Please advise

Hi Laura,

The only thing one can say with certainty is that quite a substantial number of men who have had HT/RT, especially those diagnosed with locally advanced PCa ,experience a progressive increase in their PSA, sometimes starting several years after treatment. (I am one of them).

PSA is one of the things oncologists consider in deciding what the next steps can be and when. They have the whole histology of the patient on which to make a decision though it has to be said that some are more proactive than others in trying to establish where any new tumours are, whilst others may for example wait until the PSA has risen to a certain level (varies from one oncologist/hospital to another) before initiating scans and or treatment, often HT sometimes in conjunction with something else which is termed salvage treatment.

My view is it would be sensible to get the opinion of your dad's consultant on how he views his PSA progression. His GP might be able to arrange this or a route I have used previously is to contact the consultant's secretary for an appointment. In my case although my PSA was only about 1.44 at the time, my consultant felt the way the PSA had increased led him to think that there could be some new or residual cancer in my Prostate. An MRI scan he initiated proved he was right and HIFU (High Intensity Focusedl Ultrasound) was arranged in another hospital as salvage treatment within a trial. However, even if an oncologist is prepared to sanction an MRI with a PSA sub 3, some cancer cells can be so dispersed as not to show up on even a high quality MRI scan. So imminent further investigation can depend on an individual consultant and a particular patient and his push to try to investigate the reason for rising PSA and how/when to start further treatment.