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Biological Recurrence?

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User
Posted 02 Mar 2022 at 14:39

Thanks in advance for reading..


As in my profile,Post op PSA was stable for 2 years since Feb 2018, when I had RP.


Became detectable in July 2019, at 0.03


Now it has gone from .05 in March 2021 , to .06 in December 2021, to 0.07 in Feb 2022


Is 3 successive rises Biological Recurrence, or is that counted only when 0.1 is exceeded?


Nurse has referred me back to the onco surgeon, but I wonder if anyone has had a similar rise, and what treatments they were offered.


Can anyone share their experience?
obviously worried


Thanks again…


 

User
Posted 02 Mar 2022 at 19:49
A biochemical recurrence post-surgery is defined as a PSA of 0.2 or more OR three successive rises above 0.1

Your trend is fairly consistent so in all likelihood you will end up with salvage treatment at some point but it is not a certainty at the moment - you may just have quite a high 'healthy' PSA which stabilises at or around 0.1 ... John had surgery 12 years ago and salvage RT 10 years ago and his PSA has been bobbing along between <0.1 and 0.11 ever since!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 02 Mar 2022 at 22:48

Antony, the first part of my profile lists my PSA progress. The contents of the profile doesn't make good reading, but I have adapted to my new norm and some of the side effects are rare.


Treatments are improving all the time and there probably are better options available.


Your more sensitive testing at least lets you know what is happening.


Thanks Chris


 

User
Posted 02 Mar 2022 at 23:20
My figures are similar albeit taking 7 years to get there.

I have just been for a PSMA PET scan and am currently waiting for the results.

My onco said 3 consecutive rises now counts as a recurrence but he and the second opinion I had said it was safe to wait until 0.2 to pull the trigger on further treatment.

I had the option of the scan as I have private cover from work. Apparently it won't be generally available on the NHS until later this year..
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User
Posted 02 Mar 2022 at 19:49
A biochemical recurrence post-surgery is defined as a PSA of 0.2 or more OR three successive rises above 0.1

Your trend is fairly consistent so in all likelihood you will end up with salvage treatment at some point but it is not a certainty at the moment - you may just have quite a high 'healthy' PSA which stabilises at or around 0.1 ... John had surgery 12 years ago and salvage RT 10 years ago and his PSA has been bobbing along between <0.1 and 0.11 ever since!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 02 Mar 2022 at 22:48

Antony, the first part of my profile lists my PSA progress. The contents of the profile doesn't make good reading, but I have adapted to my new norm and some of the side effects are rare.


Treatments are improving all the time and there probably are better options available.


Your more sensitive testing at least lets you know what is happening.


Thanks Chris


 

User
Posted 02 Mar 2022 at 23:20
My figures are similar albeit taking 7 years to get there.

I have just been for a PSMA PET scan and am currently waiting for the results.

My onco said 3 consecutive rises now counts as a recurrence but he and the second opinion I had said it was safe to wait until 0.2 to pull the trigger on further treatment.

I had the option of the scan as I have private cover from work. Apparently it won't be generally available on the NHS until later this year..
User
Posted 03 Mar 2022 at 21:52

Hi,


As has been said it might stabilise.


From what I've read if it continues you will likely have hormone treatment for a while then radiotherapy followed by more hormones.     


Some don't get hormones before if the psa is very low.   


I tried a nomigram using different assumptions for me, with a 4+4 Gleason.  Having hormones made a dramatic improvement in the probability of 7 years without further recurrance.


There might be other treatments but they often assume the recurrance is in the prostate bed, which it often is if the rise is slow.   Sometimes they do a psma scan to check and find if there are any stray growths that can be captured during the radiotherapy.


Mine crept over the undetectable threshold of <0.05 last December and I await another psa test in late April.  If it only goes up by 0.01 I'll accept that as it's standard at many hospitals to only tell you when it gets to 0.1.  So far I seem to be far more relaxed than I expected but worries might strike nearer the date.


All the best,
Peter

Edited by member 03 Mar 2022 at 21:56  | Reason: Not specified

 
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