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PSA velocity

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User
Posted 27 Dec 2016 at 23:29
. Hello all. I was wondering if any of you know about the implications for a fast rising PSA prior to surgery. I have to decide if I should have radiotherapy immediately or wait until/unless my PSA rises. I have come across an article in the Harvard medical school website which says that PSA velocity prior to surgery is important. I am 49 years old. PSA rose from 12.5 to 16.5 in the ten weeks prior to surgery. Had robotic prostatectomy eight weeks ago. After surgery Gleason score 7 3+4 microscopic cells on margins and extra capsular extension of the tumour. I haven't had first post operative PSA results yet. Many thanks
User
Posted 28 Dec 2016 at 08:39

Hi
It was very important in my case. Far more important than even the experts knew. Read my profile I am 49 too. My initial psa was 15 and on the day of surgery it was 43. Unfortunately they found cancer on the bladder and in 5 of 18 lymph node. My post op psa was the worse they had seen in 2 yrs at 1.5 , and 4 weeks later it had risen to 2.4.
My path was HT having declined RT twice. I declined it because they clearly explained they believed I had spread elsewhere , and that the RT would not be curative. To be honest I'd had enough of treatment and incontinence and ED.
At present I'm riding the gauntlet and stopped treatment completely. Psa has already risen from 0.13 to 0.9 in 12 weeks. When it gets to 3 I am having another Choline PET scan to ascertain what is going on inside me and look for spread. It's been 2 years of endless stress.
I failed 4 of 6 criteria for starting RT , one of them being high psa pre op , another being doubling rate , another being lymph spread etc. They said they were offering it merely as I was so young. If I start getting probs down there and am in pain then it is still available to me.
Best wishes on your journey xx

Edited by member 28 Dec 2016 at 08:43  | Reason: Not specified

User
Posted 28 Dec 2016 at 09:38
Benjit

A missed PSA result three years before my diagnosis was 6.9, at diagnosis it was 7.7, four months later just before my surgery it was 10. My Gleason was 4+3 and the histology revealed I had positive margins and extra capsular extension.
My first years PSA were 0.03 there were then a few fluctuations and the last couple have been 0.13. I have my next test next week and a meeting with my consultant the week after.

Some guys have had adjunctive RT others finish up having salvage RT a couple of years down the line.

Discuss the options with you consultant when you get the results of your histology.

If I knew back then what I know now I probably would have gone down the adjunctive RT route.

Thanks Chris
 
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