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SILVER

James Edge and Pamela live in Arizona. USA. He was 61 when he was diagnosed in May, 2006. His initial PSA was 18.9 ng/ml, his Gleason Score was 3 + 4 = 7 and although he says he was staged T3a, this is his pathological staging; his clinical staging would have been T1c from his narrative. His choice of treatment was Surgery. Here is his story.


May 2006.

I had my normal yearly check up as I had been doing since I was 50 years old, I had become very blasé about the results over the past 10 years as my PSA had never changed from 2.4. This time however it came back at 12.5. I was referred to a urologist in Orlando who retested me, that came back at 15.3. A biopsy was performed and when the results came back from the lab, it seemed that not enough prostatic tissue had been removed to determine a diagnosis!!

September 2006.

This presented a problem because my wife and I were about to move across country to live in Arizona, so I took the slides and report with me and then had to start the process over again with a new urologist and another biopsy after he put me on Cipro for 30 days to make sure that it was not an infection. It was not, but by now my PSA was 18.9, so another biopsy was done and PC was diagnosed.

My urologist then explained the various treatment choices that were available to me at that time. I decided to have the RP and debulk the tumor, this would then give me a more accurate look at whether the cancer had indeed left the Prostate itself.

November 2006.

After the surgery was performed, there was some extracapsular extension on one side of the prostate, but the nodes were negative for PC.

The Gleason score was confirmed at 3+4=7 and the staging was T3c NO. After the catheter was removed I had no incontinence whatsoever, so that was good news. The follow up PSA test was not however, that came back at 1.2!!

January 2007

I started 39 sessions of IMRT (Intensity Modulated Radiation Therapy) radiation to the nodes and the prostate bed, as well as the pelvic area to hopefully kill of any remaining cancers that were left after surgery.

The radiation went well, no real side effects really, my PSA after completing the treatment did get down to 0.16, not undetectable but a fairly good decline. That was my nadir after radiation.

May 2008

By now my PSA had climbed to 0.52. I was recommended to see a wonderful Prostate Cancer specialist in Los Angeles called Dr Tanya Dorff, after meeting with her, it was decided to have a CT Scan along with a Bone Scan to make sure no distant metastases were evident. Both scans were clear but my PSA continued to go up and reached 0.64.

September 2008

I then started with ADT treatment, my Meds were Lupron every 84 days, with 150 mg of Casodex daily with 0.5 mg of Avodart.

Within one month of my first Lupron injection my PSA had gone down to 0.03 and my testosterone was 12, Dr Dorff was extremely encouraged, every monthly blood test taken from that point showed the same 0.03 with the Testosterone never showing any sign of going up.

June 2009

Dr Dorff has taken me off the ADT therapy, and will now monitor my PSA tests every three months, the next one being in August.

I will update when these results become available.

 

UPDATED

September 2009

 

 

I have just had my first PSA test since coming off my ADT treatment.

PSA is still at 0.03 Testosterone is recovering.

Great news!!!!

 

UPDATED

November 2009

 

 

Latest quarterly PSA is still holding at 0.03 since stopping ADT 6 months ago.

 

UPDATED

June 2010

 

 

Most recent PSA test came back at 0.03, has held steady since May 2008. My testosterone is now at 480.

Just back from seeing my oncologist in LA, she is delighted at my continuing undetectable status, wants to see me in a year.

 

UPDATED

January 2011

 

 

After 18 months on a ADT holiday and undetectable my PSA has risen to 0.4. Last test was November 2010. My doc wants to wait for the next one in February to see the velocity and what the doubling rate is, assuming the test in November was not an error.

I guess it was always likely to begin its rise once again, but one always hopes and prays that it would take a very long time to do so. I guess 18 months holiday from ADT was good though.

Dr Dorff has said that if the PSA does continue to rise then its back on ADT once again.

I will update after my next test in February.

 

UPDATED

March 2011

 

 

My follow up PSA test came in a 0.8 in February up from 0.4 in November. So not a good result really, doubling every three months.

Back to see Dr Tanya Dorff at the Norris Cancer Center at USC in Los Angeles, had two scans done, one PET CT scan, followed the next day by a PET bone scan. After discussing my latest PSA, Dr Dorff and I agreed to begin a second round of ADT, Lupron and 150 mg Casodex, with daily 0.5mg Avodart.

After arriving back in Phoenix I received good news on both scans, they were clean although there is an area in my pelvic area that they are confident isn't cancer but it has to be ruled out. So all in all very good news, just got to have an ultrasound needle biopsy to that swelling to see exactly what it is.

My last round of ADT was very successful, it gave me almost two years off treatment, hopefully the same result will follow this time.

 

UPDATED

May 2011

 

 

This is my second round of Hormone Therapy after having 18 months in an off treatment phase.

I had my first results back after six weeks and my PSA has returned to undetectable 0.03, my testosterone went from 550 to 12, so very good news as the ADT is still proving to be effective.

 

UPDATED

November 2011

 

Just finished my second round of ADT, PSA maintained at 0.03 during the treatment, testosterone at 12.

Now beginning what I hope will be a long off treatment phase.

My next 3 month blood test will be in Feb 2012 :) .

James' e-mail address is: james.chelseablue@gmail.com