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First Hurdle jumped

User
Posted 05 Aug 2020 at 13:31

I have been a lurker since diagnosed in March 2020. Thank you to all the posts and advice on this forum I have prepared myself for this journey.


The purpose of this post is to share my data and my positive news today. I realise that the nonmogram shows my probability of recurrence as high but one battle at a time.


Summary below with more detail in profile.


Age at diagnosis - 54 - with no symptoms at all. Married with 12 year old son.


High PSA picked up in Medical screening (PSA 18) and then a NHS test (PSA 20). Despite being diagnosed in COVID times the NHS has been great with PSA test, MRI (PIRADS 5) and bone scan (clear)  all completed in April/May 2020.


Biopsy showed Gleason 8 (4+4), 12/22 cores positive (all on right side), Cribriform pattern and PNI. Staged as T2/T3a clinically localised high risk cancer (13.5 mm cancer core).


May 2020 another PSA test - 23 so quite an increase in a few months.


Too much reading on the Internet about Cribriform pattern and PSA doubling times puts me in a bad place.


May 2020 - started Hormone Therapy.


June 2020 - Radical Prostatectomy at Royal Berks, Reading. Just a fantastic team there - my first NHS hospital visit and grateful for the service and staff. Surgeon was amazing and I had Retzius-sparing robotic surgery, one set of nerve bundles spared.


August 2020 - surgeon review. Clear margins and pStaging of pT3a n0 mo. First PSA (4 weeks after op which I thought was early) was 0.025. Hope will drop a little lower before the next PSA test (3 months).


I appreciate early days and recurrence probability is high but I wanted to share some positive news. Spending too much time reading on the Internet about Gleason 8/Cribriform pattern mentally affected me. The numbers didn't look good from the biopsy but clear margins and a low-ish PSA after surgery are a good start.


Also given the go-ahead to cancel my next Prostap injection in 3 weeks. The hormone treatment affected me - frequent hot flushes, insomnia and some muscle wastage. I guess that until my PSA rises again I have a hormone treatment holiday. I have quarterly blood checks with Thriva and the Hormone treatment was doing its job as my T-levels dropped from 15.7 (May 2020) down to 0.4 (July 2020).


ED - early days but the Hormone treatment meant I have zero libido. I will be starting with a cheap pump soon to " use it or lose it". Hoping that ED will improve over the next year.


Longer than I wanted but a story from a young-ish Gleason 8 new member of the forum.

User
Posted 05 Aug 2020 at 19:06

Originally Posted by: Online Community Member
First PSA (4 weeks after op which I thought was early) was 0.025. Hope will drop a little lower before the next PSA test (3 months).


 


Since that was the reading with hormone treatment, don't panic if it is slightly higher next time. 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 06 Aug 2020 at 11:06

Ido - thank you. The detail in your profile is helpful to others but you have been through a lot!


Lexi - I am just a few weeks ahead of your husband. Life after getting the catheter out is so much better. 
I hope your husband continues to get stronger after the op. Then the wait to get the result of the surgery and that first PSA test. It goes so quickly. I am a worrier so that waiting time was tense!


Lyn - thank you! Your experience helps us in this battle - forewarned is forearmed.

User
Posted 06 Aug 2020 at 12:39

Hi WD,

Your experience is not dissimilar to my own. Please see my profile and/or personal story. I have even managed to steer clear of any hormones so far, despite an initial PSA of 131!

3 years down the line my PSA seems currently to be stable at 0.1.  I have also managed to steer clear of any adjuvant/salvage RT so far!!

Jim

Reality is merely an illusion, albeit a very persistent one - Albert Einstein
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User
Posted 05 Aug 2020 at 14:17

Here’s hoping your PSA stays low from someone who has had biochemical recurrence.


It’s good that they put you on HT prior to surgery, it will have stopped the cancer in it’s tracks. Best wishes going forward.

Ido4

User
Posted 05 Aug 2020 at 14:43

Best wishes with your recovery. First time I’ve heard of Cribriform, I will look it up.
My husband is day 9 post op today following RALP with extended lymph node dissection for Gleason 8, T2b. His biopsy report came back showing PNI also. Like you, his cancer is right sided and they saved left nerves.

User
Posted 05 Aug 2020 at 19:06

Originally Posted by: Online Community Member
First PSA (4 weeks after op which I thought was early) was 0.025. Hope will drop a little lower before the next PSA test (3 months).


 


Since that was the reading with hormone treatment, don't panic if it is slightly higher next time. 

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 06 Aug 2020 at 11:06

Ido - thank you. The detail in your profile is helpful to others but you have been through a lot!


Lexi - I am just a few weeks ahead of your husband. Life after getting the catheter out is so much better. 
I hope your husband continues to get stronger after the op. Then the wait to get the result of the surgery and that first PSA test. It goes so quickly. I am a worrier so that waiting time was tense!


Lyn - thank you! Your experience helps us in this battle - forewarned is forearmed.

User
Posted 06 Aug 2020 at 12:39

Hi WD,

Your experience is not dissimilar to my own. Please see my profile and/or personal story. I have even managed to steer clear of any hormones so far, despite an initial PSA of 131!

3 years down the line my PSA seems currently to be stable at 0.1.  I have also managed to steer clear of any adjuvant/salvage RT so far!!

Jim

Reality is merely an illusion, albeit a very persistent one - Albert Einstein
 
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