rising PSA post salvage radiotherapy

Did they not put him on hormones alongside the RT?

L Cook , I will leave the PSMA answers to those who know. 

 In answer to your question about scans before SRT, I was told that if they did a bone scan before SRT and found nothing they would still do SRT to the prostate bed. If they did a scan before SRT and found evidence of Mets SRT would be not be done. When I asked if they were guessing that the cancer was in the prostate bed, I was told it was a very educated guess based in years of experience. I am dipping in and out of BCR, next test in  few weeks will be interesting. I will follow your progress with interest.

Thanks Chris

copy / paste from consultants referral for the PSMA scan.

His pre-operative characteristics were: PSA 4.1, cT1c, Gleason 3=4=7 prostate cancer on Left lobe only in 5/5 cores (45% vol.); core positivity 50%. Probability of pelvic lymph node involvement: 5.3% (Briganti nomogram). MRI (pre-biopsy): 36cc prostate volume; no obvious tumour seen (PIRADS 2). His prostatectomy pathology was Gleason 3 + 4 = 7 disease involving 50% of the total gland volume, with a small positive margin at the left base measuring 5 mm. There was a single focus of tumour within perineural tissue, and tumour within adipose tissue was identified just at the junction of circumferential margin of the prostate, as it merged with the extra-prostatic tissue. The specimen was cautiously staged as pT2bN0.

The had presumed that cells may still be in prostate bed, therefore SRT.

PET scans not available Aberdeen at the moments - Edinburgh no longer taking people. Due to this they would seek approval for a referal to London or Manchester on NHS if required. but since meeting on Tuesday that changed to the bone scan.

We thought that the PSMA scan was superior to the choline so were happy when nothing showed.

Consultant originally said he wasnt suitable for hormone treatment - but guessing thats because they thought the OP/SRT would do the trick.

I’m very sorry to read about your situation and have to admit I don’t understand what is going on.

I had a prostatectomy.  My post operative PSA was 0.014.  In the space of a year, it had risen to 0.023.  This was still exceptionally low but as I’d had several small rises, my oncologist suspected something was going on.  I paid for a PSMA scan and it picked up cancer cells in some of my lymph nodes.  My SRT therefore targeted these nodes as well as the general prostate bed.  I was put on HT for 18 months which covered pre and post SRT.  PSA is now <0.006.

Even though I’ve been through some of the same things as your husband, i don’t know enough to say what might be going on.  If you haven’t done so, call the specialist nurses from this site.  They are brilliant and will hopefully be able to guide you.