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Psa rise after salvage radiotherapy

User
Posted 14 Apr 2020 at 22:29

Hi!

 

my husband has had RP in 2018 - he had a Gleason score of 7 at the time- then he more or less straightaway had biochemical recurrence ( looking back now I think it was actually that cancer had spread) 

He then had ht and salvage radiotherapy  with ht for a year after.His psa was undetectable after this-great! But now 9 months in it has risen from nothing to 0.1 and lastly 0.2. 

when he had his initial rp the surgeon rang me at home to say all went well but that he had difficulty locating the lymph nodes in pelvis as it ‘was a mess in there’ which made surgery more complicated.This was because my husband had a serious car crash a few years back and fractured his pelvis 

Does anyone know what will happen next? He is due another psa test in 5 weeks but I think we both know it will have gone up again.

 

User
Posted 15 Apr 2020 at 00:23

Blossom

There are a few of us on here at the moment in very similar situations. A scan would be one possible option but the scans success in detecting the location of the cancer varies depending on how the cancer presents itself. My last test was 0.34 and I am now waiting until my PSA exceeds 1 before having a scan.

Thanks Chris

Edited by member 15 Apr 2020 at 00:25  | Reason: Not specified

User
Posted 15 Apr 2020 at 07:33

Push for a scan like Chris said. However, if you can get a PSMA PET scan, it can be done at a lower PSA level.

In my view, a PET scan should be routine before any salvage RT. Maybe one day it will be.

User
Posted 15 Apr 2020 at 07:36
Blossom,

‘They’ do say that in his situation a Gallium 68 PET-PSMA scan might be appropriate (that’s if you can get one on the NHS, otherwise £2600 in UK, £400 in India), as that may pinpoint the tumour(s) and enable further targeted radiotherapy to attempt to kill off the cancer once and for all.

As Chris says, this is only successful if the cancer is large enough to be spotted on the scan.

Best of luck.

Cheers, John.

User
Posted 15 Apr 2020 at 10:14

Blossom, sorry to read that PSA is rising again after salvage treatment. I think it is likely the next move will be a return to HT once his PSA reaches a level agreed between the oncologist and yourselves. Much depends on the PSA velocity. Before any return to HT a PET scan would seem sensible to see where any recurrence is.

It is always a huge blow when things seem to be going well and then PSA starts moving again.

 

 

Ido4

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User
Posted 15 Apr 2020 at 00:23

Blossom

There are a few of us on here at the moment in very similar situations. A scan would be one possible option but the scans success in detecting the location of the cancer varies depending on how the cancer presents itself. My last test was 0.34 and I am now waiting until my PSA exceeds 1 before having a scan.

Thanks Chris

Edited by member 15 Apr 2020 at 00:25  | Reason: Not specified

User
Posted 15 Apr 2020 at 07:33

Push for a scan like Chris said. However, if you can get a PSMA PET scan, it can be done at a lower PSA level.

In my view, a PET scan should be routine before any salvage RT. Maybe one day it will be.

User
Posted 15 Apr 2020 at 07:36
Blossom,

‘They’ do say that in his situation a Gallium 68 PET-PSMA scan might be appropriate (that’s if you can get one on the NHS, otherwise £2600 in UK, £400 in India), as that may pinpoint the tumour(s) and enable further targeted radiotherapy to attempt to kill off the cancer once and for all.

As Chris says, this is only successful if the cancer is large enough to be spotted on the scan.

Best of luck.

Cheers, John.

User
Posted 15 Apr 2020 at 10:14

Blossom, sorry to read that PSA is rising again after salvage treatment. I think it is likely the next move will be a return to HT once his PSA reaches a level agreed between the oncologist and yourselves. Much depends on the PSA velocity. Before any return to HT a PET scan would seem sensible to see where any recurrence is.

It is always a huge blow when things seem to be going well and then PSA starts moving again.

 

 

Ido4

User
Posted 15 Apr 2020 at 11:58
Thank you for getting back to me.It has always been about velocity with psa rather than actual psa numbers- he didn’t have any pc symptoms other than he wet the bed twice over a period of a year- his father died from aggressive pc quite a few years back so that is the only reason our fantastic go insisted he was seen by consultant.his highest psa was 6! But doubling time and velocity high

I knew it was a question of when not if- but we are both excellent at pretending it’s not happening and we will both just crack on again!

I had cancer two years before my husband so we seem to understand how we both deal with it

 
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