Recurrence after RALP?

Thanks Music man. I totally agree with your last comment. Nothing is as it seems or as I expected. 
regards the PSMA PET scan I don’t know the details other than it was ok. I hope I don’t repeat your experience but bad news seems to lurk around every corner.

cheers

Nick

Peter2016 I think I accidentally deleted your post, sorry. But I appreciate your point of view. I am prone to worrying a little too much, so maybe too much information won’t be great for me. Tricky one! 

Cheers

Well an update on this thread. The cancer never really went away post RP and now I’m all set for another PSMA PET, HT then RT. 

Hi Nick,

I read your profile, it sounds like you're having a stressful time. 

I've made a summary of it to try to help anyone who may comment.   Your psa went down to 0.01 after surgery, which was last September, but not undetectable.  There was an element removed that they hadn't seen on scans and it was close to the bladder leaving a positive margin.    Your psa is now  0.17 after being 0.06 in February.   Your psma scan is in 6 weeks so mid-August after which HT, RT and more HT are anticipated. 

Your psa could have reached a level where a scan is more likely to find something in 6 weeks.   I'd be thinking it was in the area where they left a positive margin.

As your father has it and you're youngish you should be getting priority.

You've had quite a few delays, I'd try to keep them to the time said and make the case of your age and father. Wishing you strength and all the best, Peter 

Thanks for the précis Peter and well done for wading through my rambling. Hopefully of some interest to others.

My urologist and CNS seem keen to get me the PET on time which is great. I had one last year though and know how often the dye can fail. Fingers crossed. 

Jim, it’s been a while! Looks like your PSA is behaving itself, long may that continue. I also see you’re using a pump. Would you recommend that? Nothing really showing in that department for me yet.

Thanks for the message. I think it’s been a case of when, not if, it will rear its head, it’s just been a little quicker than I thought. 

Cheers

Nick

Morning Nick

For the time being and, hopefully, until I drop down dead from something else, my PSA is still undetectable. I had my surgery at Addenbrookes in late December 21 and post-op they initially tested down to  0.04. In September 22 they changed the testing regime and only tested down to 0.1. My latest test on 04/07/23 recorded my PSA as less than 0.1. Apparently, men (And women) without a prostate can record small amounts of PSA which are created in other parts of the body so to avoid false readings and to allay fears Addenbrookes and a number of other hospitals are now only testing PSA down to 0.1.

Re undergoing surgery, there is evidence from the US ( A 10 year review) that even if the cancer has spread outside the prostate (mine was bulging out when it was cut and diced and my T reading was increased from a T2 to a T3a) removing the "mother ship" so it can't send signals around the body has better outcomes than if it is left in and radiated.

Good luck with your next course of treatment

Ivan

Ivan,

I guess testing to 0.1 removes a lot of the worry, until it breaches that of course. I hope yours stays there.

I didn’t know there was a variation in success rates between RP and RT. I was always told they were the same. It doesn’t change anything for me but useful to know.

cheers

Nick

For a T1 or T2, the success rate is almost identical for RP and RT. For men with T3, monotherapy RT has a better outcome than mono-RP but RP with adjuvant RT is even better. For men with mets, the US research suggested that removing the prostate could slow progression by switching off the feeder to the mets. 

Thanks Lyn. I don’t know if my T score will have changed after they found the nodule full of cancer during surgery. Not relevant now I suppose - but maybe I will ask the CNS if they’d have followed the same path if they’d known it was there, i.e. RP then RT, or if they would have gone for RT only. Or does that ‘what if’ way lie madness?!