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BRONZE

Jerry Sullivan and Karen live in Florida, USA. He was 68 when he was diagnosed on August 1, 2007. His initial PSA was 5.2 ng/ml, his Gleason Score was 6 and although he does not know his staging it seems he would have been staged as T1c . His choice of treatment was Brachytherapy, IMRT (Intensity Modulated Radiation Therapy). Here is his story.

The biopsy was done in mid July, 2007, after my doctor had observed that, while Cipro lowered my PSA (I had once had a session of Prostatitis), it did not lower it enough. He suggested waiting 3 more months, but I suggested "lets get it done".

I don't recall if they ever said what the stage was, but there were three areas found, all in the front of the prostate, where a DRE (Digital Rectal Examination) would not have detected it at all, or at least until way too late. Two locations were high in the upper lobes, next to the bladder.

Subsequent MRI and PET scans showed that it was contained, so seeds were inserted (76) the first Monday in October, and IMRT (Intensity Modulated Radiation Therapy) of 25 treatments, 5 days a week except for Christmas was started the first of December, 2007 and completed in mid-January, 2008.

The PSA rapidly fell to 0.9 by late February and to 0.7 by July of 2008, but the more recent PSA in January 2009 shows 1.1, which has me worried. In March of 2008, I scheduled an appointment with my Oncologist for Jan. 21, 09 and so we will see what, if anything needs to be done. Yes, I am worried. I'll be 70 in a week, and would like to hang around quite a while longer.

After initial discomfort on urination, and mild bowel problems, I seem to have returned pretty much to normal, whatever that is.

 

UPDATED

March 2009

 

 

I saw my oncologist in late January, and he believes that I am experiencing a bump or as he prefers to call it, a "Prostate Flare" (Jerry's PSA is 1.1 ng/ml). His colleagues advise their patients to expect this, but he said that he does not because in his experience, better results were obtained when there was a flare, so he would rather not scare his patients that do not have one. In any case, I was told to expect a higher reading of PSA in July, and not to be concerned unless one in Jan. 2010 were still higher.

Currently I am experiencing a little burning on urination and my GP put me on 7 days of Cypro since there was evidence of a mild infection in the urine. Meanwhile, one of my friends who had the same treatment prior to me, by a year, by the same doctor, told me that his PSA has trended lower, but is definitely not linear. He also advised that:

Before Diagnosis-- PSA = Prostate Specific Antigen

After Diagnosis -- PSA = Prostate Specific Anxiety

 

UPDATED

August 2009

 

 

After concern over a high reading of 1.10 this past January, I was naturally somewhat anxious about the one taken this past Wednesday. However, the PSA came back at 0.30, good news, especially since my doctor considers anything less than 0.20 to be quite rare.

 

UPDATED

July 2010

 

 

I believe the last time I posted my PSA was 1.1 after it had fallen to 0.7 six months previously. Radiation was completed in January 2008, and by August 2008, my PSA stood at 0.7. Then in January 2009, it was 1.1, but my oncologist assured me that he expected this and considered it a good sign.

By August of 2009, it had fallen to 0.3, and by January of this year to 0.7. Then last week it again stood at 0.7, and as I had a scheduled appointment with my urologist (who works with my oncologist and has for 20+ years) I expressed my concern. He was a little concerned also, but reminded me that I had not yet reached a baseline, which could take 5 years, and the general guideline is to not start salvage therapy unless there is a increase in two readings above the baseline.

Also complicating this was a possible urinary infection last week which seemed to clear itself as there was no evidence today. Result, another PSA reading in 3 months and 6 months and at 6 months I will see the oncologist unless the 3 month one is of concern.

 

UPDATED

November 2011

 

I have had two successive PSA readings of 0.1, this past January and this past July. According to my oncologist and my plumber, they consider me "cured" as they tell me that they have never had a reoccurence after PSA readings below 0.2. The oncologist said I might get some ripples, but that the doctors do not get excited unless the PSA exceeds 1.0.

You can google, Dr. Douglas Swartz on the internet. He presented a paper on this subject about 18 months ago in SanFrancisco in which he showed a reoccurence rate of under .1% using the combination of seeds and external radiation that I had. However, remember that when the oncologist says that you are "cured", what it really means is that he expects that you will live long enough to die of something else.

Jerry's e-mail address is: jhsulliv@comcast.net.