Is rising PSA cause for concern

User

Posted 26 Feb 2017 at 22:06

I was diagnosed approximately 3 years ago with locally advanced prostate cancer
My PSA was 45 and Gleason score 3 + 4
No cancer was detected anywhere else other then within the prostate and locally to it
The course of treatment was 37 doses of radiotherapy and 2 years of hormone treatment

First blood test result following completion of treatment had PSA being undetectable
Was advised that if it was to rise to nadir(0) +2 then it would be deemed incurable and a course of further treatment would commence
The following blood tests(every 3 months) have been 0.2,0.3,0.3 and the most recent last week 0.4
Whilst the rise isn't huge the trend is worryingly upwards

I have been advised that I should not be concerned as this is not deemed an issue at this stage
Was therefore wondering if any others had had similar results and if so how their scenario developed

Thanks
PJ9

User

Posted 27 Feb 2017 at 17:45

Hi PJ9,

I was diagnosed in 2009 with locally advanced PCa, Gleason 4+3, PSA 12. I had radiotherapy in 2010 and overall 3 years of hormone treatment (2009 - 2012). My PSA has risen steadily from undetectable in 2010 to its current level of 1.4 in January of this year.

I have been assured that at this stage it would be pointless to do any scans as any recurrence of the tumour would be too small to be detected. Like you I have been told that no treatment will be contemplated until I reach a PSA of 2.

I have also been told that the PSA could level off after being produced again as Lyn has described. However I can't pretend that my anxiety levels haven't gone up a bit but I am resigned to waiting for my next PSA in April.

At the least I have had 6 anxiety free years and if the cancer has recurred the treatment options are better now than they have ever been.

Tom

User

Posted 20 Mar 2017 at 18:34

Thanks for your valuable feedback
Tom and I seem to have similar scenarios with similar concerns
Appreciate as Lyn advises it may be normal but how do we know ?

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User

Posted 27 Feb 2017 at 01:19

PJ9 this is perfectly normal. Unlike a man that has had the op, you still have a prostate and the healthy cells regenerate, producing small amounts of PSA. Plus the remains of the hormone treatment have finally left your body and testosterone will be starting to be produced again, which leads to a small anticipated rise in PSA. That's why your doctors wouldn't be concerned unless you went to nadir + 2.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 27 Feb 2017 at 17:45

Hi PJ9,

At the least I have had 6 anxiety free years and if the cancer has recurred the treatment options are better now than they have ever been.

Tom

User

Posted 20 Mar 2017 at 18:34

Thanks for your valuable feedback
Tom and I seem to have similar scenarios with similar concerns
Appreciate as Lyn advises it may be normal but how do we know ?

User

Posted 20 Mar 2017 at 22:33

The foregoing seems to be the case generally but not always. I was also told previously that nothing would be considered by way of investigation or treatment (likely HT), until my PSA exceeded my nadir plus 2, ie, 2.05. However, my consultant felt that my slowly but persistently rising PSA following RT was indicative of there being some further growth of tumour within the Prostate and with a bit of encouragement from me I was given an endorectal MRI scan which showed this to be the case. This was when my PSA was about 1.44. Further scans followed leading to me having salvage HIFU on 28th July 2015. My PSA taken immediately before the HIFU was 1.99. Often, as previously stated cancer cells are not sufficiently concentrated or perhaps don't produce high levels of PSA. So I consider myself fortunate that due to the pattern of PSA increases my oncologist thought it worth doing a high quality scan that led to HIIFU, thereby causing the cancer another set back. This scenario is probably more rare.

Barry

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