I'm interested in conversations about and I want to talk about

Know exactly what you want?

Show search

Notification

Error

Third time not so lucky

Email this conversation Print this conversation

User

Posted 04 May 2017 at 08:11

Good morning everyone

My third post-op PSA test wasn't due until June. However, I needed some other blood tests and asked my GP if he'd do an early, extra PSA test for me and he said yes.

In January, 6 weeks after RP, PSA was 0.014. In March, 0.015. In May, 0.019. Whilst these results may look good, my oncologist did tell me that if PSA went up to 0.016 in June, she'd recommend radiotherapy. I was pT3b and Gleason 9 with positive margins and perineural spread.

The journey continues.

Ulsterman

User

Posted 04 May 2017 at 12:27

Sorry to hear that Ulsterman but at least now you can start putting a plan together for further treatment rather than just hanging around waiting and wondering.
All the best
Julie

User

Posted 04 May 2017 at 12:57

Disappointing for you but with positive margins and PNI, not unexpected. It will be interesting to see whether she recommends RT alone or with HT.

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

User

Posted 05 May 2017 at 16:17

Lyn

Had a telephone consultation. Onco has confirmed that she considers the cancer to be active, given my pathology. However, she said she still wanted my June PSA result and then we'd discuss radiotherapy. She feels there is no need to rush.

It would be radiotherapy alone.

If I'm going to have radiotherapy anyway, I'm not sure what the benefit of delaying it is.

A bit confused.

Ulsterman

User

Posted 05 May 2017 at 17:42

It is probably useful for her to measure the rate of rise. I have had a rubbish day and not particularly functioning right now so I can't remember which way round it goes but if the PSA rises slowly it indicates cells left behind in the prostate bed and if it rises quickly it can indicate mets further afield .... or vice versa :-/

June isn't so far away - and the pause gives you a little more normality to enjoy first.

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

User

Posted 05 May 2017 at 18:06

I think with positive margins your result is not unexpected and it looks like your PSA rise is slow which is a good sign.

I had negative margins and PSA rose around a year after surgery. My doubling time was 1.2 months on one measure.

My understanding post negative margins is that if PSA is 0.2 or above (some now say less) and it has recurred in less than 3 years and the PSA doubling time is less than 6 months it is highly likely there are mets. If the rise occurs greater than 3 years after surgery and the doubling time is slow then it is more likely to be a local recurrence. I remember my surgeon talking me through this at post operation review.

Post positive margins and given the PSA rise you are seeing is relatively slow this is a relatively good sign I think.

Not easy to deal with as we always hope surgery or radiotherapy cures us but in recurrence (or progression) terms the slow rise post positive margins is the better scenario.

I really hope that RT when it comes cures you completely.

Best wishes, Ian.

Ido4

User

Posted 05 May 2017 at 18:36

Hi Ulsterman,

Oh.. I remember seeing your first post re. LIONS, it seems so long ago. You appear to be in very good hands, thankfully and as much as possible is being done.

Do you have any idea if they will do scans ? I note on your profile 16/11/16, Choline PET CT scan ? Did you ever get shown the result of that ?

All the best.

Gordon

User

Posted 06 May 2017 at 13:23

Thanks all. I didn't understand the rate of rise and doubling time that some of you have explained, so my onco probably has some of that in mind.

As some of you say, it's not at all unexpected, but it's still not nice. At 46, I think this rise tells me that PCa is what I'm going to die from and the rest of my life will be spent on treatments of some form or another. Of course, radiotherapy could still cure me, but I have to be realistic.

Gordon - the Choline PET/CT scan showed no spread and no lymph node involvement.

I'll wait and see what the onco says in June.

Ulsterman

User

Posted 06 May 2017 at 13:30

As utterly S**T as it is , those figures are very low and seemly indicative of tiny margins left. I dont want RT , but in your case you are still on a total cure path which I suppose you must bear in mind. Very best wishes friend

User

Posted 06 May 2017 at 14:44

Chris

You get one problem sorted (you know what I'm talking about) and then another comes along.

The ups and downs of PCa.

Ulsterman

Edited by member 06 May 2017 at 14:52 | Reason: Not specified

Email this conversation Print this conversation

Join the online community now.

Click through to become a member and gain access to support, information and real time replies.