Raised PSA fears

Sorry to read this, I would ask for a quicker retest if hot were me, say 2 weeks or so. What do others think? Three months seems a long time to wait when a rise like that has been recorded. 

Okay, the fact that PSA has gone above 2.1 is worrying and suggests that there has been a recurrence although it is not absolutely certain yet. There is such a thing as bounce which nay come after any form of RT but 3.8 isn't just a bounce.

After the next PSA in 3 months time, there will be some discussion about potential next steps. Ideally they will offer a decent quality scan to identify where any active cancer clusters are. The skill of a good oncologist is in knowing how long to wait before restarting the hormones - some oncos say when the PSA reaches 5 while others would recommend waiting until it reaches 10 or even higher.

Edited by member 13 May 2021 at 18:00  | Reason: Not specified

So here we are 3 months on and PSA result today was 12.6. We have our review with the specialist nurse on Friday. Could you help me with questions to ask and procedures to expect. Husband thinks he will go back on hormone therapy. Appreciate any support and I’m strong so don’t hold back. Hoping others have walked this road and can help ? Thank you

He has ulcerative colitis, that is becoming more controlled after restarting infusions. A very healthy appetite, no weight loss, only other niggle is neck shoulder pain but he put that down to work and computer screens all day.

Edited by member 21 Jul 2021 at 16:19  | Reason: Not specified

Hi Karen,

I can see the rise in you Husbands Psa is a worry as it would with all of us.I had my Brachytherpy in 2016 with different numbers and it took coming up to five years to get my Psa down to 0.08 as it is at the moment and next Psa in September but i did not have a bounce in that time maybe because it has taken five years to drop.

I think three months is a long time if like me you are a worrier so maybe ask if you could have a earlier Psa test as it is only a blood test and doesn't tie the health up too much.

Regards John.

A PET scan may pick up active cancer clusters wherever they are ... prostate bed, lymph, soft organs or bone. There are a number of different tracers used now in the UK for PET scanning; choline was the bees knees until recently but has been overtaken by Gallium, F18, 18F among others. You will hear some of these referred to as PSMA scans.

The prostate bed is a common place for recurrence; either cells left behind after surgery or new tumours in an irradiated prostate. Prostate bed just means the space where the prostate is/was and immediately around that space. 

Until fairly recently, chemo was only offered at the end stage because chemo doesn't kill prostate cancer. More recently it has been realised that chemo given early can make the hormones much more effective for longer. Many oncos are up with the game and will offer it if they think appropriate but there are still some old fashioned practitioners out there who seem unaware of the research. Why would some men resist? It is a dangerous treatment - most men seem to cope very well with docetaxel (the most common prostate cancer chemo) but like any chemotherapy, an infection can kill so important to monitor temperature, stay away from the public at key times, etc. For obvious reasons, chemo is more dangerous during a pandemic and some hospitals have simply not offered it. NICE has approved an alternative to chemo during the pandemic so that may also be part of your conversation with the onco.

Just to follow up we are now waiting for bone and CT scan (I asked why not PET and can’t remember why it’s a no) and repeat bloods and then appt with oncologist so by my thinking we will be in the dark for at least another month. 
Husband bought a new bike and has put some miles in the last few months. Apparently the seat aggravates the prostate, could explain things … grasping at straws maybe … hey ho ! 
Thank you your support. I’ll update once we have some results.

From a consultant family friend Lynn. Let’s face it you mention prostate cancer and everyone’s a bloomin expert. The number of people who’ve said my dad, brother, Uncle Tom Dick and Harry has had it and they’re ok ! Youve got to laugh. 

Best of luck.

Cheers, John.