its DNA secrets.”

The article goes on to tell of his successes with experimental treatments.

So if there is a decision to be made about initial treatment, and you always want Plan A to be decisive, its not a bad idea to have Plans B, C in your back pocket.

Nobody knows what the future brings.

Thus my comment and opinion.

Kevin, you’ve done your homework and will make an informed treatment decision. Next to catching PCa early that’s the very best any of us can do. Best wishes...Terry

Post Edited (Terry's Cellar) : 5/19/2021 10:14:55 AM (GMT-6)

Hello, NolaKevin ----

When we last heard from you, you were facing some treatment decisions, doing your due diligence in treatment research, and consulting with your medical team --- following scans and diagnostics.

How are you doing these days? Which treatment decisions rose to the top for you? How have your experiences been, these past few months?

Lots of fellowship --- support --- camaraderie --- and encouragement here.

Hoping this finds you doing well --- doing your best --- and facing forward!

When time allows, write a few lines --- and let us know how you're faring, NolaKevin!

With my best to you, from across the miles -----
CYCLONE - # Iowa State University

Thanks for checking back and it sounds like you're having typical reactions to the brachy (mild, but should improve in the coming weeks) and the ADT (annoying as heck). I was the same age as you while on ADT and I can tell you that your libido will come back, but it sure is strange having completely no interest!

Tudpock18 and Michael_T, thank you for responding. Regarding the Lupron shot, the doctors told me they wanted to do it to reduce the size of my prostate (it is slightly enlarged) and that it would help fight the cancer once I got the seeds put in. I didn't question it. Regarding the seeds, I'm embarrassed to say I'm not sure. I have it in paperwork at home, but not currently there. My libido has been gone since about a week after I got the shot, which is normal based on everything I read. Glad to hear that it will come back.

All,

It’s been a while since I posted on the forum. I hope everyone is well. I am coming up on my one year anniversary for my brachytherapy procedure and wanted to let you know that my PSA haven’t gone down as I had hoped. Following my procedure in September of 2021, I’ve had 3 check-ups with the following results:
January 2022 - 1.91
April 2022 - 2.6
July 2022 (today) - 2.7

My urologist says he’s not concerned, but I was really hoping the numbers would start going back down. He also checked the size of my prostate and said it was still smaller than before the procedure. He says he is not concerned just yet, but I’m pretty bummed out. Any thoughts to ease my concerns (or a reality check) would be greatly appreciated. Thanks.

Nola

Be patient, takes time, just make sure to use the same lab for the follow up PSA tests.

I just noticed you had ADT with the Brachy. I would of thought your PSA would of dropped fairly low just from the ADT, what does you RO have to say on that.

I assume you would be working with your RO who did the Brachy?

I didnt have ADT so nothing to mask my PSA, it has been a long road so far for me.

Best of luck.

Post Edited (Turboz) : 7/28/2022 11:18:53 AM (GMT-7)

Hello, NolaKevin ~

Diagnosed in your 50s, and I was in my 4Os, we both have to look at this as a marathon, not a sprint.

We have to constantly consider the long-range viewpoint ~ and treatment landscape.

That being said, I think the words that stood out to me most in your latest update were there words:

"I AM BUMMED."

I understand. We want to see declining PSA results. Every time. Who wouldn't?

I reflected on your update, and one thought rose to the top, above all others ...

Thinking long-range ~ thinking ahead to your future ~ what's to be lost by getting a second opinion?

Early on, my original doctor shared this sage advice:

"A great doctor should ALWAYS endorse a second opinion. Always!"

How about going in for a consultation with a medical oncologist, and ask them to review your case & treatments?

When I first went to Mayo Clinic, Dr. Kwon did this for me ~ taking that "fine-toothed comb" ~ and going through initial treatments and scans.

That valued "second set of eyes ~ sharpened by experience and insight and expertise!"

Much to be gained ~ and it might be a proactive way to lift yourself up & moving forward from that "glum and bummed" feeling that is hanging like a gray cloud above you right now.

My question for a medical oncologist would be, "Are we doing everything we should be doing, in terms of treatment, right now?"

There's power in self-advocacy. This diagnosis doesn't come with an instruction manual, but I wanted to share this thought regarding a second opinion.

You deserve the best.

When I added my medical oncologist to my team, it was a TRANSFORMATIVE day!

With my best ~
CYCLONE ~ # Iowa State University

Terry and Cyclone,

Thank you for your thoughts and the perspective. I am going to see how my next test (October) goes and talk to my oncologist. I am cognizant of the fact that because of the treatment plan I elected my prostate is still producing protein. And, you are right, it is much lower than it was when I got my biopsy results. So, again, thank you for the perspective and the reminder to stay positive.