THERE WAS NO RESPONSE TO AN UPDATE REMINDER IN 2019 SO THERE IS NO UPDATE.

11-25-2015: Blood Test was administered by Exam One

12-3-15 @ 1:59 PM Found out PSA was high (7.5) from Tim Yurek- Insurance agent

12-8-15 appointment with my GP Dr. Puffenberger.Took a second blood sample @ Clinic. Had a DRE exam by Dr. Puffenberger-Negative, no lumps and Prostate is small.

12-10-15 Found out PSA number wen up to 8.7. made appointment with Dr Michael H Rittenburg @ Riverview Urologic Associates, 423 3rd Ave #B, Kingston, PA

12-14-15 Had initial Consultation with the Urologist (Dr. Rittenburg), he did a DRE, which did not show any nodules, but did feel somewhat enlarged. He felt there was adequate concern to schedule a biopsy. He scheduled it for 1-8-15 in the morning. I fid find out at this appointment that when I turned 50 my PSA test was 5.7 and my GP never told me. Should have been on watchful waiting back in 2013.

12-22-15: PSA test at LabCorp-7.4. Scheduled this test myself. Independent of Doctors requests.

12-28-15: Called Fox Chase in Philadelphia & Sent in Online Form request.

12-29-15: Set up an appointment with DR Marc C. Smaldone-Urologist

1-11-16 Fox Chase initial appointment with Mark Smaldone

2-5-16 scheduled biopsy for 2-5 at FCCC

2-12-16: Phone call from Dr Marc Smaldone (Kim heard as well):

• 4 of the 12 cores were positive for PCa
• Confined to half of the prostate.
• 2 had Gleason score of 6
• 2 had a Gleason score of 7
• Staging: T1c.

2-17-16: Meet with Dr Smaldone to review treatment options; Sugery vs Radiation

3-8-16: MRI at Fox Chase-Tumor shown to be closer to the edge of the capsule and possibly capsule extension.

3-9-16: Consultation with Dr Mark Hallman- Radiation Oncologist & Marc Smaldone-Urologist. Dr Hallman did another DRE, couldn't feel any nodule, however the MRI showed the Tumor to be closer to the edge of the capsule and possibly capsule extension. Upgraded staging to T3a. Now became High Risk.

3-15-16: Pre Admission testing-CT Scan & Bone Scan. All tests were clear. I made my descsion to go with surgery this day, and scheduled it for 3-28-16.

3-28-16: Surgery-Surgery went well, no visual evidence the tumor escaped the capsule

3-29-16: Discharged-5PM

3-30-16: First Day Home- Swelling in Stomach & Groin area, Visiting nurse stopped by.

4-6-16: Catheter Removed.

General Note: very good control of my bladder and have very little need of Pads. Only lasted 2 weeks.

6-8-16: Dr Smaldone Apt @ 9:15 Huntington Pike-PSA Testing-Undetectable

9-14-16: Dr Smaldone Apt @ 9:15 Huntington Pike Ultra-sensitive PSA @ 0.03

12-14-16: Ultra-sensitive PSA @ 0.07

12-14-16: Appointment with Dr Mark Hallman-radiation Oncologist @ Fox Chase-Dr Hallman did another DRE, couldn't feel any issues. However he suggested I start Radiation Therapy-Wanted me to have the procedure at Fox C. Didn't seem interested in working with a clinic other than Fox Chase.

12-16-16: Appointment with Dr Marc Smaldone-Said my decision but waiting till next PSA test results would be ok. He said I should go find a Radiation Oncologist closer to home, and he would stay my Urologist and work with them directly.

1-22-17: Meet with Dr Christopher Peters Radiation Oncologist at Northeast Radiation Oncology in Scranton. Recommended having 39 sessions of radiation. Didn't recommend ADT.

1-24-17: had PSA test again, PSA @ 0.1. So it is increasing.

Scheduled imaging/mapping for Radiation Treatments for 2/15/17

02/15/17 - Did imaging/mapping for Radiation Treatments. Current thinking at this time was RT alone no need for ADT. I was scheduled to start RT on 2/28/17 at NROC in Scranton, PA with Dr. Peters. However given the feedback I received on this site, I decided to get another opinion. So I made an appointment at Geisinger, which I was able to get quickly.

02/22/17 - I meet with Dr Uzma Malik a radiation oncologist at Geisinger' s Henry Cancer Center in Wilkes-Barre, PA. I was basically told the same thing, didn't need ADT. She said I should start radiation soon, but also believed It should be limited to the prostate bed only, and don't need to include lymph nodes or whole pelvis, since I had no positive margins, no seminal vesicle or node involvement. She did order another PSA test.

02/24/17 - PSA test, PSA @0.14 rapid increase over very short period of time. If you map my PSA increases from 9/9/16 (@0.03), 12/5/16 (@0.07), 2/24/17 (@0.14), I calculate PSADT to be slightly less than 3 months which is very fast.

02/25/17 - I sent this email to Dr. Peters (Radiation Oncologist), I was called to start Radiation Therapy this Tuesday 2-28-17 at 6 PM. I need to hold off on starting this therapy, until I speak with you. Please read my concerns below. I had my PSA tested again yesterday (2-24-17) and it came back 0.14 (using the same lab). This is an increase of 0.04 from 0.10 in approximately 1 month. This is the third increase in about 6 months from 0.03. The doubling time is very quick, and the slope of the line on the PSA chart is getting steeper suggesting an acceleration is rise. Also since my PSA recurrence happened so early after having my prostate was removed. It seems to me to suggest that my PCa is somewhat aggressive, and should also be treated aggressively. There is allot of current research that supports the use of ADT with EBRT, which can improve long term survival. There was a 20 year study, just published in the New England Journal of Medicine, which studied radiation with or without Antiandrogen Therapy in Recurrent Prostate Cancer. The conclusions of the study suggests significant improvement of long term overall survival and lower incidences of metastatic prostate cancer. Also the MSKCC nomograms for 6 year progression free probability after salvage radiation therapy for my specific data is 43% w/o ADT, and 66% with ADT. I certainly would prefer not to need ADT, given all the side effects. However I believe strongly that a combination of ADT & EBRT together is warranted and will help to improve my chances of survival. Maybe a shorter period of ADT for 6 months ( 2 prior, 2 during, and 2 after) would be more appropriate than 24 months suggested in the NEJM study. I would appreciate the opportunity to talk with you by phone if possible.

02/28/17 - Nurse from NROC called me to say they received my email, and That DR Peters would like to meet with me. Scheduled an appointment for 3/2/17.

03/02/17 - I meet again with DR Peters a radiation oncologist at Northeast Radiation Oncology in Scranton, PA. He agreed with my assessment in my email. Treatment has changed to start ADT immediately, (daily Bicalutamide 50 mg pill). Bone scan, and CT scan scheduled for 3/10/17, 3 month Zoladex shot scheduled for 3/17/17, start radiation 4/3/17. RT is 39 treatments with Tomotherapy to whole pelvic bed. Currently I believe ADT will only be for 6 months, then monthly PSA testing.

03/10/17 - Bone scan, and CT scan at Advanced Imaging in Scranton, PA

03/15/17 - Appointment with Dr Smaldone-Did by phone. Confirmed approach with RT and ADT.

03/17/17 - Bone scan and CT scan clear. Got first Zoladex shot 3 month.

04/01/17 - Took last Bicalutamide pill

04/18/17 - Start radiation . RT is 39 treatments with Tomotherapy to whole pelvic bed. Pelvis area 45 gy, and prostate bed 68-70 gy. Currently I believe ADT will only be for 4-6 months.

06/14/17 - Completed radiation therapy. Got ADT Shot 3 Month

07/12/17 - NROC Follow up, Blood work-Testosterone Low-PSA Undetectable ultra sensitive

11/15/17 - NROC Follow up, Blood work-

03/2018 - Blood Work: Testosterone Low-PSA Undetectable ultra sensitive

Charles's e-mail address is: csmithpe AT live.com (replace "AT" with "@")

NOTE: Charles has not updated his story for more than 15 months, so you may not receive any response from him.