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PSA increase?

User
Posted 29 Sep 2020 at 17:24

Hi all, results today of recent blood test...... PSA 0.18.     Up from 0.11 in January. Nearly five years since my prostatectomy. Onco urging me to have radiotherapy. Opinions please guys. 

User
Posted 29 Sep 2020 at 21:16
In general, if the PSA drops low straight after RP and then climbs slowly, that is fairly typical of stray cells left in the prostate bed. If the PSA is high post op and / or climbs quickly, it is indicative of mets. On that basis, it appears that RT has a very good chance in your case.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 30 Sep 2020 at 02:04
Yes, I would be looking at a Gallium 68 PET-PSMA scan (more accurate than a cheaper Choline scan) soon, but you would have to travel to get one, as only a few places offer it. That’s so Dan Dare the radiologist knows where to aim his ray-gun.

Even then it might not pick up anything. You might start on hormone tablets and see how your PSA is in a few months time.

Best of luck.

Cheers, John.

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User
Posted 29 Sep 2020 at 19:58
Onco urging is pretty strong. Has it been said the RT would be to the Prostate bed which seems most likely? Much depends on the experience of you onco and your trust in him/her because other than the PSA there is not a lot for him/her to go on. It's very unlikely that cancer cells would show up on a scan at this level.

It would be helpful if you put your diagnosis and histology briefly and in an ongoing way under your bio. Various bits of information just given in threads tends to become lost over time and having this all in one place helps responders more readily know your situation and can sometimes enable a more suitable reply.

Barry
User
Posted 29 Sep 2020 at 20:08

Yes to the prostate bed. Had rp five years ago.

User
Posted 29 Sep 2020 at 21:16
In general, if the PSA drops low straight after RP and then climbs slowly, that is fairly typical of stray cells left in the prostate bed. If the PSA is high post op and / or climbs quickly, it is indicative of mets. On that basis, it appears that RT has a very good chance in your case.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 29 Sep 2020 at 21:24

Thank you Lyn, that’s encouraging.

User
Posted 29 Sep 2020 at 22:28
What was your final pathology and Gleason score?
User
Posted 29 Sep 2020 at 22:55

Gleason 4+3,stage t2c/3aN0Mx. Psa pre surgery 11.46

User
Posted 29 Sep 2020 at 23:22
Might be worth asking about a PET scan in case there are any lymph nodes involved outside the normal field for SRT. It certainly changed Ulsterman s treatment to include areas that would not have been treated.

If you can't get one don't dwell on it you still have a great chance of a durable remission.

User
Posted 29 Sep 2020 at 23:30

Thank you, would there be a contrast dye involved in the scan? Reason I ask is I only have 7% kidney function and am not yet on dialysis.

User
Posted 29 Sep 2020 at 23:51
It's a radio isotope infusion like a bone scan. I don't know if it's contraindicated..
User
Posted 30 Sep 2020 at 02:04
Yes, I would be looking at a Gallium 68 PET-PSMA scan (more accurate than a cheaper Choline scan) soon, but you would have to travel to get one, as only a few places offer it. That’s so Dan Dare the radiologist knows where to aim his ray-gun.

Even then it might not pick up anything. You might start on hormone tablets and see how your PSA is in a few months time.

Best of luck.

Cheers, John.

 
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