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Had my 4-month PSA test today
Today was a very good day - my 4-month PSA test came back at 0.473 ng/mL. So, now we move from 4-month tests to 6-month tests..
History —> After my PSA reached 4.2 in 2012 (at 56y), a “blind” biopsy showed low-grade, localized prostate cancer: Gleason 6(3+3); an independent second opinion confirmed this. I chose active surveillance (AS)..
During the time I was on AS, we not only tracked PSA (every 4-6-months) and biopsy (about every 2-1/4 years), we also regularly monitored other numbers (% Free PSA, PSA Doubling Time, and PSA Density), as well as obtained biomarker (genomic) test results..
After about 9 years on AS, my Gleason reached 7(3+4), PSA reached 7.976, and a Prolaris biomarker test indicated that I had “exceeded the threshold for active surveillance.” The Gleason 7 and the Prolaris test results were my cues to leave AS and seek active treatment..
Those 9 years on AS bought me time to get referrals, evaluate all available treatment modalities, and take advantage of medical and technological advances. I ultimately chose 28 sessions of proton radiation + SpaceOAR Vue. Prior to starting treatment (April-May 2021 at 65y), a 2nd opinion increased the Gleason to 7(4+3), so we simply added 6 months (two 3-month injections) of Eligard..
Now 4+ years post-treatment, my PSA hovers between 0.35-0.55. My most recent PSA test (today) was 0.473..
Today, it’s as if nothing ever happened - just walked in a door, got treated (28x), and walked out the door…..it’s practically back to the way it was before my prostate cancer journey started. That’s the way medical treatments should be..
Yes, today was a very good day.
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So happy to hear your good news.
CONGRATS !!! : )))) Those are wonderful news !
May your PSA stay that low (or lower) forever 🙂 It is always great to hear about successful treatments and good results .
I wish my husband had your doctor following his AS, and thanks for sharing exact AS protocol so other patients can see it and know how it is done correctly.
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2 ReactionsWhen I was initially diagnosed with PC, my wife and I had in-depth discussions about me going on AS.
She expressed that she wanted me to have surgery (saying she couldn’t bear the thought of cancer being in my body); my urologist recommended surgery (but, offered no sound explanation as to why).
But, having been getting annual PSA tests for 12 years, I showed her the little data I had collected
indicating that with my numbers, active surveillance was the appropriate decision for me.
With that decision made, much of my time has been spent maintaining normalcy for my wife and myself, and insulating her from the continuous grind - physical and mental - of test-after-test-after-test. (But, with the good PSA news that I had today, I couldn’t help but to text her and share the news with her!)
It has all worked out just fine and as planned. My wife now understands about active surveillance and is glad that I took that route.
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Hug
4 ReactionsCongratulations. Always a relief after receiving good PSA test results. Here's to many more
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1 ReactionThat's amazing news! 🙂 So happy for you! 🙂
Great news.
I'm curious. What was your experience with SpaceOAR? Do you think it heled and was there any SE's from the procedure? I'm preparing to a 20 session (fraction) EBRT and my radiologist doesn't want me to use it. I'd have to travel 180 miles north to get it if I choose. The SpaceOAR procedure isn't offered here even though "here' is deemed to be a center of excellence.
A lengthy explanation —> My experience with SpaceOAR (when I was treated during April-May 2021) was positive.
If I were getting external radiation treatments today, I would insist on using a rectal spacer (SpaceOAR, Barrigel, or BioProtect). There would have to be an extraordinarily clear and demonstrated reason not to use it - the rectum does not tolerate radiation well at all.
SpaceOAR Hydrogel was FDA-Approved in 2015. Studies show that SpaceOAR not only reduces rectal radiation dose, but also protects from late GI and GU toxicities, and provides urinary, bowel, and sexual quality-of-life improvement: https://pubmed.ncbi.nlm.nih.gov/34029607/
That 1.3cm-1.5cm additional rectal space (1.5cm-1.7cm for BioProtect) provides “insurance” against rectal injury. If it were me, unless they could assure - not “guarantee” because there are no guarantees - but, simply assure that they would not hit the rectum with radiation, I would insist.
Dr. Rossi talks about it at 4:49:40 during his presentation (https://www.youtube.com/live/WTqPnSRYtW4?feature=share) at the 2023 mid-year PCRI conference.
My urologist had never used it before - he had always used endorectal balloons. I respectfully told him that didn’t want that. So, I personally reached out to Boston Scientific to find out more about SpaceOAR Hydrogel.
At the time, Boston Scientific was offering one free consultation for patients to call in to discuss SpaceOAR. After that call, I gave them my doctor’s contact information. It took a couple of weeks for the product to come in, but that was ok since we still had to find a urologist to inject it (since my doctor had never done it). We found another urologist in the urology department who had injected it, so we brought him on board,
In the meantime, I read that Boston Scientific had a newer SpaceOAR product called SpaceOAR Vue (FDA-approved in 2019), containing approximately 1% iodine bound to the hydrogel to be more visible under CT scan.
So, after waiting a couple of more weeks for the SpaceOAR Vue product to come in, I had the gel injected. I had no adverse side-effects from the SpaceOAR injection. Yes, there was some bleeding and pain at the injection site (which is to be expected). I’d recommend that you ask them to be generous with the lidocaine (or whatever it is called that they use to numb the areas), both where they penetrate the skin and all the way ahead of where they’re injecting the hydrogel.
If not SpaceOAR, maybe they have access to Barrigel or BioProtect?
> SpaceOAR: https://www.spaceoar.com/find-a-doctor/
> Barrigel: https://barrigel.com/barrigel-physician-locator
> BioProtect: https://bioprotect.com/patient-microsite/#bioprotect-map
Good luck!
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2 ReactionsVery helpful. Thank you.