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PSA rising steadily

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User
Posted 18 Feb 2022 at 21:18

Hi Guys,

It has been a long time since I was a regular contributor to these conversations, but my PSA is slowly but surely creeping up and I wonder if anyone else is in the same boat?

In a nutshell I was diagnosed back in 2007 locally advanced G9T3N?  At that time EBRT was offered on a curative basis , I was given 60/40 odds, and once I came off HT it was clear that things weren't perfect, PSA rising from 0.2 to 6.2 between 2011-13.  I was lucky to be offered salvage HDRBrachytherapy, and after that in 2015, and coming off HT again in 2016 things looked good.  It took 5 years for my PSA to rise to 1, but it is now rising steadily 2.7 with a doubling rate of about 12 months.

Had a chat with the consultant today, he agrees with me, my PSA falls into the 'neither nowt nor sumat' category, its not really rising rapidly enough to be a concern, but its rising too fast for comfort.

Your thoughts would be appreciated.

User
Posted 18 Feb 2022 at 21:18

Hi Guys,

It has been a long time since I was a regular contributor to these conversations, but my PSA is slowly but surely creeping up and I wonder if anyone else is in the same boat?

In a nutshell I was diagnosed back in 2007 locally advanced G9T3N?  At that time EBRT was offered on a curative basis , I was given 60/40 odds, and once I came off HT it was clear that things weren't perfect, PSA rising from 0.2 to 6.2 between 2011-13.  I was lucky to be offered salvage HDRBrachytherapy, and after that in 2015, and coming off HT again in 2016 things looked good.  It took 5 years for my PSA to rise to 1, but it is now rising steadily 2.7 with a doubling rate of about 12 months.

Had a chat with the consultant today, he agrees with me, my PSA falls into the 'neither nowt nor sumat' category, its not really rising rapidly enough to be a concern, but its rising too fast for comfort.

Your thoughts would be appreciated.

User
Posted 18 Feb 2022 at 23:37
Obviously not good to see you back, Dave but good to know that you are still alive & kicking and haven't been wiped out in the pandemic.

If you were my man, we would be marching down to the hospital to ask for a PET scan - PSMA is one possibility but with a PSA of 2.7 if PSMA isn't easily available I would accept a choline scan first in the hope that it picks up the problem area. Once you know where it is, you have a better idea of next steps.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 19 Feb 2022 at 09:18

Hi Dave 
When my Psa started to rise from 0.04  in 2016 mine was doubling every psa test it got to 3.1 had a scan and I had three hot spots , I asked for early Chemo and got it , that was in Oct 2017 , six sessions 
and back on HT I was good for three years , then came of HT for a break but in a year it is now 4,6 and I am back in for a PSMA PET/CT SCAN next Tuesday , I will be asking about another go at chemo 
But My Profile will tell you more 

Good Luck 

Regards Barry

User
Posted 18 May 2022 at 21:09

Just an update, my latest PSA test has fallen back to 2.1, from a highpoint of 2.7 just 3 months ago.   My consultant is happy and has scotched all talk of scans and HT.

One thing that perplexes me is why it has fallen?  Having received external beam RT and then salvage HDR Brachytherapy my prostate, or what was left of it, was in a pretty poor state.  But it is now over 6 years since I received any sort of treatment.  During that time my PSA has slowly risen from a mere 0.2 to 2.6 this spring, and it has been a constant steady rise, (the only drops falling within the +/- 0.1 range).  So I fondly imagined that my good prostate cells were slowly growing and rebuilding and this accounted for the slow steady rise in my PSA.

But what I wonder has caused it to fall from 2.7 to 2.1? 

User
Posted 18 May 2022 at 21:33

Well that is a nice result. I don't think I'd be asking questions, I'd just have a quiet celebration and get on with enjoying life.

Dave

User
Posted 19 May 2022 at 01:29
In many men PSA post treatment does rise and fall slightly for no obvious reason, but a dramatic increase at one test, or the general trend being upward, gives an indication of how cancer cells are progressing over time. In my case there has been an increase at every PSA test since the first one after HIFU in 2015, except for one following a template biopsy when it fell. I put this considerable fall down to part of the tumour having been removed in needle cores but can't be sure this was the case. PSA then started to increase again, slowly but persistently, until my second HIFU in December 2021, after which it fell substantially as one would hope following treatment (to 0.02). So this will be a new reference point for me.

There does not appear any obvious reason for quite a substantial drop in your PSA Dave but it could be your increases and decreases are going to be wider apart for awhile. We know that this sometimes happens. Update us after your next PSA test.

Barry
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User
Posted 18 Feb 2022 at 23:37
Obviously not good to see you back, Dave but good to know that you are still alive & kicking and haven't been wiped out in the pandemic.

If you were my man, we would be marching down to the hospital to ask for a PET scan - PSMA is one possibility but with a PSA of 2.7 if PSMA isn't easily available I would accept a choline scan first in the hope that it picks up the problem area. Once you know where it is, you have a better idea of next steps.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 19 Feb 2022 at 09:18

Hi Dave 
When my Psa started to rise from 0.04  in 2016 mine was doubling every psa test it got to 3.1 had a scan and I had three hot spots , I asked for early Chemo and got it , that was in Oct 2017 , six sessions 
and back on HT I was good for three years , then came of HT for a break but in a year it is now 4,6 and I am back in for a PSMA PET/CT SCAN next Tuesday , I will be asking about another go at chemo 
But My Profile will tell you more 

Good Luck 

Regards Barry

User
Posted 19 Feb 2022 at 17:59

My consultant discussed PET scan and HT, and its on the agenda if the PSA starts to rise rapidly.  At the moment the rise in PSA is steady but not accelerating, so presumably some of the increase is due to regrowth of healthy prostate tissue?  I have noticed a slow but steady improvement in my fitness since I have come off HT.  5 years ago I was using those arthritic aids to open cans and bottles, now I don't need them, its the same in the bedroom where i have regained some functionality, so as you can guess I am not keen to go back on HT. 

   

User
Posted 20 Feb 2022 at 00:02
Good recovery markers - even if you do need HT again in the future, hopefully you will have a good few years of opening your own jars first!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 18 May 2022 at 21:09

Just an update, my latest PSA test has fallen back to 2.1, from a highpoint of 2.7 just 3 months ago.   My consultant is happy and has scotched all talk of scans and HT.

One thing that perplexes me is why it has fallen?  Having received external beam RT and then salvage HDR Brachytherapy my prostate, or what was left of it, was in a pretty poor state.  But it is now over 6 years since I received any sort of treatment.  During that time my PSA has slowly risen from a mere 0.2 to 2.6 this spring, and it has been a constant steady rise, (the only drops falling within the +/- 0.1 range).  So I fondly imagined that my good prostate cells were slowly growing and rebuilding and this accounted for the slow steady rise in my PSA.

But what I wonder has caused it to fall from 2.7 to 2.1? 

User
Posted 18 May 2022 at 21:33

Well that is a nice result. I don't think I'd be asking questions, I'd just have a quiet celebration and get on with enjoying life.

Dave

User
Posted 19 May 2022 at 01:29
In many men PSA post treatment does rise and fall slightly for no obvious reason, but a dramatic increase at one test, or the general trend being upward, gives an indication of how cancer cells are progressing over time. In my case there has been an increase at every PSA test since the first one after HIFU in 2015, except for one following a template biopsy when it fell. I put this considerable fall down to part of the tumour having been removed in needle cores but can't be sure this was the case. PSA then started to increase again, slowly but persistently, until my second HIFU in December 2021, after which it fell substantially as one would hope following treatment (to 0.02). So this will be a new reference point for me.

There does not appear any obvious reason for quite a substantial drop in your PSA Dave but it could be your increases and decreases are going to be wider apart for awhile. We know that this sometimes happens. Update us after your next PSA test.

Barry
User
Posted 28 Dec 2023 at 22:08

Hi Barry,

My father is in similar situation where his psa is doubling every month now. Diagnosed in june 2022 with metastatic spread to bones, went through chemo and then on HT .

in last few tests his psa is (monthly tests) 0.04 -> 0.58 -> 1.850 and now 2.550 (dec 2023).

Do you think in this case chemo again and continue HT (abiraterone) will help?

 
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