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Rise in PSA after treatment stopped

User
Posted 11 Oct 2019 at 10:19

Hello,

I posted on here in February 2015, when my dad was diagnosed with Prostate Cancer, and received so many helpful replies.  Dad was diagnosed with aggressive Prostate Cancer - no symptoms, PSA 11, Gleason 4 + 5.  He was scanned and told that the cancer had spread locally but not metastasized (as far as they could see).  

He was immediately put on Hormone Therapy (sorry, not sure of the name of it) and then received radiotherapy, which finished at the end of 2015.  He stayed on the HT for 3 years, as is standard.  His PSA came down to <0.1, as expected and all was good.  At his first PSA test after coming off the treatment in October last year, it had risen to 1, then at the end of May it rose to 3.2.  The doctor was slightly concerned so asked him to have another test in 3 months' time.  He thought the doctors were going to contact him to arrange the PSA test but didn't hear so I got him to chase it up and he finally had the test on Monday.  The following day the GP called to say his PSA has now gone up to 9 and he has referred him back to the oncologist.  

I know this isn't a good sign as it has gone up so quickly and the cancer was aggressive.  We are waiting for the appointment to come through but in the meantime, I was just looking for some reassurance really that there are more treatment options available for him to extend his life?  Will he be able to have HT again as it seemed to be effective last time, although I know it lose effectiveness after a certain amount of time?

Some more info - he is 80 and has had a lot of health problems since his diagnosis.  He was diagnosed with heart failure 3 years ago caused by AF and mitral heart valve regurgitation, although they have now stabilised him and have signed him off for now and can't believe how well he looks.  He was diagnosed with anal cancer earlier this year also and they were unable to give him the usual RT due to him having had it before so the surgeon has attempted to remove all of it - he goes for 3 monthly check ups at the moment to check it hasn't come back.  He did have an MRI scan too, which again showed the cancer hadn't metastasized.  He also has had several non-melanoma skin cancers removed.  

I just feel so sorry for him as he is such a fit 80 year old (apart from the above! ha ha!) We lost my mum in 2013 and he was heartbroken but threw himself into his running - he still runs/walks 5k ever week and did a 10k a few weeks ago, albeit slower than he used to!  He doesn't have any symptoms at the moment.

Thanks, feel better just for typing that all out!

User
Posted 11 Oct 2019 at 22:11

He sounds a warrior. He's not on treatment at the moment and his psa is roughly trebling every 6 months over the last year since he stopped hormones.

PSA doubling time is a common way of assessing condition and when to start treatment.  There are people on here who know what it could signify.  I'd think they will start him on another treatment soon but I can never remember the names.

User
Posted 11 Oct 2019 at 22:17

Hi    I am no expert but wanted to reply to bump you up in the hope someone with more knowledge can advise you. I would think there is plenty more treatments in the toolbox your dad could have to help. What does he think though?

He could most likely restart HT which would hopefully knock back the PCa for some time but how did it affect his quality of life last time?  Chemotherapy I am not sure  about given his heart issues and age.

Sometimes no treatment might be best especially if he is enjoying life and has no symptoms .He needs to weigh up how much he values his quality of life against how much extra time treatment may give him with possible unpleasant side effects. Your dad will need to be guided by his oncologist and of course it is your dad's choice ultimately. He may do very well for some time yet without any treatment at all and perhaps reserve treatment  for when he starts having symptoms should they arise.

Best regards

Ann

I

Edited by member 11 Oct 2019 at 22:19  | Reason: Not specified

User
Posted 12 Oct 2019 at 08:43

Hello,

My PSA was starting to rise, click on the link below to see what actions my oncologist took for me:

https://community.prostatecanceruk.org/posts/t21462-Oh-dear---back-on-Hormone-Therapy

Hope this helps.

 

Arthur

User
Posted 12 Oct 2019 at 09:50

Chardonnay,

I would guess they will put him on hormone treatment to pause it (and will need to monitor impact on heart), and do some scans to work out the current staging. Until they know that, it's not really possible to guess what they will propose.

Wishing you the best, and good that he has no symptoms, and really excellent that he's exercising. There is evidence that exercise slows the progression of prostate cancer.

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User
Posted 11 Oct 2019 at 22:11

He sounds a warrior. He's not on treatment at the moment and his psa is roughly trebling every 6 months over the last year since he stopped hormones.

PSA doubling time is a common way of assessing condition and when to start treatment.  There are people on here who know what it could signify.  I'd think they will start him on another treatment soon but I can never remember the names.

User
Posted 11 Oct 2019 at 22:17

Hi    I am no expert but wanted to reply to bump you up in the hope someone with more knowledge can advise you. I would think there is plenty more treatments in the toolbox your dad could have to help. What does he think though?

He could most likely restart HT which would hopefully knock back the PCa for some time but how did it affect his quality of life last time?  Chemotherapy I am not sure  about given his heart issues and age.

Sometimes no treatment might be best especially if he is enjoying life and has no symptoms .He needs to weigh up how much he values his quality of life against how much extra time treatment may give him with possible unpleasant side effects. Your dad will need to be guided by his oncologist and of course it is your dad's choice ultimately. He may do very well for some time yet without any treatment at all and perhaps reserve treatment  for when he starts having symptoms should they arise.

Best regards

Ann

I

Edited by member 11 Oct 2019 at 22:19  | Reason: Not specified

User
Posted 12 Oct 2019 at 08:43

Hello,

My PSA was starting to rise, click on the link below to see what actions my oncologist took for me:

https://community.prostatecanceruk.org/posts/t21462-Oh-dear---back-on-Hormone-Therapy

Hope this helps.

 

Arthur

User
Posted 12 Oct 2019 at 09:11

Hello, thank you all so much for your replies!

To answer your questions Ann, he is still in shock at the moment really and I don't think he wants to think about it until he sees the consultant.  His first thought was that he would have to have chemo, which he is terrified of (I think due to seeing my mum go through it with Bowel Cancer, although of course all treatments are different).  As you say though, I don't think that will be an option for him anyway due to his heart problem.  He didn't like being on the HT, he had hot flushes and put some weight on but other than that, I think it was bearable.  He does have a good quality of life, and is very young for his age, especially considering all that he has been through.  I know he is sick to the back teeth of hospitals and treatment (he had a big skin cancer removed from his head at the beginning of July and only finally had the dressing removed yesterday).  I know he was hoping for a bit of clear water now to get on with his life, and his running, which means so much to him.  It certainly could be worth considering holding off treatment for a bit and it's something that he can discuss with the oncologist I think.

Sorry to hear about your needing to resume HT Arthur, but pleased to see that it is working for you in bringing your PSA levels right down again.  I hope it carries on working for you for a long time.  That does give me some hope.  

Thanks again and all the best to you all!

 

User
Posted 12 Oct 2019 at 09:50

Chardonnay,

I would guess they will put him on hormone treatment to pause it (and will need to monitor impact on heart), and do some scans to work out the current staging. Until they know that, it's not really possible to guess what they will propose.

Wishing you the best, and good that he has no symptoms, and really excellent that he's exercising. There is evidence that exercise slows the progression of prostate cancer.

User
Posted 12 Oct 2019 at 17:45
Thanks Andy. Yes, we're expecting them to scan him and guess we will know more then. Exercise has definitely helped him so much, mentally and physically, just hope he can continue!

We don't have a date for him to see the consultant yet, but will update when I have more news.

 
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