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Help with injections

User
Posted 11 Sep 2019 at 13:42

Hi all I am the wife of somebody who has his prostate removed in February 2015.  Everything was going ok with his recovery, however in March 2018 he had his usual PSA blood test and his PSA was rising.  He was then put on hormone injections and then in October 2018 he has 35 course of radiotherapy.  He recovered well and went back to work in the January.  He then subsequently had a blood test in March 2019 and he was at 0.18.  


The consultant then said that if it was the same he would be discharged.  Went to the hospital on Monday to find that his PSA has risen to 0.25.  He was shocked and upset.  The next course is he will go back in November, if his PSA is the same or higher he will put on hormone injections.  Both of us are very upset and wondering what will happen.


Anybody been through the same at all ?


 


Thanks 


 

User
Posted 11 Sep 2019 at 18:07

Sorry you find yourself in this situation.


So I guess what happened is that some mets remained after the prostatectomy, which caused the raise in PSA.


Do you know if a scan was done to find where they were before the salvage radiotherapy? Often, they will assume they're in the prostate bed, and this is the area which receives the radiotherapy. Sometimes pelvic lymph nodes and seminal vesicles will be included - it depends what the original diagnosis was, and the histology on the removed prostate and any lymph nodes.


Note that you don't yet know if you have rising PSA - one PSA reading isn't enough to say, and I hope the next one shows you don't.


If the next PSA reading shows you do have rising PSA after the salvage radiotherapy, it would suggest the remaining cancer cells might be somewhere else - somewhere not covered by the salvage radiotherapy. I would ask for a scan to find them, although while PSA is still that low, finding them on a scan is often not successful. Some types of scan should be done before starting hormone therapy if possible. If the cells are in an area which can be treated with more radiotherapy without exposing same area as before (which likely already had max allowable dose), then further targeted radiotherapy treatment might be possible.


Anyway, wishing you the best for the next readings.

User
Posted 11 Sep 2019 at 20:29

Hi he had a scan before the radiotherapy. He has had his lymph nodes dissection and seminal vesicles removed. His lymph nodes were shown to be clear.


Hopefully in November his Psa will come down and his scan will show where the little buggers are. I'm hoping that it was just a glitch 

 
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