Psa raise 5 years after brachytherapy

SUM, why do you think the threshold criteria are related to imaging? The BCR thresholds are based on what amount of PSA can be generated in a body that doesn't have prostate cancer - I don't think there is any relation to imaging. 

That’s good isn’t it. DH’s went to 0.01 too. Stayed there a few years. 

If a man has had EBRT, brachy, FLA, HIFU or whatever and his PSA reaches 2, there is no reason to be concerned. If it goes over 2+nadir, he is in BCR regardless of what scans might or might not be arranged or what they might show. Some oncos don't arrange a new scan or restart treatment until the PSA reaches 5, 10 or even 20 - he was still in BCR as soon as he hit that 2+nadir threshold.

You perhaps have an unrealistic confidence in the reliability of scans. CJ had BCR and the best tracers available but his PSA reached 100 and still nothing was showing up on the scans. Some PCa just doesn't show up and micromets are almost impossible to detect until it is too late.

Chigwell. Great to hear you are doing so well. Those we know that have had brachy and the cancer has returned have had it return a while before the 10 year mark. So that is probably correct about reaching 10 years. DH had his 7 years ago, almost exactly as he had it in the January just after his 58th birthday. He will be 65 later this month. 

Best wishes,

Chris

The consultant phoned this evening. He said dh’s psa shouldn’t be 1.7 so he’s asked for another psa test at the end feb. When it reaches 2.1 he’s to return to discuss what to do next. Dh found out this year that he carries the BRCA2 gene. If we had known this when he was first diagnosed perhaps prostate removal would have been recommended. 

PSA meanderings. You can click on my profile for a bit of information but I think to run you through my treatment path will be helpful.

I am rapidly approaching my 79th birthday and have complete faith in my very talented Urology Professor

My LDR procedure took place in Bart's at the Royal London on 20th April 2010 ,13 years ago next month. My lowest PSA reading

ever was 1.0(Nadir) back in November 2012. During the post procedure years my PSA has slowly, very slowly, meandered up and down and currently sits at 3.3, down from 3.8 in October 2022. For the past 3 maybe 4 years my Professor of Urology, a lovely man,

and I have agreed that no further scan or biopsy will be considered until PSA has breached 5.0. I have regular PSA blood tests and

never take my eye off the ball(Needle). The doubling of my PSA from 1.6 in March 2012 to now has taken 11 years.

I continue to play Golf 3 times every week and ride a mountain bike 2 times each week for an hour or so. This is not an admiration seeking exercise but an encouragement to all LDR patients and to those considering LDR as a treatment.

I would be very happy to offer any further details of my experiences. I continue to keep in touch with other men who over the years

have been interested in my opinions via this website. I drift in and out of prostatecancer.uk most days.

Best wishes

Chigwell2010.

Thanks for reply Chigwell. It looks like your psa moves about a bit. Dh’s went as low as 0.02 where it stayed for several years. Then started to creep up, slowly at first. But it did a jump from 0.7 to 1.7 in 6 months. Then 1.7 to 2.1 in the last 3 months. So is going up faster now. All we can do is wait and see what the consultant says. We know a few people who have had brachytherapy. Their psa has either stayed more or less on the nadir. Or it has slowly crept back up and the cancer returned. One of them is no longer with us as he left returning to the consultant too late. Another has had his prostate removed and reconstructive surgery. Another is about to try hi-fu or other type of treatment. They are all a fair bit older than dh. But as those we know whose psa had risen again all had a return of cancer, it made us assume that would be the case for dh as soon as the psa started to rise. I can’t see why else it would rise as much as it has. 

Thanks. Will keep you posted. I just need to persuade dh to phone the results through to the consultant. He’s reluctant. He is already saying he doesn’t want treatment because he’s worried about side effects. But we don’t know for definite that it has returned.