PSA rise after radical prostatectomy

User

Posted 28 May 2022 at 00:07

I was diagnosed with advanced prostate cancer, Gleason 9, in late 2016 and had a radical prostatectomy. Some months later after my PSA increased the cancer was detected in a lymph node. Radiotherapy followed and hormone tablets for a few years. About 12 months ago, my PSA increased so I now have Zoladex injections. In recent months my PSA has increased from 0.17, to 0.30 and most recently to 0.55. Is this likely to be an indication that the cancer is returning?

User

Posted 28 May 2022 at 10:36

Steve, sorry to hear this, I am one step behind you, at what level of PSA did you start zoladex.

I am sure our experts will be able to answer your question.

Thanks Chris

User

Posted 28 May 2022 at 12:06

Chris, my consultant told me that the Biculatimide tablets would start losing their effect after 3- 3 1/2 years, he was right and PSA role from 0.001, up to 0.2, then I went on Zoladex infections. PSA dropped and has started rising again, within 12 months. Now at 0.55

User

Posted 28 May 2022 at 12:34

You should ask for a PSMA PET scan to find where the cancer cells are.

Then they can decide what treatment would be suitable.

User

Posted 28 May 2022 at 13:09

I’ve just had a CT scan of the pelvis. Waiting on the results now

User

Posted 28 May 2022 at 13:19

Steve , I haven't had any HT, my PSA started to rise after Salvage RT and is now 1.4. I had a CT and bone scan a few weeks ago that was part of a trial, that didn't show anything. I am expecting to get an appointment for a PSMA scan within the next few weeks.

Thanks Chris

User

Posted 28 May 2022 at 14:10

The cancer had already returned a year ago which is why they decided to start you on Zoladex.

I don't think a scan makes much difference to your situation - what is more important is to understand why your pSA is rising so soon after you started Zoladex. A testosterone test would indicate whether the cancer has become hormone refractory (in which case they may suggest chemo or adding enzalutimide, abiraterone or apalutimide) or the zoladex just isn't working well enough (in which case they may put you back onto the bicalutimide tablets).

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

User

Posted 28 May 2022 at 20:17

Thank you. I will ask about the testosterone test as the nurse discussed the cancer becoming hormone refractory. My last scan 12 months ago, showed nothing of concern. The doctor suggested that the cancer is ‘microscopic particles’ which could not be localised. This scan may show something different. I guess it’s a waiting game until the next meeting with the consultant.

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