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PSA up now a bone scan.

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User
Posted 27 Jun 2023 at 19:35

Back in 2006 I was diagnosed with Prostate cancer with a PSA of 17, treatment was 20 sessions of radiotherapy followed by Zoladex implant every 3 months for 3 years, my PSA then dropped to 0.10. There it remained until 2011 when it went up to 0.40.

From then until 2018 it varied between 0.40 and 0.71, but since then every test has shown a slight increase:

15th June 2018 PSA@0.59

24th Dec 2018 PSA@0.81

11th July 2019 PSA@0.71

3rd Dec 2019 PSA@0.71

8th Sept 2020 PSA@0.75

12th March 2021 PSA@0.84

16th Sept 2021 PSA@0.94

15th March 2022 PSA@1.15

8th Sept 2022 PSA@1.47

24th March 2023 PSA@2.17

24th June 2023 PSA@2.57

I have had a chat with my GP and she is not to concerned at the moment.
But today I have received an appointment for a full bone scan from the hospital for next Wednesday should I be concerned.

User
Posted 12 Mar 2024 at 15:53
I know the rise looks steep but they don't go by how much it rises, they go by how fast it is doubling and your doubling time is quite slow at nearly 12 months. As you had full scans last August which didn't identify any new tumours, there is very little that the hospital can do. The only treatment would be lifelong hormone therapy and they perhaps want to delay that for as long as they can to enable you to maintain quality of life. You could ask the oncologist or nurse specialist at what point they would consider starting you on HT - some hospitals will do this when the PSA gets to 5 or 10 - one member here was told by his onco that she wouldn't start HT until the PSA is 20!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 30 Jun 2023 at 16:21
When your PSA rises to its minimum value + 2, you officially have a recurrence so yes, unfortunately there is cause for concern.

User
Posted 30 Jun 2023 at 20:11

Roy, I had surgery in 2014, salvage RT in 2017, I went on a failed PCa vaccine trial a couple of years ago. Last year a PSMA scan picked up a tumor in a lymph node which was treated with 5 sessions of SABR, Another rise this year resulted in another PSMA scan and another 5 sessions of SABR to another lymph node, this time with 6 months of bicalutamide. I just keep going,if it works it works if it doesn't at least I tried.

Fingers crossed for you.

Thanks Chris 

User
Posted 01 Jul 2023 at 16:24
Your "doubling time" is 13 months, which is pretty slow so, given your age, even left untreated, something else is very likely to get you before the cancer does. I suspect that's perhaps why your GP said she's not too concerned about it. When you reach your 80s, quality of life is an important consideration.

All the best,

Chris

User
Posted 07 Aug 2023 at 12:32

Hi all, just to let you know that my latest CT scan, is clear, great news, way forward is continue with 3 monthly PSA checks and wait and see, which is how it has been for the last couple of years.

Regarding my back pain, I now have some patches to try, do seem to be helping.

User
Posted 12 Mar 2024 at 15:20

As soon as DH’s husbands psa was 2 over his nadir of 0.01 (he had brachytherapy, psa stayed low 5 years before creeping up) they said they’d see him for scans. At 2.0 they wouldn’t see him. 3 months later at 2.7 he had an MRI nothing showed up. So he had a psma scan. This showed the psa was coming from several lymph nodes, no cancer in the prostate though.  3 months later psa was 4.9 so he is now on lifelong HT. 

I would see if you can have psma scan. That should show if there is anything to worry about. 

User
Posted 12 Mar 2024 at 20:47

I think you should be having a PSMA PET scan to find the cancer. Given that hasn't happened, I would be asking for it.

User
Posted 30 Jun 2023 at 00:03

I guess it is a little concerning. It could be a brand new tumour in the prostate. Treatment options will be limited if it is. I think OldBarry was in this situation and fortunately HIFU was offered.

Dave

User
Posted 30 Jun 2023 at 18:47

Thanks both, bit worried now, not that I can do anything about things but wait and see what scan brings forth, been told that if cancer is in the bones that there is nothing much that can be done about it! Which is even more worrying.

User
Posted 30 Jun 2023 at 18:58

Hi Devonroy,

Sorry to hear about the unwelcome rise in your PSA.

I now that it is easier said than done, but if you can try to distract yourself as much as possible between now and next Wednesday (until the scan is done), it may help.  Use whatever means of distraction work for you.

Best wishes,

JedSee.

User
Posted 30 Jun 2023 at 19:36
If you now have Some PCa confined within your Prostate, one of the Focal Therapies may be possible and I would recommend you investigate.. If the cancer is limited to perhaps two or three places outside the Prostate it may be possible to treat these with appropriate radiation if the paths of previous RT can be avoided. A negative bone scan would be good but there could be cancer in Lymph Nodes or other places. I would be pressing for a PSMA which would also show whether in bones and in some countries they use the greater embracing PSMA scan instead of a bone only scan. Probably a good MRI is best is best to check the Prostate.

Unfortunately, if it is too big an ask to treat a few specific areas, a more advanced form of HT/Chemo could be possibilities.

Try to remain positive.

Barry
User
Posted 05 Jul 2023 at 17:12

Scan all done no problem, apparently it will be 14/21 days before I get my results, will need to be patient.

User
Posted 12 Jul 2023 at 20:35
Spondylosis is age-related “wear and tear” in the spine. Nothing to do with cancer, so that’s good news.

Chris

User
Posted 13 Jul 2023 at 12:12

Urology Nurse tells me that the CT scan is to check on my thyroid, lungs and other bits and pieces.

They will then have a full set of scans to refer to should my PSA continue to rise.

User
Posted 13 Jul 2023 at 20:10

That’s good news DevonRoy.

Ido4

User
Posted 07 Aug 2023 at 13:33
Great news Devonroy.

Ido4

User
Posted 25 Aug 2023 at 16:26

Oh' dear PSA up again for the 9th time, now 3.22, when is the time to be concerned as the Hospital do not seem to be!

User
Posted 15 Mar 2024 at 11:37

Good news, spoke to my cancer nurse to day and she reassured me that the sudden jump she believes is due to the fact that I had recently spent a week in hospital with cholangitis (often referred to as primary biliary cirrhosis) a type of liver disease.
The hospital had taken the PSA test during the time I was in hospital and she is 90% sure that the next test I have in early April will show a lower figure.

User
Posted 15 Mar 2024 at 11:59
Fingers crossed all round for a good result in April!
User
Posted 04 Apr 2024 at 16:49

Result of latest test 3rd April is 5.36 only slightly lower than last test.

Oncology nurse still thinks that next test might show it down again, thinks that all the problems I had during my hospital visit in early March may still be effecting the result.

But to be on the safe side she is going to suggest that I have a PET scan [what ever that is], may be a month before I get an appointment.

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User
Posted 30 Jun 2023 at 00:03

I guess it is a little concerning. It could be a brand new tumour in the prostate. Treatment options will be limited if it is. I think OldBarry was in this situation and fortunately HIFU was offered.

Dave

User
Posted 30 Jun 2023 at 16:21
When your PSA rises to its minimum value + 2, you officially have a recurrence so yes, unfortunately there is cause for concern.

User
Posted 30 Jun 2023 at 18:47

Thanks both, bit worried now, not that I can do anything about things but wait and see what scan brings forth, been told that if cancer is in the bones that there is nothing much that can be done about it! Which is even more worrying.

User
Posted 30 Jun 2023 at 18:58

Hi Devonroy,

Sorry to hear about the unwelcome rise in your PSA.

I now that it is easier said than done, but if you can try to distract yourself as much as possible between now and next Wednesday (until the scan is done), it may help.  Use whatever means of distraction work for you.

Best wishes,

JedSee.

User
Posted 30 Jun 2023 at 19:36
If you now have Some PCa confined within your Prostate, one of the Focal Therapies may be possible and I would recommend you investigate.. If the cancer is limited to perhaps two or three places outside the Prostate it may be possible to treat these with appropriate radiation if the paths of previous RT can be avoided. A negative bone scan would be good but there could be cancer in Lymph Nodes or other places. I would be pressing for a PSMA which would also show whether in bones and in some countries they use the greater embracing PSMA scan instead of a bone only scan. Probably a good MRI is best is best to check the Prostate.

Unfortunately, if it is too big an ask to treat a few specific areas, a more advanced form of HT/Chemo could be possibilities.

Try to remain positive.

Barry
User
Posted 30 Jun 2023 at 20:11

Roy, I had surgery in 2014, salvage RT in 2017, I went on a failed PCa vaccine trial a couple of years ago. Last year a PSMA scan picked up a tumor in a lymph node which was treated with 5 sessions of SABR, Another rise this year resulted in another PSMA scan and another 5 sessions of SABR to another lymph node, this time with 6 months of bicalutamide. I just keep going,if it works it works if it doesn't at least I tried.

Fingers crossed for you.

Thanks Chris 

User
Posted 01 Jul 2023 at 09:52
Thanks all for your encouragement, will be back when I know results in meantime will try to remain positive, Wimbledon will help.
User
Posted 01 Jul 2023 at 16:24
Your "doubling time" is 13 months, which is pretty slow so, given your age, even left untreated, something else is very likely to get you before the cancer does. I suspect that's perhaps why your GP said she's not too concerned about it. When you reach your 80s, quality of life is an important consideration.

All the best,

Chris

User
Posted 05 Jul 2023 at 17:12

Scan all done no problem, apparently it will be 14/21 days before I get my results, will need to be patient.

User
Posted 12 Jul 2023 at 14:52

Results received to day, scan shows no evidence of any bony metastases but signs of significant degenerative lumber spondylosis.

Therefore I am to continue on the PSA tracker every 3 months.

Not sure what significant spondylosis means at the moment.

User
Posted 12 Jul 2023 at 16:24
No sooner had I received phone call as above but through the post comes an appointment for a CT Thorax abdo pelvis with contrast scan, no idea what it is for, tried to find out from the hospital but just went around in circles.

Is it to do with my PC or lumber spondylosis, no idea.

Up one minute down the next.

User
Posted 12 Jul 2023 at 20:35
Spondylosis is age-related “wear and tear” in the spine. Nothing to do with cancer, so that’s good news.

Chris

User
Posted 13 Jul 2023 at 12:12

Urology Nurse tells me that the CT scan is to check on my thyroid, lungs and other bits and pieces.

They will then have a full set of scans to refer to should my PSA continue to rise.

User
Posted 13 Jul 2023 at 20:10

That’s good news DevonRoy.

Ido4

User
Posted 06 Aug 2023 at 19:35

I’m sorry but what I’d HIFU? Thank you.

User
Posted 07 Aug 2023 at 12:32

Hi all, just to let you know that my latest CT scan, is clear, great news, way forward is continue with 3 monthly PSA checks and wait and see, which is how it has been for the last couple of years.

Regarding my back pain, I now have some patches to try, do seem to be helping.

User
Posted 07 Aug 2023 at 13:33
Great news Devonroy.

Ido4

User
Posted 25 Aug 2023 at 16:26

Oh' dear PSA up again for the 9th time, now 3.22, when is the time to be concerned as the Hospital do not seem to be!

User
Posted 12 Mar 2024 at 14:56
PSA up again:

24th November 2023

PSA @ 3.46 up 0.24

7th March 2024

PSA @5.61 up 2.15

Rather large jump this time, when should I be given treatment, hospital not very concerned, just advised check PSA again 1st week in April.

User
Posted 12 Mar 2024 at 15:20

As soon as DH’s husbands psa was 2 over his nadir of 0.01 (he had brachytherapy, psa stayed low 5 years before creeping up) they said they’d see him for scans. At 2.0 they wouldn’t see him. 3 months later at 2.7 he had an MRI nothing showed up. So he had a psma scan. This showed the psa was coming from several lymph nodes, no cancer in the prostate though.  3 months later psa was 4.9 so he is now on lifelong HT. 

I would see if you can have psma scan. That should show if there is anything to worry about. 

User
Posted 12 Mar 2024 at 15:53
I know the rise looks steep but they don't go by how much it rises, they go by how fast it is doubling and your doubling time is quite slow at nearly 12 months. As you had full scans last August which didn't identify any new tumours, there is very little that the hospital can do. The only treatment would be lifelong hormone therapy and they perhaps want to delay that for as long as they can to enable you to maintain quality of life. You could ask the oncologist or nurse specialist at what point they would consider starting you on HT - some hospitals will do this when the PSA gets to 5 or 10 - one member here was told by his onco that she wouldn't start HT until the PSA is 20!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 12 Mar 2024 at 20:47

I think you should be having a PSMA PET scan to find the cancer. Given that hasn't happened, I would be asking for it.

User
Posted 13 Mar 2024 at 14:45
I had a full bone MRI and PSMA scan in July of last year, both were all clear.
User
Posted 15 Mar 2024 at 11:37

Good news, spoke to my cancer nurse to day and she reassured me that the sudden jump she believes is due to the fact that I had recently spent a week in hospital with cholangitis (often referred to as primary biliary cirrhosis) a type of liver disease.
The hospital had taken the PSA test during the time I was in hospital and she is 90% sure that the next test I have in early April will show a lower figure.

User
Posted 15 Mar 2024 at 11:59
Fingers crossed all round for a good result in April!
User
Posted 04 Apr 2024 at 16:49

Result of latest test 3rd April is 5.36 only slightly lower than last test.

Oncology nurse still thinks that next test might show it down again, thinks that all the problems I had during my hospital visit in early March may still be effecting the result.

But to be on the safe side she is going to suggest that I have a PET scan [what ever that is], may be a month before I get an appointment.

 
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