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Rising lelel of PSA post-RP

User
Posted 24 Feb 2022 at 13:36






I have a question for those that have had a radical prostatectomy.

Following prostate removal, has your PSA level ever increased from a very low level, to a level that has necessitated salvage radiotherapy, or has it ever reversed its direction of travel, staving off the inevitable further treatment?

 

Thanks for any replies.






User
Posted 24 Feb 2022 at 18:04
Depends how low you are talking- tiny rises at 2 or 3 decimal places can be meaningless but if your PSA goes above 0.1 and then keeps rising, you have a problem. Since salvage RT, John's PSA has bobbed around between <0.1 and 0.11 so onco view is that there is either still a bit of cancer but it is snoozing OR he just has a high 'normal' level of PSA 🤷‍♀️
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Feb 2022 at 20:49

 Bernster.


Can you put some dates to the PSA results. I would still want another test before starting SRT


Lyn, i think you may have read the 0.2 as 2.0.


Thanks Chris


 


 

Edited by member 24 Feb 2022 at 20:56  | Reason: Not specified

User
Posted 24 Feb 2022 at 21:39
In response to the original question, my PSA after the operation eventually drifted up into the measurable range (>0.05 in my hospital) but then seemed to stall in the "teens" for well over a year. The consultant said it was conceivable that there was a bit of normal tissue remaining that had regained activity but wasn't going anywhere.

However after about 5 readings the rise got going again, and with a couple of results above the critical 0.2 value I am in line for salvage RT. Currently on hormone therapy. Things have been delayed a bit - a couple of days before the initial oncology consultation I had happened to have a bit of bleeding from the rectum, not experienced before.. I obviously mentioned it when asked, and it meant I got referred for colonoscopy which took a little while (should be rapid, but Omicron) but found a large polyp in the rectum. Discussed with the oncology consultant yesterday. Everything is now delayed more while I await polyp removal and then time for wound recovery before radiotherapy. Essentially it means I need to stay on the hormones longer, but they have brought down the PSA reading so I am hoping the cancer cells have gone back to sleep.

(Polyp not a good thing to have - first it wouldn't be good to spray ionising radiation on tissue that is already not normal, and second the effect of radiation might make it more difficult to remove subsequently).

Anyway Bernster, here's hoping your PSA isn't doing too much. Either staying put, or at least rising so slowly that it can be dealt with with good chance of success.
User
Posted 24 Feb 2022 at 22:19

Originally Posted by: Online Community Member


 


Lyn, i think you may have read the 0.2 as 2.0.


Thanks Chris



A typo, Chris ... fat fingers, small keyboard 🙄

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
Show Most Thanked Posts
User
Posted 24 Feb 2022 at 18:04
Depends how low you are talking- tiny rises at 2 or 3 decimal places can be meaningless but if your PSA goes above 0.1 and then keeps rising, you have a problem. Since salvage RT, John's PSA has bobbed around between <0.1 and 0.11 so onco view is that there is either still a bit of cancer but it is snoozing OR he just has a high 'normal' level of PSA 🤷‍♀️
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Feb 2022 at 19:07

Originally Posted by: Online Community Member
Depends how low you are talking- tiny rises at 2 or 3 decimal places can be meaningless but if your PSA goes above 0.1 and then keeps rising, you have a problem. Since salvage RT, John's PSA has bobbed around between <0.1 and 0.11 so onco view is that there is either still a bit of cancer but it is snoozing OR he just has a high 'normal' level of PSA 🤷‍♀️


 


Mine has gone, over a period of one year, from: undetectable -> 0.04 -> 0.14 (an increase of 350%!) and was told if it continues to rise and exceeds 0.2, RT and hormone treatment will be considered. I just wondered if it ever reverses direction, when having no treatment?

User
Posted 24 Feb 2022 at 19:50

No - once it is over 0.14 you have a biochemical recurrence. It might be possible to get the PSA lower with diet or supplements but all that would do is nask the problem, not solve it. Surprised that your doctors want to wait until you reach 0.2 - in many areas of the country, salvage HT / RT would be starting now. Has your urologist referred you to oncology? Don't let him / her drag their heels :-/

Edited by member 24 Feb 2022 at 22:20  | Reason: Fat fingers

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Feb 2022 at 20:49

 Bernster.


Can you put some dates to the PSA results. I would still want another test before starting SRT


Lyn, i think you may have read the 0.2 as 2.0.


Thanks Chris


 


 

Edited by member 24 Feb 2022 at 20:56  | Reason: Not specified

User
Posted 24 Feb 2022 at 21:39
In response to the original question, my PSA after the operation eventually drifted up into the measurable range (>0.05 in my hospital) but then seemed to stall in the "teens" for well over a year. The consultant said it was conceivable that there was a bit of normal tissue remaining that had regained activity but wasn't going anywhere.

However after about 5 readings the rise got going again, and with a couple of results above the critical 0.2 value I am in line for salvage RT. Currently on hormone therapy. Things have been delayed a bit - a couple of days before the initial oncology consultation I had happened to have a bit of bleeding from the rectum, not experienced before.. I obviously mentioned it when asked, and it meant I got referred for colonoscopy which took a little while (should be rapid, but Omicron) but found a large polyp in the rectum. Discussed with the oncology consultant yesterday. Everything is now delayed more while I await polyp removal and then time for wound recovery before radiotherapy. Essentially it means I need to stay on the hormones longer, but they have brought down the PSA reading so I am hoping the cancer cells have gone back to sleep.

(Polyp not a good thing to have - first it wouldn't be good to spray ionising radiation on tissue that is already not normal, and second the effect of radiation might make it more difficult to remove subsequently).

Anyway Bernster, here's hoping your PSA isn't doing too much. Either staying put, or at least rising so slowly that it can be dealt with with good chance of success.
User
Posted 24 Feb 2022 at 22:19

Originally Posted by: Online Community Member


 


Lyn, i think you may have read the 0.2 as 2.0.


Thanks Chris



A typo, Chris ... fat fingers, small keyboard 🙄

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 24 Feb 2022 at 23:27

Originally Posted by: Online Community Member


 Bernster.


Can you put some dates to the PSA results. I would still want another test before starting SRT


Lyn, i think you may have read the 0.2 as 2.0.


Thanks Chris


 


In answer to your question, it was roughly 4 months between each reading.


User
Posted 24 Feb 2022 at 23:29

Originally Posted by: Online Community Member
In response to the original question, my PSA after the operation eventually drifted up into the measurable range (>0.05 in my hospital) but then seemed to stall in the "teens" for well over a year. The consultant said it was conceivable that there was a bit of normal tissue remaining that had regained activity but wasn't going anywhere.

However after about 5 readings the rise got going again, and with a couple of results above the critical 0.2 value I am in line for salvage RT. Currently on hormone therapy. Things have been delayed a bit - a couple of days before the initial oncology consultation I had happened to have a bit of bleeding from the rectum, not experienced before.. I obviously mentioned it when asked, and it meant I got referred for colonoscopy which took a little while (should be rapid, but Omicron) but found a large polyp in the rectum. Discussed with the oncology consultant yesterday. Everything is now delayed more while I await polyp removal and then time for wound recovery before radiotherapy. Essentially it means I need to stay on the hormones longer, but they have brought down the PSA reading so I am hoping the cancer cells have gone back to sleep.

(Polyp not a good thing to have - first it wouldn't be good to spray ionising radiation on tissue that is already not normal, and second the effect of radiation might make it more difficult to remove subsequently).

Anyway Bernster, here's hoping your PSA isn't doing too much. Either staying put, or at least rising so slowly that it can be dealt with with good chance of success.


 


I had a polyp removed after a colonoscopy 3 years ago before PC was diagnosed. A repeat colonoscopy is due but I guess has been delayed by Covid-19. Worrying to hear and out polyp complications.

 
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