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PSA .13 after Prostate removed 1 yr ago

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User
Posted 16 Apr 2019 at 00:49

Prostate removed a years ago now psa .13 what to do ?

User
Posted 16 Apr 2019 at 07:33

Originally Posted by: Online Community Member
Maybe click my picture and read my profile. It seems I’m the village idiot , but my psa was 1.5 after surgery. I’ve refused all RT and treatment 4 yrs on based on QOL and being told I was incurable due to lymph spread. My psa is at present over 100 and they have just maybe found some stuff going on in my abdomen. I’m still sat here knowing I’ll die io this but have zero desire to be filled with poison Chemo, not be chemically castrated. I refused RT maybe 6 times but it is different in your case as you could still be cured ...... yes cured. We are all different on this site and have our own views. I’m tending not to post on my own huge journey anymore because I guess my views are looked upon very negatively by some members who do anything they can to ‘survive ‘ , but paying the consequences side effect wise. Depends on your age as well. I’m nearly 52. I have a long term friend in the same boat as you. He too is four yrs on and his psa has climbed and climbed minutely to 0.14. Hrs a lover like me haha and has no intention of SRT now his erectile function is full again.

Please don't think like that, your approach is inspirational and I think you have made several rational decisions.  It is well know PC is both undetreated and overtreated so it is imperative patients make the right choice for themselves.

 

User
Posted 16 Apr 2019 at 08:31
If you have already been put on bicalutimide then there is no point waiting for the next few PSA tests to see whether there is a rise. The bicalutimide will lower your PSA and disguise the recurrence. It seems your doctor is already convinced that you have a recurrence; perhaps it was expected based on the pathology after your operation. If you do not go ahead with RT then you will be on hormones for the rest of your life with no opportunity of remission so radiotherapy seems worth the risk to me but it depends a bit on how old you are and whether you have other medical conditions.

For many men, the side effects of the hormones are far more distressing than the side effects of the radiotherapy.

ChrisJ’s situation is rather different to yours. His post-op PSA stayed high right from the start, indicating mets that had not been diagnosed. Your low PSA that is now rising indicates some cancer cells left behind in the prostate bed, which is treatable. My husband had successful salvage RT/HT nearly 8 years ago.

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

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User
Posted 16 Apr 2019 at 02:26
Wait and see what your next PSA is in three month’s time and if that figure has increased. Biochemical recurrence (the bugger’s back) after prostatectomy is considered present if there are three consecutive readings over 0.1, or one over 0.2.

Let’s hope your next test is <0.1, ‘undetectable’.

Best of luck.

Cheers, John.

User
Posted 16 Apr 2019 at 02:30
I see you have a simultaneous post here on the same subject. May I suggest you concentrate on one thread only?

The answer to your question is wait and see what your next PSA is in three month’s time and if that figure has increased. Biochemical recurrence (the bugger’s back) after prostatectomy is considered present if there are three consecutive readings over 0.1, or one over 0.2.

Let’s hope your next test is <0.1, ‘undetectable’.

Best of luck.

Cheers, John.

User
Posted 16 Apr 2019 at 02:42

Thanks for ur reply. My psa was was 0. Then went to .05. .08. Now .13.  What treatment would you suggest.  Dr has me on Bicalutamide.   Sorry about double post   

User
Posted 16 Apr 2019 at 03:22

Have you been offered salvage radiotherapy?

Ulsterman

User
Posted 16 Apr 2019 at 03:55

Yes. But they said no hurry.   I have no  symptoms or problems the only way I know I have this cancer is because they tell me I asked my own  medical doctor if I would die of something else before this killed me and he said probably    I am in good health and I have no other problems I just really don’t know what to do because I hear of the radiation can cause a lot of bad Side effects 

User
Posted 16 Apr 2019 at 07:07
Maybe click my picture and read my profile. It seems I’m the village idiot , but my psa was 1.5 after surgery. I’ve refused all RT and treatment 4 yrs on based on QOL and being told I was incurable due to lymph spread. My psa is at present over 100 and they have just maybe found some stuff going on in my abdomen. I’m still sat here knowing I’ll die io this but have zero desire to be filled with poison Chemo, not be chemically castrated. I refused RT maybe 6 times but it is different in your case as you could still be cured ...... yes cured. We are all different on this site and have our own views. I’m tending not to post on my own huge journey anymore because I guess my views are looked upon very negatively by some members who do anything they can to ‘survive ‘ , but paying the consequences side effect wise. Depends on your age as well. I’m nearly 52. I have a long term friend in the same boat as you. He too is four yrs on and his psa has climbed and climbed minutely to 0.14. Hrs a lover like me haha and has no intention of SRT now his erectile function is full again.
User
Posted 16 Apr 2019 at 07:33

Originally Posted by: Online Community Member
Maybe click my picture and read my profile. It seems I’m the village idiot , but my psa was 1.5 after surgery. I’ve refused all RT and treatment 4 yrs on based on QOL and being told I was incurable due to lymph spread. My psa is at present over 100 and they have just maybe found some stuff going on in my abdomen. I’m still sat here knowing I’ll die io this but have zero desire to be filled with poison Chemo, not be chemically castrated. I refused RT maybe 6 times but it is different in your case as you could still be cured ...... yes cured. We are all different on this site and have our own views. I’m tending not to post on my own huge journey anymore because I guess my views are looked upon very negatively by some members who do anything they can to ‘survive ‘ , but paying the consequences side effect wise. Depends on your age as well. I’m nearly 52. I have a long term friend in the same boat as you. He too is four yrs on and his psa has climbed and climbed minutely to 0.14. Hrs a lover like me haha and has no intention of SRT now his erectile function is full again.

Please don't think like that, your approach is inspirational and I think you have made several rational decisions.  It is well know PC is both undetreated and overtreated so it is imperative patients make the right choice for themselves.

 

User
Posted 16 Apr 2019 at 08:28

The bicalutamide will hold things back and you can take your time deciding whether to have further  radical treatment in an attempt to cure it.

Are your doctors going to put you on PROSTAP or similar?

Click my profile, you’ll see that we all take different approaches. I decided on radical salvage radiotherapy alongside hormone therapy after my recurrence.

It has left me with further side effects but I’m ok with my decision.

 

Ido4

User
Posted 16 Apr 2019 at 08:31
If you have already been put on bicalutimide then there is no point waiting for the next few PSA tests to see whether there is a rise. The bicalutimide will lower your PSA and disguise the recurrence. It seems your doctor is already convinced that you have a recurrence; perhaps it was expected based on the pathology after your operation. If you do not go ahead with RT then you will be on hormones for the rest of your life with no opportunity of remission so radiotherapy seems worth the risk to me but it depends a bit on how old you are and whether you have other medical conditions.

For many men, the side effects of the hormones are far more distressing than the side effects of the radiotherapy.

ChrisJ’s situation is rather different to yours. His post-op PSA stayed high right from the start, indicating mets that had not been diagnosed. Your low PSA that is now rising indicates some cancer cells left behind in the prostate bed, which is treatable. My husband had successful salvage RT/HT nearly 8 years ago.

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

User
Posted 16 Apr 2019 at 08:42

Thank you very much for your reply. I go to see the doctor again May 1st   Hoping PSA has dropped with this medicine  But who  knows 

User
Posted 16 Apr 2019 at 12:22

My friend was on Bicalutamide (Casodex) for two years before it ceased to be effective. He was switched to the ‘old-fashioned’ drug Diethylstilbestrol. He is doing well on that. He had no side-effects whatsover with Bicalutamide, apart from reduced PSA.

His urologist said he was lucky to get two years out of Bicalutamide as it usually becomes ineffective after twelve to eighteen months.

Cheers, John.

Edited by member 16 Apr 2019 at 14:00  | Reason: Not specified

User
Posted 18 Apr 2019 at 05:05

John did your friend have  radiation    Thank you

User
Posted 18 Apr 2019 at 10:15

Hi,

Chris is 85 and he was diagnosed five years ago. He has had three monthly abdominal hormone injections since then which reduced his PSA, but which were subsequently supplemented by Casodex via oral. He has had no side effects from any of these therapies, lucky bugger.

Radiotherapy has never been mentioned, and I guess if the current drug stops working, his next step would be to switch to Enzalutamide or Abiraterone.

Cheers, John.

Edited by member 18 Apr 2019 at 10:22  | Reason: Not specified

User
Posted 19 Apr 2019 at 01:49

Thank you  for reply.  I’m still deciding what to do

User
Posted 19 Apr 2019 at 23:27
It is very unlikely that with a PSA such as yours, (although it could well be higher but for the HT you are now on), that even better scans would reveal the whereabouts of any cancer cells. As PSA increases, the chances of identifying where the cancer cells are located improves but this is not certain. If cancer is identified where iRT can treat this can be a good option but radiating around the Prostate bed regardless of any cancer being seen is hit or miss. In the absence of any cancer cells being identified or suspected, it is more likely to continue with HT and other down the line treatments as and when called for.
Barry
User
Posted 20 Apr 2019 at 02:31

I had a CT Scan and a bone and there was no cancer found.  

User
Posted 20 Apr 2019 at 06:33

Well, that’s good news at least.

I spoke about possible recurrence in my own case to the leading prostate cancer oncologist at The Royal Marsden Hospital (so far, so good, the bugger’s still gone🤞). He said in the event of salvage radiotherapy, it would be better to have a specific target to aim the radiation at, rather than irradiating the whole prostate bed, with its increased risk of unfortunate side-effects.

He said if I had significant rises in PSA in consecutive tests, the next step would be to have a scan to determine the size and location of any metastases. I think the best you can get on the NHS is a pet-CT scan using Choline as a tracing agent, but a far more accurate one is the pet-PSMA scan which uses the Gallium-68 isotope, yours for only £2600 in England, £400 in India.

I suggest you discuss the possibility of another scan with your oncologist before any RT.

Cheers, John

 

https://www.stricklandscanner.org.uk/about-us/news-and-views/archive/psma

 

 

Edited by member 20 Apr 2019 at 06:45  | Reason: Not specified

User
Posted 20 Apr 2019 at 14:07

Thank you very much

 
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