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Rising PSA after RP and SRT

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User
Posted 21 Jun 2019 at 17:10

We are extremely worried about husband's latest PSA results.

RP Aug 2015

SRT Aug 2016

PSA June  2018 0.45, Dec 2018 0.62  and June 2019 1.22

Scan being arranged for Aug, and further PSA test, then consultant will decide on next treatment. No hormone treatment as yet.

Does this mean that the cancer has spread?

User
Posted 21 Jun 2019 at 22:03
Hi

I believe they say that three consecutive rises are indicative of biochemical recurrence, particularly if its 0.2 or above.

In terms of spread it maybe that there are some rogue cells in the prostate bed or possibly micro mets floating around.

My PSA has risen to 0.12 after RP and RT and they classed this as a biochemical recurrence. But also said they won’t start further treatment until my PSA reaches 10

Be interested to see if the scan sees anything at such a low PSA

Take care

Bri

User
Posted 22 Jun 2019 at 16:02
As the PSA went low and then has climbed steadily since, it may be that the active cells are still in the area where the prostate was, or in lymph nodes.

Some oncos will re-start HT when the PSA gets to 5 or 10, others will wait longer. Some are less bothered about the PSA threshold and will start HT when the doubling time is getting shorter. In Dad's case, that would be if the doubling time got to 3 months. Our onco said that if a scan shows limited lymph activity away from the pelvis, he would give John a short course of RT to the affected nodes but this isn't possible in the pelvis where he has already had the maximum dose.

It is devastating to go through all the treatments and find the cancer still comes back. But hopefully, Mr Fish will still be here many years from now.

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

User
Posted 22 Jun 2019 at 22:08

Thank you Lyn. It's good to be able to write on here about our fears - there's so much knowledge and understanding on this site. 

User
Posted 22 Jun 2019 at 22:57

What is of particular concern is that PSA continued to rise regardless of the SRT. It's understandable why the consultant wants MRI scan but be prepared that this may not show any cancer and if PSA continues to rise there may come a point where a systemic treatment approach has to be considered. On the other hand, if cancer is seen where SRT was not  previously directed, it might be possible to treat one or a very few small tumours with further RT.

Edited by member 22 Jun 2019 at 22:59  | Reason: Not specified

Barry
User
Posted 06 Jul 2019 at 14:24

Originally Posted by: Online Community Member

 

But at this step I think we dread that the cure is less likely, that forever treatment is on the cards, scary stuff.

As somebody who has seen his PSA rise for 3 successive times after EBRT three years ago, I get that completely and it's possibly something that we can forget. It's certainly weighing on my mind rather than any fears of mortality.

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User
Posted 21 Jun 2019 at 22:03
Hi

I believe they say that three consecutive rises are indicative of biochemical recurrence, particularly if its 0.2 or above.

In terms of spread it maybe that there are some rogue cells in the prostate bed or possibly micro mets floating around.

My PSA has risen to 0.12 after RP and RT and they classed this as a biochemical recurrence. But also said they won’t start further treatment until my PSA reaches 10

Be interested to see if the scan sees anything at such a low PSA

Take care

Bri

User
Posted 22 Jun 2019 at 15:35

Thank you so much for your comment Bri.

It's a 'oh no, here we go again' time,  that awful panic and fear of what's ahead.

But at this step I think we dread that the cure is less likely, that forever treatment is on the cards, scary stuff.

At the back of our minds we thought this moment might come, each step has been a shock and worse than we expected. We  just try to block it out whilst getting on with life, but  it creeps in again near results time. 

I've no idea what a ct scan may show at this time, his liver results are good so consultant doesn't think bones affected? We don't know whether a different scan is on the cards, there are so many questions which perhaps only time will answer.

 

 

 

 

User
Posted 22 Jun 2019 at 16:02
As the PSA went low and then has climbed steadily since, it may be that the active cells are still in the area where the prostate was, or in lymph nodes.

Some oncos will re-start HT when the PSA gets to 5 or 10, others will wait longer. Some are less bothered about the PSA threshold and will start HT when the doubling time is getting shorter. In Dad's case, that would be if the doubling time got to 3 months. Our onco said that if a scan shows limited lymph activity away from the pelvis, he would give John a short course of RT to the affected nodes but this isn't possible in the pelvis where he has already had the maximum dose.

It is devastating to go through all the treatments and find the cancer still comes back. But hopefully, Mr Fish will still be here many years from now.

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

User
Posted 22 Jun 2019 at 22:08

Thank you Lyn. It's good to be able to write on here about our fears - there's so much knowledge and understanding on this site. 

User
Posted 22 Jun 2019 at 22:57

What is of particular concern is that PSA continued to rise regardless of the SRT. It's understandable why the consultant wants MRI scan but be prepared that this may not show any cancer and if PSA continues to rise there may come a point where a systemic treatment approach has to be considered. On the other hand, if cancer is seen where SRT was not  previously directed, it might be possible to treat one or a very few small tumours with further RT.

Edited by member 22 Jun 2019 at 22:59  | Reason: Not specified

Barry
User
Posted 06 Jul 2019 at 14:24

Originally Posted by: Online Community Member

 

But at this step I think we dread that the cure is less likely, that forever treatment is on the cards, scary stuff.

As somebody who has seen his PSA rise for 3 successive times after EBRT three years ago, I get that completely and it's possibly something that we can forget. It's certainly weighing on my mind rather than any fears of mortality.

User
Posted 08 Jul 2019 at 00:18

Thanks Pete. We all hope for several years with little or no rise in the PSA, putting off any further treatment for as long as possible. It's just horrible when things happen too soon, seems unfair somehow. 

 
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