Guest guest Posted February 11, 2011 Report Share Posted February 11, 2011 bobbishop99 wrote: .... > March - May 2010 - 33 sessions of EBRT at the Cancer Clinic in > Harley Street (Britain's top medical address). Further problems > with urethral stricture - start self-catheterisation twice a > week to prevent scar blocking the pipe. > September 2010 - PSA 3.6 > December 2010 - PSA 5.24 > > Now to me this seems pretty scary as I would have expected the > PSA count to be virtually non-existent at this stage. I am in > good health otherwise - fit and active, almost completely > continent - some ED but things are improving fast. My > oncologist says it's too early for any further treatment. My > urologist remains cheerful and optimistic but doesn't seem to > have any very convincing explanation as to why my PSA is where > it is. > > Can anyone out there explain what might be going on? Bob, I'm not a doctor or an expert of any kind. What I say below could well be wrong. I'm just a software geek like you who has had cancer and learned something about it the hard way and by reading what others have written. It is possible that you are experiencing a " PSA bounce " , however I think it is most likely that you have a " recurrence " of your cancer. I would expect the men most likely to have a bounce are men who have a prostate, i.e., never had surgery, only radiation. In your case there is little or no prostate left. The PSA you are seeing may not be coming from the area where the radiation was, but from cancer cells that have spread. This is a question that you can ask your radiation oncologist. Is it possible for a man to have this much of a bounce who has no prostate? How likely is it? At this point all the " definitive " treatments (surgery and radiation) have already been tried. That means that if you still do have cancer the currently available follow on treatments will be designed to help you live with it and keep it from hurting you rather than to completely eliminate it. This is indeed scary, but it's far from the end. As Metcalf pointed out, he was in your shoes 15 years ago and he's still alive and kicking today. He's not alone in that. There are other men who have lived symptom free for ten, fifteen, or even more years after a recurrence. It's very difficult to predict what will happen to any individual man. I recommend the following course of action: 1. Learn about prostate cancer. Learn about treatment options. Learn especially about " androgen deprivation therapy " (ADT), also called " hormone therapy " , which is the next treatment that is generally prescribed for men in your situation. 2. Learn about any lifestyle changes that might help you battle the cancer. Some experts believe that a " Mediterranean " diet is better than a diet rich in meat and dairy. Some believe that getting yourself in good physical shape in terms of weight control and exercise will help. Some believe that certain supplements can help - pomegranate juice or extract have been touted a lot lately and I believe there are others. Some have suggested vitamin C, resveratrol (found in red wine!) - but I'm no expert on that. 3. Gather up a list of questions and make an appointment with your oncologist. To my mind, the most important question is: What milestones should trigger further treatment, presumably with ADT? She said that she didn't think you should get further treatment at this time. Ask her when you should seek treatment? Should it be if and when the PSA reaches 10, if and when it reaches 20, or what? How often should the PSA be tested in her view? If it were me, I would try to pin her down. I wouldn't be satisfied with " let's wait and see. " I'd want to know what we were waiting for and what we expect to see. I'd want to have a plan for my future treatment and not just be put off until things reach a desperate state and it's obvious that something has to be done and maybe should have been done already. She undoubtedly knows more about this than I do, but there is some current evidence that getting treated sooner rather than later can prolong life. Some doctors here in the U.S. are starting ADT when the patient's PSA reaches 4.0. Some wait for 10.0 and some wait longer, but you are now in the range where a great many doctors would now begin treatment. It is important not to begin treatment until you know you need it. So if there is any possibility that this is just a " bounce " , it's worth waiting a bit. I think it's also a great idea to begin any lifestyle changes that might help in the hope that they can reduce the need for further treatment - though I doubt that they can eliminate the need. But I don't think you should wait long and I do think there should be a definite plan for the future. Finally, I would like to say after looking at your blog that it looks to me like you've got the important things in hand. Cancer is one of those nasty things that happen to a lot of us on our way from the cradle to the grave. It has to be borne and dealt with as best we can. But the really important things are what we do in the time we've got. I can't think of much that is more satisfying, more human, and more to be desired than what you're already doing - computer programming and music. I'm pretty good at computer programming, but I'd give the traditional left testicle if it would make me good at music. Best of luck with your treatment and, whatever you do, please don't let it interfere with your singing. Alan ________________________________________________________________________________\ ____ It's here! Your new message! Get new email alerts with the free Yahoo! 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