PSA rise story: In the Fall of 2009 my PSA was 0.9. At about the same time, I started testosterone therapy due to low testosterone. In March 2010, my PSA was 1.3. Then in December 2010, my PSA jumped to 2.3. I immediately stopped the testosterone therapy in December.
I was referred to a urologist and had a biopsy in January 2011. In February (2011) the biopsy results indicated cancer in the right side at four sites (4 out of 12). Three were scored Gleason 6 and the fourth Gleason 7 (3+4). The slides were then sent to a noted facility in Baltimore where the scores now were 3+4 for three and 3+3 for the other. Gleason 7 meant I had a 'intermediate risk' prostate cancer 'score'. I then had a bone scan (negative) and a transrectal coil MRI plus follow-up PSA and testosterone levels. The bone scan was negative and the MRI showed no detectable tumor outside of the organ. My PSA (from late February) was 1.7 and my testosterone levels were in the low 200.
After much consultation, I have decided on the following treatments: Hormonal (i.e Lupron) injections for six months, 25 IMRT sessions (5X5) starting after 6-8 weeks of Lupron, then "seeds" - Brachytherapy. My decision was driven by the Gleason 7 score plus the Hopkins Partin table that indicated that there was a chance (10-15%) that cancer might not be confined to prostate.
I finished up 25 treatments of IMRT on early June.
Some fatigue toward end plus frequent urination for about a two weeks.
I started 6 months of Lupron in March (2011)and finished up in August. Had hot flashes plus need to urinate several times at night.
On August 18, 2011 I had 'seeds' implanted by the radiation oncologist from University of Maryland Medical school. No major problems after a the first few days of procedure; no major pain, no need for catheter, some need to urinate more frequently.
Now in the fourth month after the last treatment (seeds), I am pretty much back to normal. My hot flashes are finally pretty much gone; I was surprised that it took almost four months after last injection to get a reprieve from the hot flashes.
I had a PSA test a few weeks ago (3 months after last treatment) but do not have results. I really don't want to know PSA values until the 6 month interval.
That's it for now.
I had my first post-treatment PSA test done (3 months after 'seeds' and last Lupron injection. The test was done on November 18, 2011 and the the results came back at 0.40. The most noticeable side effects primarily from the Lupron (hot flashes) were over by December, 2011 (about 4 months after last Lupron injection.
However, I have new results from my primary care doctor (January 2012) indicating that I have anemia. My next PSA test and oncology appointment is in February (2012). Prior to this, I am being referred to a gastroenterologist for a colonscopy/endoscopy to rule out possible internal bleeding. Here are some of my CBC numbers: Lymph% 14;EOS% 7.5; RBC 13.2; HGB 13.2; HCT 36.8. I will talk to my radiation oncologist also about these numbers.
I will report back once I get the new PSA number and the find out more about the anemia.
The last time I reported I indicated that I had finished up with Brachytherapy after having 25 external beam radiation treatments (IMRT) and 6 months of ADT. My first post treatment PSA was 0.5 (3 months out); my second PSA (6 months out) was 0.7 and now at 9 months it is 0.6. I am now been swtiched to a 6 month PSA check. I mentioned last time my primary care doctor indicated my blood results were showing a bit of anemia. He indicated I should have a colonoscopy to check this out. I was a due for 5 yr colonoscopy so I scheduled it. It came back with one small polyp but nothing else. I also had an endoscopic exam and that was normal. My oncologist indicated that she was not concern with my blood numbers showing some anemia and that could be expected frpm my course of radiation (from EB and seeds). I have had no side effects these last few months. It has been one year from my seeds implant.
Updaing my last two PSA numbers: 12 months post treatment (EBRT + Lupron + brachytherapy): 0.6
18 months post treatment: 0.3
Rectal Bleeding: I had IMRT plus ADT plus brachytherapy done during the year 2011 for a Gleason 7 (3+4) as noted previously. I currently have been showing some rectal bleeding (about 2 years after the IMRT). I had a colonoscopy done during May 2012 ( my 5 year check up). One very small polyps only plus an internal hemorrhoid. I noticed recently (5/2012) some rectal bleeding, much more than on occasion from the hemorrhoid. It lasted a day or so but then stopped. In a talk with my radiation oncologist, I followed up with my GI doctor this morning. By the way, my 2012 colonoscopy confirmed the presence of petechiae suggestive of post radiation changes. Right now I have been recommended to use a stool softener and monitor the recurrence of bleeding. I will need to come back if this happens twice or so a month for further evaluations and possible treatments. I am also to get my hemoglobin count done every three to four months to make sure I am not bleeding.
My current PSA is 0.2 (24 months after last treatment). This down from 0.3 six months ago. My last report mentioned two episodes of rectal bleeding due to IMRT. After consultations with GI doctor I went on a stool softener and that fixed the problem. No bleeding in past 5 months.
I had two PSA tests in 2014 (March 0.2) and September (0.1). During the spring of 2013, I had a brief episode of rectal bleeding. On consultation with my GI doctor, it was determined to be radiation treatment related. There were three of four brief rectal bleeding events during early 2013, but then bleeding stopped. During June, 2014, my rectal bleeding began agin. But this time I would have more frequent episodes. Not large amounts of blood but more frequent...every few days. I made an appointment with my GI doctor who suggested fulgaration to treat the bleeding. He was already familiar with the radiation affected area on my rectal wall having doing a routine colonoscopy about a year after my last radiation session. Fulgaration (cauterizing) did the trick. I have no further episodes of bleeding.
My next PSA is in September. I am now showing a PSA number of less than 0.1 since 4 years from my last treatment. To reiterate; I had 3 months of ADT (Lupron), then start of EBRT for 25 sessions (plus 3 more months of Lupron) followed by Bachytheraphy.
All is fine. PSA running at 0.1. It has been 5 years since last treatment. I am now on the yearly PSA check (rather than the six month check). No side effects.
Terry's e-mail address is: gerry AT pobox.com (replace "AT" with "@")