I'm interested in conversations about and I want to talk about
Know exactly what you want?
Show search

Notification

Error

Gradual PSA rise post RP op

User
Posted 22 Jul 2022 at 11:04

Hi all

I’m interested in views/experience of rising PSA after robotic surgery.  My husband had op 3 years ago in June ‘19 and first psa was undetectable, after 4 months it was 0.02 but we were told not to be concerned. However over last 3 years of being tested between 3/6 monthly it is now at 0.16. Originally from scans etc they were confident it was confined to p gland. The protocol at the RM seems to be to wait until 0.2 to scan to see what’s going on. I’ve gleaned from this forum that some seem to go for RT despite scans being clear - there’s so much to read and just wondered about any others experience? Thank you 

User
Posted 22 Jul 2022 at 13:03

How, welcome to the forum no one wants to be on. His slow rise is not an unusual story for men on here. Salvage RT is a typical next treatment. Some guys are getting PSMA scans before SRT , other men are still getting SRT based on a very educated guess and years of experience. The trigger for SRT used to be 0.2 but of late that value seems to vary.  Picking up hot spots at 0.2 is difficult, even with the better scans. 

Give the nurses on this site a call, they are brilliant, 08000748383. 

Thanks Chris 

User
Posted 23 Jul 2022 at 22:34

In 3 years it's gone from 0.02 to 0.16.

0.02  > 0.04 > 0.08 > 0.16  is the doubling rate.  So it's doubling approx every year although it might not have risen like that and perhaps the gap of the last result is more significant.   That's fairly slow which is usually not bad.   I find it hard to say good as it's never good,  although it's in the better zone.

Has he been referred to Oncology from Urology. 

As said above he's getting close to the point where a scan will be more meaningful although it's always a trade off between letting the psa rise to make the scan more accurate and having treatment as soon as possible.   

I think with your husband's rise it's likely to be less of a gamble to say the recurrance is in the prostate bed and they could aim the RT at that without a scan.  That was and still is a common way of doing it although modern PSMA scans are now changing it so that people have a psma scan first.  Scans are normally better at finding one larger lesion at lower psa levels than a few smaller ones. 

 I'm not at all qualified to say.  Some people have found a scan redirected their treatment so it's a choice for you and the skill of the oncologist.  I think I'm going to be in this situation and think I'll ask for a scan at a low level or pay for one but want to hear what the Oncologist says.  I'm still with Urology as it hasn't got that high yet.  Hope it's good for you.  Regards Peter 

Show Most Thanked Posts
User
Posted 22 Jul 2022 at 13:03

How, welcome to the forum no one wants to be on. His slow rise is not an unusual story for men on here. Salvage RT is a typical next treatment. Some guys are getting PSMA scans before SRT , other men are still getting SRT based on a very educated guess and years of experience. The trigger for SRT used to be 0.2 but of late that value seems to vary.  Picking up hot spots at 0.2 is difficult, even with the better scans. 

Give the nurses on this site a call, they are brilliant, 08000748383. 

Thanks Chris 

User
Posted 22 Jul 2022 at 13:34

Thank you chris

User
Posted 23 Jul 2022 at 22:34

In 3 years it's gone from 0.02 to 0.16.

0.02  > 0.04 > 0.08 > 0.16  is the doubling rate.  So it's doubling approx every year although it might not have risen like that and perhaps the gap of the last result is more significant.   That's fairly slow which is usually not bad.   I find it hard to say good as it's never good,  although it's in the better zone.

Has he been referred to Oncology from Urology. 

As said above he's getting close to the point where a scan will be more meaningful although it's always a trade off between letting the psa rise to make the scan more accurate and having treatment as soon as possible.   

I think with your husband's rise it's likely to be less of a gamble to say the recurrance is in the prostate bed and they could aim the RT at that without a scan.  That was and still is a common way of doing it although modern PSMA scans are now changing it so that people have a psma scan first.  Scans are normally better at finding one larger lesion at lower psa levels than a few smaller ones. 

 I'm not at all qualified to say.  Some people have found a scan redirected their treatment so it's a choice for you and the skill of the oncologist.  I think I'm going to be in this situation and think I'll ask for a scan at a low level or pay for one but want to hear what the Oncologist says.  I'm still with Urology as it hasn't got that high yet.  Hope it's good for you.  Regards Peter 

User
Posted 25 Jul 2022 at 11:24

Thanks Peter. Still with urology but will ask about oncology referral at next test, even if it hasn’t quite reached .2.  As you say I think it will be a gamble but good to be armed with the knowledge etc. The rises have been gradual 0.02, 0.03, 0.04- like this to 0.09, then drop to 0.08 and stayed the same and then .11 and now .16. 
Im doubting whether a scan will show anything but just wanted to be a bit more aware and am very grateful that people are happy to share on this forum.

thanks

User
Posted 17 Jan 2023 at 14:50

After a continued rise in PSA it does appear that my husband has had a biochemical recurrence after 3& a half years post robotic surgery (psa 0.14). He is now looking at 20 radiotherapy sessions to prostate bed (no HT beforehand)   Today offered to consider a trial to use a ProSpace device  which seems to be like a spacer to move bowel back during each radiation session. Does anybody have any experience or advice with this please? It’s a lot to take in when not expecting this news as first time with oncology as opposed to regular urology  appointments- thank you .

Edited by member 17 Jan 2023 at 14:51  | Reason: Not specified

User
Posted 17 Jan 2023 at 22:44

I'm confused. ProSpace was the name of the balloon rectal spacer which was used before SpaceOAR came on the scene. The Rutherford Cancer Centres used it I think (certainly they used one of the balloon types of spacer). Maybe the name is being used for something different now?

Also, you can't normally have a rectal spacer if you have no prostate, since it pushes the prostate and the rectum apart by 1cm, but without a prostate, there's nothing to push apart.

Maybe this is something different from what I'm imagining?

User
Posted 18 Jan 2023 at 00:02

I think it is a trial of Prospare - a device is placed up the bum for each RT session to sit where the prostate should have been.

HOW, I can't think if any other member here who has mentioned this trial so your husband could be our trailblazer!!!

Edited by member 18 Jan 2023 at 00:04  | Reason: Not specified

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

User
Posted 18 Jan 2023 at 00:02

Prospare trial (POPS) details

https://www.cancerresearchuk.org/about-cancer/find-a-clinical-trial/study-looking-at-device-to-help-reduce-side-effects-from-prostate-cancer-radiotherapy-after-surgery-pops#undefined

 

Edited by member 18 Jan 2023 at 00:04  | Reason: To activate hyperlink

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

User
Posted 18 Jan 2023 at 14:51

Sorry, it is ProSpare and it’s what Lynn has spotted! Thanks for replying all the same

User
Posted 18 Jan 2023 at 14:51

Yes Lynn, this is the trial- just looking at the atm. Thanks 

 
Forum Jump  
©2024 Prostate Cancer UK