PSA rise 7yrs after RT

Hi Tony,

Firstly, I am very sorry that you are experiencing increasing PSA levels and urinary problems to boot. You don't say in your profile that I can see the period you were on HT (if at all). HT usually results in a sharp drop in PSA with RT further lowering this over a period between 6 - 24 months post RT when a nadir is reached. This ideally should be sub 1. In my case it was 0.05. Your nadir was well above this but your subsequent rises in PSA were nevertheless fairy small for a long period and until more recently. My PSA increased very slowly but persistently after my nadir as detailed in my Profile and at an increasing rate. My oncologist thought the cancer may have regrown within the Prostate and this indeed was the case. I did make it clear that I was prepared to have further investigations and treatment. Eventually, by the time my PSA had reached 1.99 I had HIFU salvage therapy which significantly reduced my PSA. (This was an early intervention as a tumour was seen on a high quality MRI scan and found in a template transperineal biopsy. Often a patient with a sub 2 PSA after RT would not be investigated or the cancer not sufficiently concentrated to show on a scan). Some cancer was either not identified or left when I had HIFU and PSA is now rising again and I have an appointment in February to consider whether I should just be monitored for a while longer or if some further treatment would be appropriate, maybe repeat HIFU.

Everybody is different but there can be similarities with my case. I too have a diverticulum which means not all urine is expelled and is one reason for frequency. It was quite often during and for some weeks after RT but several weeks after that returned to my pre RT frequency of twice a night. More recently the need to pee means greater urgency but at 80 years of age the bladder is bound to be weaker anyway!

In your shoes I would made an appointment with GP when results of forthcoming blood test are known. It may be considered appropriate for an appointment to be made with urologist regarding urinary situation and oncologist to discuss thoughts on investigating your rising PSA. You might be considered a suitable patient for HIFU or Cyrotherapy, possibly but at least get an idea of how the consultants see it.

Ray