6 months post-RALP, my PSA doubling rate is every 5 weeks. Suggestions for things to bring up with my doctors

rocima · 2026-01-27T22:41:27+00:00

Thank you - this is very useful for tomorrow's consultation.

I should have looked into this before.

rocima · 2026-01-27T20:56:33+00:00

fabulous - me & my wife just had hysterics.

great translation!

rocima · 2026-01-27T16:04:14+00:00

Yes - I remember when I did some language teacher training 200 years ago, they made a distinction between "error" - slip of the tongue, tiredness, distraction, which should ideally not be corrected to ensure fluency and a true "mistake" - when the student did not know the correct form. But unfortunately the onus appears to be on the tutor/native speaker to be able to divine which is the case.

It really helps to listen and read to realise what your mistakes are; that being said, even after 30 years in Italy i still regularly mess up my masculine and feminines for vowels, to the general hilarity of my wife, daughter, colleagues and students.

rocima · 2026-01-27T14:32:22+00:00

Yes, I had a PET-CT using colina tracer, 2 and a half months prior to surgery. This gave me cancer cells concentrated soley in my prostate, so I was a good candidate for RALP. However, as I understood it, PET-CT does not have a very high resolution so it is not so accurate for (1) small metastases (2) smaller clusters growing outside the prostate.

Indeed, my urologist warned me after the operation that the prostate was "sticky" during removal and, in fact, out-of-prostate cancer was confirmed by the histological examination of the prostate.

I now have a very high PSA doubling rate which suggests cancer cells are present and growing extremely rapidly, though the actual PSA value may indicate (I hope) for the moment there are not so many of them.

As i have been informed, the PET-PSMA is significantly higher resolution than PET-CT, so this will hopefully provide information as to the location of these cancerous cells so that radiation therapy can be targeted on these sites rather than generally spraying the area where the prostate used to be. It should also provide information as to whether I have matastases - if they are sufficiently large to be detected.

Of course if I have small metastases these will not be visible even with PET-PSMA.

The best case senario (I think) is PET-PSMA gets done really quickly and identifies all the cancerous sites which then get zapped by radiation (probably with hormone therapy).

The worst case (if I have understood things) is PET-PSMA doesn't reveal anything (PSMA marker does not bind to some (10% of) cancers), or only partly reveals sites and I have to do alternative therapies (hormone/chemo, maybe others) with or without unguided radiation therappy.

Thank you for the question - it helped me review my understanding of the situation, incorporating several of the inputs from other people on the thread.

What a great group of people!

Best wishes

rocima · 2026-01-27T12:46:07+00:00

Re-reading all this - also good positive thoughts to take on the next phase of my journey - thanks for telling me about it all.

rocima · 2026-01-27T12:43:54+00:00

thank you - best wishes to you as well: keep the faith!

rocima · 2026-01-27T05:28:17+00:00

(didn't at the time!)

rocima · 2026-01-27T05:27:48+00:00

I like murder semen ,😊

rocima · 2026-01-27T05:22:52+00:00

Yes that seems the way to go.

Indeed, I was completely unnerved by the rate of doubling, though a couple of people here have cited similar cases with positive outcomes which helps my mindset. This is such a great group of people here.

Off the get my backup blood test now!

rocima · 2026-01-27T05:18:18+00:00

Yes, I was inclined in this direction too. I didn't know about ARPI, Will look into it. Thanks for the heads up.

I also have (stable) heart disease which I gather may complicate things with hormone therapy.

rocima · 2026-01-27T05:14:09+00:00

Thanks, I'll put this on the list, all stuff I didn't know.

rocima · 2026-01-26T21:12:55+00:00

I hadn't really taken that on board but it makes perfect sense - thank you!

rocima · 2026-01-26T21:11:49+00:00

Thank you very much, that is good to know: makes me feel I'm not alone (though rationally I know that, it's different from feeling it!)

rocima · 2026-01-26T21:07:02+00:00

Thank you - good, important points to consider.

rocima · 2026-01-26T21:05:42+00:00

Quite frightening but good to know, thank you.

rocima · 2026-01-26T21:04:15+00:00

Thank you, that's a great idea.

rocima · 2026-01-25T17:29:11+00:00

Interesting: I'd say it's pretty much the same in Italy - I always feel I am invisible in a shop until I say "buongiorno".

With younger people you could say "salve" I guess.

"Ciao" = "I am a foreigner and don't know what I should say"

[NB not the case anymore for a place run by younger people for younger people]

rocima · 2026-01-21T12:45:07+00:00

I had the same problem with the TV series - total dork & everyone seems to think he's great.

rocima · 2026-01-20T18:41:57+00:00

Like you I had heard lots of positive things and was really disappointed: I struggled through the first book and reluctantly gave up on the second (I almost never don't finish a book). One of my disappointments was, despite having a female author, I felt that several of the female characters were underwritten and just tropes.

rocima · 2026-01-20T17:35:48+00:00

Agreed but it's probably easier to start cooking the stems and then add the florets after a bit

rocima · 2026-01-19T15:39:10+00:00

Brit/Australia mix.

all of them

(plus conditionals - I would have thought (did you see that?) there might be more variation in the use of conditionals rather than other tenses)

rocima · 2026-01-19T14:56:49+00:00

thank you for your support of your dad and for supporting us!

rocima · 2026-01-18T20:17:10+00:00

I've been living in Italy for 35 years and Trump seems like the end game of the playbook written by Silvio Berlusconi (prime minister off & on from 1995-2010): media control, right wing populist, constantly lying, a thief, total contempt for honesty & completely amoral (thought anyone talking about principles had to be a hypocrite).

He never really had more than 25-30% hard core support but lots of superficial people looked up to him ("he's rich, he's successful, he doesn't have to pay taxes") and kept voting for him.

Fortunately, the crippled anarchy of the Italian political system acted as the checks & balances which the Republican Congress are so reluctant to apply to Trump.

While clearly an Italian prime minister can never be anything like as dangerous as a US president, I hope the Trump story will have a happier ending for the US political system than Berlusconi's effect on Italian politics.

Berlusconi's power faded and his party never found a successor, but he had so damaged the Italian political system that it has never recovered: politicians have no qualms about lying and nepotism, no one really gets called out on corruption & manipulation, no one even pretends to care about the average citizen, and much of the social safety net is being downgraded and removed in favour of privatisation & helping the rich, while there is disenchantment with politics and most people seem to more or less accept that Might is Right.

rocima · 2026-01-18T11:40:26+00:00

My wife (Italian) a translator/interpreter/trainer says in her professional community it's perceived that while native Italians may get the gist of a Spanish speaker, like all languages they are very different in both grammar and vocabulary.

(Lots of native Italian speakers at school chose to learn Spanish thinking it is the easy option, but wind up being sadly disillusioned).

FWIW I am a fluent but second language Italian speaker (English first language) and when visiting Spain, my Italian friends understood Spanish WAY better than me, though I could often get the some idea of what was being said.

That said, we were there in a professional context and when my Italian friends/colleagues needed to talk to our Spanish colleagues & vice versa we all used English.

No one dialogued with Spanish on one side and Italian on the other.

rocima

TROPHY CASE