One year post RP and zero PSA

Well, the subject line says it all. I had a prostatechtomy in June, 2006 and
just got the results of my last PSA test done in late July- zero, zip, nada.

I still have to have what I expect is a final consultation with my uro, but
it is my understanding that I can now consider myself cured of PCa.

So, how is life now about 18 mo after being diagnosed with PCa and 14 months
after surgery. Pretty good, not as good as before surgery, but pretty good
nonetheless.

I am healthy and totally dry and have been for 12 mo. But I can only get a
usable erection with bimix injection. This works pretty good, but sex isn't
what it used to be. I would say that my sexual satisfaction is at best half
of what it was before surgery.

But I am rid of the PCa and that is great!!!

So, this is my last post to this group unless things turn to s****. But I
will keep monitoring the group (it is useful to know what can happen and how
to deal with it) and of course my PSA.

David Marchand

David&Joan wrote:
> Well, the subject line says it all. I had a prostatechtomy in June, 2006 and
> just got the results of my last PSA test done in late July- zero, zip, nada.
>
> I still have to have what I expect is a final consultation with my uro, but
> it is my understanding that I can now consider myself cured of PCa.
>
> So, how is life now about 18 mo after being diagnosed with PCa and 14 months
> after surgery. Pretty good, not as good as before surgery, but pretty good
> nonetheless.

> But I am rid of the PCa and that is great!!!
>
> So, this is my last post to this group unless things turn to s****. But I
> will keep monitoring the group (it is useful to know what can happen and how
> to deal with it) and of course my PSA.
>
> David Marchand
>

I don't understand what your uro is telling you at all. I had an RRP in
Oct '04. My uro onc says I'll be debatably cured if and when my PSA is
still essentially zero in the year 2014, more definitely cured with zero
in 2019. For the foreseeable future -- certainly several years -- he is
measuring my PSA every three months. And, no, he gets not one cent for
my PSA tests. I've never heard of anyone being considered cured in five
years, let alone one.

I.P.

On Aug 24, 6:30 pm, "I.P. Freely" <fuhgheddabou...@noway.nohow> wrote:
> David&Joan wrote:
> > Well, the subject line says it all. I had a prostatechtomy in June, 2006 and
> > just got the results of my last PSA test done in late July- zero, zip, nada.
>
> > I still have to have what I expect is a final consultation with my uro, but
> > it is my understanding that I can now consider myself cured of PCa.
>
> > So, how is life now about 18 mo after being diagnosed with PCa and 14 months
> > after surgery. Pretty good, not as good as before surgery, but pretty good
> > nonetheless.
> > But I am rid of the PCa and that is great!!!
>
> > So, this is my last post to this group unless things turn to s****. But I
> > will keep monitoring the group (it is useful to know what can happen and how
> > to deal with it) and of course my PSA.
>
> > David Marchand
>
> I don't understand what your uro is telling you at all. I had an RRP in
> Oct '04. My uro onc says I'll be debatably cured if and when my PSA is
> still essentially zero in the year 2014, more definitely cured with zero
> in 2019. For the foreseeable future -- certainly several years -- he is
> measuring my PSA every three months. And, no, he gets not one cent for
> my PSA tests. I've never heard of anyone being considered cured in five
> years, let alone one.
>
> I.P.- Hide quoted text -
>
> - Show quoted text -

It sounds like David is going to continue to monitor his PSA. In the
current literature, most doctors won't approach the word "cure" unless
there have been 15 consecutive years of undetectable PSA levels post
surgery.

In this world of PCa, we either "have it or we don't." So you can't
worry about it every day or you'll go crazy. Every time we do see an
undetectable reading after a test, it is cause for a celebration. If
we do find that cancer has returned, then we make a game plan and move
forward. I know it is not that simple, but I'm trying to "box it" a
little :-)

All the best to you guys,

Idaho
--------
Age: 54
PSA: 4.3
Biopsy: T1c, 3+3=6, 2 pos. samples in one side
Da Vinci 31 Jul 2007: saved nerve bundle on non-cancerous side
Final pathology: Confined to prostate, T2a, 3+3=6
Please visit my web site: http://pca-info.blogspot.com

I rejoice with you that after one year your PSA is undetectable. Mine
has been the same for 2 years now, and I hope it will be after a third.

Rather than consider myself cured, I prefer to look at the numbers.
After every test my surgeon told me the percentage chance of a
recurrence. After 2 years undetectable PSA the percentage he says is now
2%. That's close to 'cured' but not 100%. Good enough for me, but still
worth being watchful and continuing the tests.

Invicta

Idaho Guy wrote:
> On Aug 24, 6:30 pm, "I.P. Freely" <fuhgheddabou...@noway.nohow> wrote:
>> David&Joan wrote:
>>> Well, the subject line says it all. I had a prostatechtomy in June, 2006 and
>>> just got the results of my last PSA test done in late July- zero, zip, nada.
>>> I still have to have what I expect is a final consultation with my uro, but
>>> it is my understanding that I can now consider myself cured of PCa.
>>> So, how is life now about 18 mo after being diagnosed with PCa and 14 months
>>> after surgery. Pretty good, not as good as before surgery, but pretty good
>>> nonetheless.
>>> But I am rid of the PCa and that is great!!!
>>> So, this is my last post to this group unless things turn to s****. But I
>>> will keep monitoring the group (it is useful to know what can happen and how
>>> to deal with it) and of course my PSA.
>>> David Marchand
>> I don't understand what your uro is telling you at all. I had an RRP in
>> Oct '04. My uro onc says I'll be debatably cured if and when my PSA is
>> still essentially zero in the year 2014, more definitely cured with zero
>> in 2019. For the foreseeable future -- certainly several years -- he is
>> measuring my PSA every three months. And, no, he gets not one cent for
>> my PSA tests. I've never heard of anyone being considered cured in five
>> years, let alone one.
>>
>> I.P.- Hide quoted text -
>>
>> - Show quoted text -
>
> It sounds like David is going to continue to monitor his PSA. In the
> current literature, most doctors won't approach the word "cure" unless
> there have been 15 consecutive years of undetectable PSA levels post
> surgery.
>
> In this world of PCa, we either "have it or we don't." So you can't
> worry about it every day or you'll go crazy. Every time we do see an
> undetectable reading after a test, it is cause for a celebration. If
> we do find that cancer has returned, then we make a game plan and move
> forward. I know it is not that simple, but I'm trying to "box it" a
> little :-)
>
> All the best to you guys,
>
> Idaho
> --------
> Age: 54
> PSA: 4.3
> Biopsy: T1c, 3+3=6, 2 pos. samples in one side
> Da Vinci 31 Jul 2007: saved nerve bundle on non-cancerous side
> Final pathology: Confined to prostate, T2a, 3+3=6
> Please visit my web site: http://pca-info.blogspot.com
>
>
>

Invicta...Congratulations on your undectable PSA, I wish you many,
many more.

It intrigues me that your doctor says that, at 2 years post-treatment,
your remaining chance of biochemical failure is 2%, or thereabouts.
Do you have any idea how he arrives at this estimate?

Swanson has studied the biochemical failure rate over extended periods
of time (>20 years) for both RT and RP. He has found that the
cumulative recurrence rate increases in a roughly linear fashion over
time. In other words, if we had an initial cohort of 1,000 men with
similar GS, PSA and TNM staging, and they were treated similarly and
then followed over time, and the ultimate number of men who recurred
was say 100 at 20 years post-op, then we would expect roughly 5 men to
fail each year. Biochemical recurrence rates are not strikingly
different for low-risk men treated either surgically or with RT.
Using the Hopkin's nomogram (M. Han, A. W. Partin, M. Zahurak, S.
Piantadosi, J. Epstein and P. C. Walsh; J. Urol., 169, 517-523, 2003;
the paper can be found at http://www.prostate-help.org/download/jhnomo.pdf),
we see that for T1c, PSA=4-10, GS=6 men, they have a 5% failure rate
at 10 years. Extending this trend linearly would suggest a cumulative
failure rate around 10% at 20 years.

So an individual's estimated chance for biochemical recurrence depends
upon initial staging and life expectancy. On average, a man with
GS=5, PSA<4 and T1c staging would have a 2% chance of failure at 20
years. Slighly after treatment it could be said that he had a 2%
chance of failing if he expected to live another 20 years. Most other
groups, like the GS=6 example above, would have higher expected
failure rates at 20 years. Again, I am intrigued by your doctor's
statement and would like to know how he arrived at it. Were you in a
low risk group and / or are you older with a shorter remaining life
expectancy?..Best wishes and good health, ron

David&Joan wrote:

> Well, the subject line says it all. I had a prostatechtomy in June, 2006
> and just got the results of my last PSA test done in late July- zero, zip,
> nada.

Congratulations! I hope you have many more undetectable PSAs in your
future.

> I still have to have what I expect is a final consultation with my uro,
> but it is my understanding that I can now consider myself cured of PCa.

My understanding is that guys like you and me -- post-RP -- should continue
to monitor PSA levels for several years following the surgery. We've both
read many accounts on this NG of men who were undetectable for two or more
years before their PSA started to rise again.

After my September PSA check, which I hope to be another "<0.01," I expect
to go to having it checked every 6 months for the next couple of years, and
then back to once a year. But we're still watching. My docs and I do not
know if I'm cured or not.

I hope it's all gone. I think it's all gone. But I do not know it's all
gone. And that's probably where your head should be, too. Sorry to be a
wet blanket; after all, another undetectable *is* good news. But please
keep checking. If it's still there, the sooner you know, the better your
prognosis. And don't be surprised if your uro wants to see you again in
six months.

As far as the ED: you might still be healing, so continued visits to a doc
with some ED expertise might be worth your while. Again, we've both read
stories on this NG from men who've regained full sexual function but only
after more than a year without erections.

All the best,

charlie

--
6/2006 PSA 5.2, DRE suspicious
7/2006 Biopsy: *2 of 10 positive, Gleason 7(3+4)
11/2006 LRP: *Clear margins
PSA < 0.01 on 1/2007, 3/2007, 6/2007
so far, so good ...

"David&Joan" <djmarchand@cox.net> wrote in message
news:rmKzi.87976$TW6.72799@newsfe06.phx...

> Well, the subject line says it all. I had a prostatechtomy in June, 2006
> and just got the results of my last PSA test done in late July- zero, zip,
> nada.


Dave,

I implore you to continue to feed us your PSA data. We need the good with
the bad.



--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04 (06/12/2007)
Non Illegitimi Carborundum

"invicta" <nomail@hotmail.com> wrote in message
news:46cfff9f$0$21104$da0feed9@news.zen.co.uk...
>I rejoice with you that after one year your PSA is undetectable. Mine has
>been the same for 2 years now, and I hope it will be after a third.
>
> Rather than consider myself cured, I prefer to look at the numbers. After
> every test my surgeon told me the percentage chance of a recurrence. After
> 2 years undetectable PSA the percentage he says is now 2%. That's close to
> 'cured' but not 100%. Good enough for me, but still worth being watchful
> and continuing the tests.

Hi, Invicta.

Is this your first foray into our little group or are you merely using a
different handle?

If the former, please let us know your history and stats.





--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04 (06/12/2007)
Non Illegitimi Carborundum

On August 24, David wrote:

> Well, the subject line says it all. I had a prostatechtomy in June, 2006 and
> just got the results of my last PSA test done in late July- zero, zip, nada.
>
> I still have to have what I expect is a final consultation with my uro, but
> it is my understanding that I can now consider myself cured of PCa.

(snip)

/Activate wet-blanket mode/

No.

Roughly 30% of prostatectomies result in biological failure within five
years.

Keep checking. It will never be over.

Regards,

Steve J

"Steve Jordan" <mycroftscj1@cox.net> wrote in message
news:IW1Ai.53346$Mu5.19409@newsfe15.phx...
> On August 24, David wrote:
>
>> Well, the subject line says it all. I had a prostatechtomy in June, 2006 and just got
>> the results of my last PSA test done in late July- zero, zip, nada.
>>
>> I still have to have what I expect is a final consultation with my uro, but it is my
>> understanding that I can now consider myself cured of PCa.
>
> (snip)
>
> /Activate wet-blanket mode/
>
> No.
>
> Roughly 30% of prostatectomies result in biological failure within five years.
>
> Keep checking. It will never be over.

/Activate blanket-dryer mode/

Yes, but a significant number of those fail in the first year.
Since you made it past that, you're now looking at something
less than 30%, maybe 25% or even 20%.

And each year that you hold your low PSA, your odds keep
getting better.

Also, be aware that the 30% includes cases with Gleason 8-10,
with positive margins, and with other signs of poor prognosis.
Your odds were probably much better than 30% to begin with
and now, a year later, have improved still further.

The blanket is always a little damp, but hopefully you can sleep
under it without too much tossing and turning.

Best of luck.

Alan

As Alan indicates, the percentage failure rate should be quoted based on
an individual's particular case.

The 2% chance of failure after more than 2 years undetectable PSA was
quoted to me by my surgeon as a measure of the actual potential failure
using the statistics based on my Gleason, negative margins, age, more
than 2 years undetectable PSA, and other factors personal to my case.

The wet blanket approach is of course important. No one should be lulled
into a false sense of security. On the other hand, quoting a 30% chance
of failure can be misleading for the reasons Alan rightly suggests.
There are graphs published which give the likely chance of failure, and
that was presumably the source for the 2% I was quoted.

2% is not zero. But I rejoice in the success of the operation and the
very low chance of it all now going wrong.

Invicta.

Alan Meyer wrote:
> "Steve Jordan" <mycroftscj1@cox.net> wrote in message
> news:IW1Ai.53346$Mu5.19409@newsfe15.phx...
>> On August 24, David wrote:
>>
>>> Well, the subject line says it all. I had a prostatechtomy in June, 2006 and just got
>>> the results of my last PSA test done in late July- zero, zip, nada.
>>>
>>> I still have to have what I expect is a final consultation with my uro, but it is my
>>> understanding that I can now consider myself cured of PCa.
>> (snip)
>>
>> /Activate wet-blanket mode/
>>
>> No.
>>
>> Roughly 30% of prostatectomies result in biological failure within five years.
>>
>> Keep checking. It will never be over.
>
> /Activate blanket-dryer mode/
>
> Yes, but a significant number of those fail in the first year.
> Since you made it past that, you're now looking at something
> less than 30%, maybe 25% or even 20%.
>
> And each year that you hold your low PSA, your odds keep
> getting better.
>
> Also, be aware that the 30% includes cases with Gleason 8-10,
> with positive margins, and with other signs of poor prognosis.
> Your odds were probably much better than 30% to begin with
> and now, a year later, have improved still further.
>
> The blanket is always a little damp, but hopefully you can sleep
> under it without too much tossing and turning.
>
> Best of luck.
>
> Alan
>
>

Baesed on my Gleason, containment, neg margins, etc. my surgeon quoted
my chances of biological failure of 7%. So it does vary from indivdual
to individual...

That was almost 4 years ago, and still PSA is zero!!

In article <46d30a64$0$21085$da0feed9@news.zen.co.uk>, invicta
<nomail@hotmail.com> wrote:

> As Alan indicates, the percentage failure rate should be quoted based on
> an individual's particular case.
>
> The 2% chance of failure after more than 2 years undetectable PSA was
> quoted to me by my surgeon as a measure of the actual potential failure
> using the statistics based on my Gleason, negative margins, age, more
> than 2 years undetectable PSA, and other factors personal to my case.
>
> The wet blanket approach is of course important. No one should be lulled
> into a false sense of security. On the other hand, quoting a 30% chance
> of failure can be misleading for the reasons Alan rightly suggests.
> There are graphs published which give the likely chance of failure, and
> that was presumably the source for the 2% I was quoted.
>
> 2% is not zero. But I rejoice in the success of the operation and the
> very low chance of it all now going wrong.
>
> Invicta.
>
> Alan Meyer wrote:
> > "Steve Jordan" <mycroftscj1@cox.net> wrote in message
> > news:IW1Ai.53346$Mu5.19409@newsfe15.phx...
> >> On August 24, David wrote:
> >>
> >>> Well, the subject line says it all. I had a prostatechtomy in June, 2006
> >>> and just got
> >>> the results of my last PSA test done in late July- zero, zip, nada.
> >>>
> >>> I still have to have what I expect is a final consultation with my uro,
> >>> but it is my
> >>> understanding that I can now consider myself cured of PCa.
> >> (snip)
> >>
> >> /Activate wet-blanket mode/
> >>
> >> No.
> >>
> >> Roughly 30% of prostatectomies result in biological failure within five
> >> years.
> >>
> >> Keep checking. It will never be over.
> >
> > /Activate blanket-dryer mode/
> >
> > Yes, but a significant number of those fail in the first year.
> > Since you made it past that, you're now looking at something
> > less than 30%, maybe 25% or even 20%.
> >
> > And each year that you hold your low PSA, your odds keep
> > getting better.
> >
> > Also, be aware that the 30% includes cases with Gleason 8-10,
> > with positive margins, and with other signs of poor prognosis.
> > Your odds were probably much better than 30% to begin with
> > and now, a year later, have improved still further.
> >
> > The blanket is always a little damp, but hopefully you can sleep
> > under it without too much tossing and turning.
> >
> > Best of luck.
> >
> > Alan
> >
> >