Salvage radiotherapy after radical prostatectomy

Hi Ido4 

i been following your story with interest, I was also diagnosed with a Ductal component after surgery. Really good to see how well you are doing, you must be very happy. I am at the crossroads if I should retire at 60 or not.

How are you today and has your Testosterone come back to normal?

Cheers

Munster

Hi Munster, I’ve just read your profile. You’ve been through the mill too.

My latest PSA on 8th June was <0.1, my health board don’t do high sensitivity PSA tests. I’m very happy with the result. I’ve been having pain in my left buttock, leg, knee and foot for a few months now. Because of my history I was sent fr an MRI to check for trapped nerves or spinal cord issues. That scan showed all was well ok apart from some deterioration in my lower spine and a bit of stenosis. I’m hoping all is fine but get a bone scan on Thursday 6th July to make sure nothing serious is going on. My worry is intraductal prostate cancer doesn’t express much PSA. 
Otherwise I keep fit walking, golfing and looking after my 16 month old grandson once a week. I have slight incontinence issues and some bowel issues due to the salvage radiotherapy. I have no idea what level my testosterone is at, my local GP refuses to test it! Hope you stay well.

Hi Ido4 

Good to hear you PSA is under control and you are doing well. I also have slight dibbles and the runs more frequently. I guess that is to be expected considering the procedures we have had thus far. 

My oncologist was not at all concerned about any of my symptoms. He said all he was concerned about was the Gleeson score. Like you I am concerned that Ductal or Intraductal cancer behave differently in terms of the PSA and something is missed. Just moved from check every 3 months to every 6 months. 

Apart from Intraductal Invasion, Did you also have:

Lymphovacular invasion?

Extrosprostatic Extention?

Ductal Component- mine was 30%

All of the best next week.

Cheers

Munster

Hi Munster, I had extraprostatic extension and intraductal cancer. There wasn’t any mention of ductal involvement that I can remember. When the cancer recurred there was cancer in the prostate bed and a seminal vesicle remnant left after surgery so I’m guessing I was T3b rather than T3a. Because my PSA rose very quickly to 0.7 and the doubling time was 1.2 months my oncologist wasn’t keen to do the salvage radiotherapy. The reason being he couldn’t explain a PSA of 0.7/0.8 from the scans alone and he thought I had micro metastasis throughout my body which would explain the PSA figures. When I compared my recurrence stats in the European Urology site I found I had only a 15% chance of surviving 10 years. I’m hoping I’m in that 15%! All the best.

Thanks Ido4  looks like you had rough ride. Great to see you are doing so well. Not sure what LVI and Mixed DAC will mean for me. Only time will tell. 

Cheers

Munstee

Do you have the link to the calculator you used to determine your survival rate. I tried looking but did not find anything that would all the factors into consideration.

Thanks

Munster

Hi Munster,

my urology team were of the opinion that intraductal involvement was a predictor of worse prognosis but that it was very difficult to say by how much and when, the European Urology Association site now requires you to purchase access so I can’t check it out anymore. I’ll have a look to see if I can find more up to date articles.