PSA has shown an increase from 1.98 in 2006 to 3.08 in 2009, 4.24 in 2010 and 6.31 in 2011 when a biopsy in that year showed 1 core of 16 positive for adenocarcinoma (5% of volume). I was prescribed Avodart and put on Active Surveillance.
Repeat PSA's were 2.55 in Sept. 2011, 2.91 in Apr. 2012, 4.48 in Oct. 2012, and a repeat of 4.41 in Nov. 2012.
At this stage, I was referred to an oncologist and chose to have an MRI and another PSA done which were scheduled for Apr. 2013. The PSA was 5.49 and the MRI showed a small suspicious mass ( 0.9 x 1.6 x 1.0 cm ) in the left mid-base peripheral zone. The left apex from which the original positive biopsy core came was unremarkable. I was told that this small mass lies about 1.2 cm from the rectal mucosa and is a difficult area to reach with a biopsy needle.
I was given the choices of a repeat biopsy to target this area identified by MRI which may not succeed and means more waiting (my opinion), radiation therapy, or surgery. I am still on Avodart.
I decided on surgery which was done in June, 2013. The pathology report indicated a Gleason score of 3+4 = 7, carcinoma involving approximately 5% of the prostate tissue bilaterally, no positive surgical margins, no seminal vesicle involvement, and the three lymph nodes that were sampled negative for malignancy. The tumor was classed pT2c.
At the time of surgery, I had been on Avodart for 2 years and my PSA was 5.49. The Avodart had halved my PSA but had done nothing to stop the increase. Three months following surgery, my PSA was reported as less than 0.02 (non-detectable). There was no PSA done at six months, and at nine months the PSA was reported as 1.3. I have recently had this last PSA repeated. I am now awaiting the result and trying to decide what to do next should this result be confirmed.
Following robotic surgery, my PSA on Sept. 30, 2013 was 0, but had increased to 0.13 on March 27, 2014. (This had been reported erroneously as 1.3 earlier). Repeat PSA was 0.16 (April 9), 0.18 (April 29), and 0.20 (May 12). On May 15, 2014, I was prescribed Casodex for 30 days and given an injection of Zolodex which was good for 3 months. On Aug.7, my PSA had decreased to less than 0.02 and I had my second injection of Zolodex. I was also scheduled for EBRT which began on August 27 and ended October 17,2014. (36 treatments). PSA measured on Oct.22, 2014, and April 10, 2015 have both been non-detectable. I am scheduled for another PSA on July 17, 2015. One side effect of HDT was a drop in my testosterone level from 12.4nm/L on May 12, 2014 to 0nm/L on April 10, 2015. I have felt the effect of this low testosterone daily, and hope that it will eventually begin to recover.
All PSA`s done since July 2015 have been non-detectable. I am scheduled for another in September 2016. My testosterone did recover and was 12.1 nmol/L in February 2016. I am active physically and feel well.
Since my last update, all PSA's have been non-detectable. My next PSA is scheduled for October 2017. Impotency is the one side-effect that I still have.
Killean's e-mail address is: killean1 AT rogers.com (replace "AT" with "@")