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Re: Proton Beam therapy & hi PSA

It is a difficult decision. I was about the same age with similar #'s and had considered doing the Beam Therapy at a local spot with a solid reputation but opted to just get it yanked and hope that the side effects weren't too severe. Can you get a "follow up blast" if the original procedure didn't quite get the job done?

Re: Proton Beam therapy & hi PSA

Whoa, Greg, whoa!! Don't gallop into salvage therapies until you KNOW you need to do so.

You say you have a total failure of treatment because of four PSA tests, two of which are identical showing that the profile is not a typical one of a continuous, ever increasing profile.

Don't ever forget that the PSA test has many limitations. It was developed to test the outcome of surgery because at that time the view was that the protein identified as Prostate Specific Antigen was, well....prostate specific. And therefore if there was no prostate, there should be no PSA. BUT....it is not prostate specific, being produced by other organs, so even men who have had surgery sometimes have a detectable PSA.

BUT....you have a prostate gland, you have not had your gland removed, so it is possible that the peculiar pattern of PSA readings you are experiencing may in fact have nothing to do with failure of your chosen therapy. It is very much in your insterests to take into account things like long term radiation proctitus, bladder or prostate infections and the like.

You should, i believe, have a series of tests to see if the PSA changes are in fact most likely to be caused by prostate cancer. Keep a close track of PSA numbers for a while - maybe monthly tests - and talk to your medical advisers about the possibioity of a course of anti-biotics or tests fro bladder infections.

If you don't want to follow that route and instead start ADT (Androgen Deprivation Therapy) then you need to know that although some men have severe reactions, especailly to so called ADT3 where a mixture of drugs are used, many men do not have sever reactions - especially if you use only one drug. That has been my position to date as you willknow if you have read my story to date.

Can I suggest you go along to Chuck Maack's site at The Prostate Advocate . Chuck has been on ADT for most of the past fifteen years and has some good advice on his site, including this:

ADT is NOT the horrendous treatment that some claim it to be, and many of those who claim so never even had the treatment themselves – they rather echo someone else’s comments who may have experienced some of the side effects that can occur, but that person likely had no idea how he could have relieved whatever side effects he is complaining about.

All the best
Terry in Australia

Re: Proton Beam therapy & hi PSA

Me again,,,,my scans are good and I'm more relaxed about
The whole damn thing,,,thanks so much for all
All your replies especially Terry...
By the way I've been on antibiotics for a while
now...........greg

Re: Proton Beam therapy & hi PSA

My condition,,,,,,met with my urologist today. Since my last PSA of 13 a couple weeks ago, I've decided to wait another couple weeks do another PSA back-to-back with a biopsy. Can't friggin wait.......
This will help me understand whether this walnut of mine is trying to kill me sooner rather than later.
My Doc recommends Salvage/Cryotherapy if my numbers are aggressive. If the
biopsy shows hardly anything we'll watch and wait.......
My understanding is since I have good scans and no symptoms that the only Salvage therapy is Cryotherapy.......Hormone therapy was mainly for someone older
or showing PC symptoms.....later greg

Re: Proton Beam therapy & hi PSA

Greg,

Be aware that a biopsy after radiation therapy is extremely difficult to read accurately and there is considerable diasgreement as to whether the material can be graded according to the Gleason code.

You really need an expert pathologist to look at many material.

Re: Proton Beam therapy & hi PSA

Terry and everyone else that gets this...As of previous posts;

Recently had my new Biopsy (understand this is 5 years out from Proton Beam
Therapy which I assumed failed considering my PSA now is 13). Well my Biopsy came back negative, no cancer in 12 samples, at first we thought this was good but my Doc says that my Proton Beam may very well had worked and that its possibly a Micro-Matastis that we now see. To validate he wants to do a saturated Biopsy,
thats 28 samples, 6 weeks out from the last biopsy. I'm not sure how and if I want to proceed but I'm going to contact Loma Linda hospital and try for over-the-phone second opinion.
thats it,,,,, the beat goes on........greg

Re: Proton Beam therapy & hi PSA

You might like to ask how a micrometastasised disease can generate a fairly high level of PSA? If the disease is too small to find, it seems more logical to me that there must be another cause!!

Re: Proton Beam therapy & hi PSA

Terry ,thanks for your reply,,,,I think I will do nothing for a while. I think I'll go on antibiotics again,,, my biopsy report not only said no cancer cells but also
that I have an inflamed and atrophy prostate. The inflamed part is what gets me
but still with it being a radiated prostate it put things in a skewed perspective.
later g

Re: Proton Beam therapy & hi PSA

This is a follow -up on what I've posted about myself over the last 3 months.
The latest;
Apparently my Proton Beam did work. The latest biopsy was a saturated type,
meaning they took 28 sample 3 weeks ago. Now drum roll please," No Cancer"
And I still have a PSA of 13. All this with clear scans and two treatments of
Anti-biotics for infection ,,,,go figure . Apparently its micro-matastisis.
Doc says we watch and wait. I placed a call to Loma Linda to try and get another opinion on this situation...This is a situation that I've never come a cross in all my reading on PC.
So Terry what say you ???

in the last 3 months a PSA of 7, 13, 13.4, and 13
I was treated 5 years ago with Proton Beam,,,2 years later it was a PSA of .5

later greg

Re: Proton Beam therapy & hi PSA

I say three things Greg:

1. The Golden Rule of prostate cancer is There Are No Rules.

2. PSA is not prostate cancer specific and can be elevated for any number of reasons, some of which have been identified, some of which haven't. The test was never initially intended for use after radiation therapy.

3. As anyone on Active Surveillance will tell you, a negative biopsy means that it is not a positive biopsy. That is to say no evidence of cancer does not mean that there is no cancer it meely means that no cancer was found.

I'm sorry you are in this position and wish you all the best for the future.

Terry in Australia

Re: Proton Beam therapy & hi PSA

thanks Terry for the out-of -the-box look at it all....Your outlook gets much respect from me.....thanks greg

Re: Proton Beam therapy & hi PSA

Congrats! By "later" we hope you mean you will keep us posted.
Wishing you all the best.
Don O.

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