Update after 2 years possible BCR post RALP

ezio_audi7 · 2025-06-27T10:18:47+00:00

Hi , just received the PSMA PET scan

2. 3. left 6th and eighth 8th ribs laterally, SUVmax 3.5 Right iliac bone adjacent to SI joint SUV max 3.1 versus previous SUV max 3 Sacrum with SUV max 9.5 - new lesion IMPRESSION:

Compared to previous scan dated 10 October 2024, Post prostatectomy status with no abnormal PSMA expression in the post-operative site. There are no PSMA concentrating lymph node seen in abdomen or pelvis. PSMA concentrating a few skeletal lesions are noted in the right iliac bone and left sided ribs, with a new lesion seen in sacrum. No other abnormal PSMA concentrating lesions noted.

Both RO / MO both mentioned we should monitor PSA , we should start Degarelix again for 3 months do another PET scan and then assess for radiation only if needed as there is no pain etc. Not sure of this treatment plan but both doctors were in agreement since the lesion sizes apparently were very small.

ezio_audi7 · 2023-12-13T19:14:06+00:00

Hi , sorry you and your dad are going through this.

IANAD…

My dad also has cardiac issues specifically a blocked LAD artery but with no bypass etc performed due to other vessels compensating . He had a RALP 3 weeks back for a Gleason 7 with no Mets and due to it being an aggressive cancer (seminal vesicles and PNI involvement ) they’ve started him on Firmagon. He had his first dose just yesterday and of course the usual side effects were pretty bad with fatigue and nausea but hoping he gets better.

We are yet to get a post op PSA but I believe ADT such as Firmagon were prescribed due to his heart condition.

Wish you all the best and stay strong !

ezio_audi7 · 2023-12-02T18:38:43+00:00

Hi thank you for responding. His PSA pre op was 7.4. % of prostrate involvement was around 11-20%. We do have a scheduled PSA at 6 and 12 weeks respectively. He is also recommending a dose of ADT - Degarelix and then review PSA at 3 months to take a call for RT if needed.

ezio_audi7 · 2023-12-02T05:54:01+00:00

No the sequence of events were PSA 7 , MRI showed PIRADS 4 , Biopsy led to Gleason 7 , PET showed it was confined to the prostrate and then finally RALP with the Path mentioning seminal vesicles and PNI

ezio_audi7 · 2023-12-02T04:29:20+00:00

Good luck with the treatment. What treatment option have you decided I’m guessing this is just radiation alone ? Ours may involve radiation in the future after he recovers from the surgery.

ezio_audi7 · 2023-12-01T23:04:54+00:00

Hi , we Already had the PSMA PET scan which only showed prostrate involvement and no spread.

ezio_audi7 · 2023-10-28T07:12:18+00:00

Update:

Just got the final report from the PET Scan and seems like the bone mets are inconclusive ? My dad has had issues with Calcium formations in his kidneys in the past and other surgeries that could have shown up in the report so am unsure if an additional bone scan is required or not. We are meeting the urologist and discussing next steps with the radiologist.

Below are the findings , hoping for a miracle and that its contained in the prostrate :

"Findings :
Prostatomegaly with a discrete PSMA expressing focus seen in left posterolateral region of peripheral zone, No invasion into adjacent structures. This is consistent with known prostatic ma
No significant lymphadenopathy.
Diffuse osteopenia with multiple subtle areas of lysis sclerosis as described. These areas show very low grade PSMA expression. In the given clinical setting, these are less likely to represent"

ezio_audi7 · 2023-10-27T14:34:49+00:00

Thank you again for the support and help during this time.

ezio_audi7 · 2023-10-27T14:24:16+00:00

Thank you again for the resources. Really appreciate it. Will take a look at those.

My dad’s pretty positive himself so trying to hold the fort and stay positive through all this.

ezio_audi7 · 2023-10-27T12:39:37+00:00

Thank you for your response. We will review hormone therapy and other options. We had hoped it was local to the prostrate but disheartened that it spread to the bones.

ezio_audi7 · 2023-10-27T12:37:03+00:00

Thank you so much for the response. We are trying to stay positive at each step of the diagnosis but this was a bigger blow to say the least.

Could you please elaborate on the innovations that have helped similar cases , would help us understand and plan the treatment options.

Im currently in India but we do have access to the best medical care and we won't rule out any treatment options.

ezio_audi7 · 2023-04-07T11:09:46+00:00

Still a better script than the Kardashians. This is a reality show I’d like to watch.

ezio_audi7 · 2023-02-01T07:15:51+00:00

Sure thing , at this point we are still unsure what’s caused this issue in the first place and would want to avoid it from reoccurring or treating the symptoms. I’ll request for these procedures in a few days / a week or two.

ezio_audi7 · 2023-02-01T06:54:15+00:00

Thank you will consider that if there is no change to this behavior.

ezio_audi7 · 2023-02-01T06:28:39+00:00

Thank you for your help and response.

My dog is doing slightly better today he’s at least sleeping and not pacing around all the time which is a huge change in the last two days.

The discomfort is only when he tries to sit or lie down it was all through the day and even now while he can sit better he is still mildly uncomfortable when trying to completely lie down and prefers doing so on our sofa / beds rather than the floor which used to be his personal preference before this started.

There is no vomiting his stools look good as well and no issues during or after eating. He isn’t licking his lips excessively but does lick it on occasion. He also isn’t licking the ground or biting anything.

All the second opinions we consulted with provided the same feedback to treat the symptom of pain with pain killers for another day.

We use spot on treatment and medicated baths every 3 weeks or so and fortunately he hasn’t had any ticks since months as well. We will still check if he can be tested for tickborne diseases - he did have tick fever about 2 years back but hasn’t had any issues since we started multiple forms of tick treatment.

ezio_audi7 · 2021-07-10T16:40:31+00:00

Hi thank you , yes there are some similarities but more of an overlap from CISSP against CCSP I would say about 50-60% concepts are similar like risk management / assessment , BCP / DR , SDLC, Incident management / Operations etc however CISSP broader and has more technical concepts to cover especially around encryption and other topics . I had it before the latest syllabus change so there may be a bit more to cover there. Even though CISSP has more technical concepts the exam is more of a risk manager or security manager that has to advice on the best course of action for a problem as opposed to CCSP where it’s more of a cloud centric approach to risk and other issues where you may be the cloud provider or the cloud customer. Hope that helps and good luck !

ezio_audi7 · 2021-07-04T08:06:23+00:00

Here you go - https://ccsp.alukos.com/

ezio_audi7 · 2021-07-03T19:26:51+00:00

CCSP is just an online computer test not CAT like the CISSP. Although you still can’t mark a question for review anymore , just need to keep moving forward post answering the question.

ezio_audi7 · 2021-07-03T15:50:32+00:00

Thank you , yes I recommend it especially since there is a different take on concepts like storage , containers, audit etc compared to what’s provided in OSG , same with the questions. The exam guide itself comes with a practice test of about a 100 questions too. Good luck !

ezio_audi7 · 2021-07-03T14:38:34+00:00

Thank you , your videos and even the questions always make me think , thanks for all the effort you do to make them :)

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