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Biochemical Recurrence

Posted 30 Jan 2017 at 20:59
I had a radical prostatectomy in July 2015. Before surgery Gleason 3+4, MRI showed tumour on left side of gland possibly beginning to break through capsule. Post surgery histology showed ductal involvement and confirmed cancer had broken through. Negative surgical margins and PSA stayed <0.1 until 1/9/16 when it as 0.3. Quickly rise to 0.7 by 30/11/16. Gadolinium enhanced MRI on 24/10/16 showed tumour on prostate bed. I saw oncologist on 11/11/16, he was highly suspicious of metastatic disease due to rapidly rising PSA and short time to recurrence. I was sent for choline F18 PET scan on 20/12/16. This showed a subtle uptake on prostate bed plus a moderate uptake at seminal vesicle remnant or where it was with SUV 8.2.

I started bicalutamide for 21 days on 20/12/16 followed by prostap injection on 29/12 and again 26/1. When I saw oncologist 9/1/17 where he explained that radiotherapy on the seminal vesicle area would involve a lot f bowel being hit and wasn't worth the side effects. Long term hormone therapy was wha he recommends for as long as it works. I asked for surgical opinion (still waiting) and a second opinion. The second opinion was that I should have a planning scan with a full bladder to see if that moves any bowel out of the way. I see oncologist again 27/2/17 to discuss PSA and talk about planning scan. I am concerned that at 56 I am heading down a very bad road. Any advice or suggestions on how best to proceed welcome. Best wishes to all.


Posted 30 Jan 2017 at 22:51

Hello , sorry to hear of this. I had my op a month before you at the age of 48 with even worse results. I had confirmed spread to lymphs and positive margins at bladder neck. They offered RT but as with you they felt I had metastatic disease due to very rapid psa rise. Post op was 1.5 at eight weeks and 2.4,at twelve weeks. They said it wouldn't be curative so I didn't have it. They also said they wouldn't target lymph area in case of damage. I think they wanted to avoid recurrence at bladder. I too had PET scan but despite high psa showed nothing on the bed nor the bladder nor any local lymphs. I didn't trust it tbh. At least they feel they know where yours is and have seen residue. My psa continues to March on and another scan planned soon. Keep in touch and best wishes.

If life gives you lemons , then make lemonade

Posted 31 Jan 2017 at 06:18
Thanks for the reply Chris. Reading your profile, you have been through the mill. I just wish the medical profession would be more proactive. Catching this vile disease early is what should be happening. I will keep you posted. I am so put out at the return of my disease. Take care.


Posted 03 May 2017 at 15:45
I have posted this on the treatment group but as I am under 60 and still working thought I would add an update here too.

I thought I would post an update on my salvage radiotherapy. I finished the last of my 20 sessions last Wednesday 26th April with 55 Grays bring targeted at the Prostate bed and the seminal vesicle remnant with active cancer. I have coped surprisingly well so far but feel pretty tired and am having bowel issues in terms of urgency. I am using Fybogel to calm this aspect down. I find I need to go to the loo multiple times before I begin to settle down. I am managing to go out but am trying to time it so that I am not cuaght out. My next PROSTAP 3 injection is on 18th May and I will continue on this for two years post radiotherapy I believe.

I am trying to visualise the cancer has gone and hope that in two years time my PSA will stay down after HT stops.

My body has been hammered with laparoscopic radical prostatectomy, HT and now radiotherapy in a period of about 21 months. I am trying to remain positive and to that end have managed to get travel insurance and have booked flights to Canad in July to see our eldest son who is working in Calgary for a few months. Something to really look forward to which is really important for all of us in our situation. You are all amazing people and this site is so useful. I would find life much more difficult without it as well as my family and friends too of course. Best wishes, Ian.


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