Worried PC will return - further treatment

I think you are overthinking or working yourself into a panic. Why are you assuming that the cancer is suppressed rather than killed? If you are concerned that your PSA isn't low enough, you have misunderstood what to expect of PSA readings post-RT - your PSA readings are excellent. In response to your questions:

1 With my original diagnosis is it likely the cancer will return?
With any treatment (radiotherapy, surgery, focal treatments) there is a risk of the cancer returning but they wouldn't have given you the RT if they didn't believe it was curable

2 If so, in what timescale, 6 months? a year? 2 years?
No one would be able to say - my dad's recurrence was about 15 years after his treatment but his PSA is climbing so slowly that he has still not needed any further treatment 7 years after the recurrence.

3 Has anyone, having finished Zolodex treatment and been on 6 monthly PSA tests, then moved, at their request, to 3 monthly PSA tests ?

There is generally no point going to 3 monthly testing as the oncologist wouldn't see you until you got to 2.02 anyway. However, there is no harm in asking your GP for 3 monthly tests starting 3 months after the last injection runs out (so 4 months from now).

4 Is an increase PSA to 2.1 a general yardstick to indicate the cancer has returned?
Biochemical recurrence is defined as 2.0 plus your lowest reading so 2.02

5 If and when, the cancer returns what further treatment can I expect? - another CT scan ?, Radiation - Not allowed ?, Zolodex injections for another say 2-3 years? Any other treatment?
Lifelong HT - possibly with chemotherapy or a new generation additional hormone

Edited by member 04 Dec 2022 at 01:08  | Reason: italics

Some of the information is new to me as my consultant is a man of few words and his consultations are very short . He usually ends with suggesting he passes me to a cancer nurse which I decline (he probably has an always increasing caseload and needs to lose a few patients)

I’m now more inclined not to go to 3 monthly PSA tests as long as my PSA results are less than 2.02.

Thinking more positively, I’m looking forward to less side effects eg less hot flushes, feeling less tired and perhaps losing a bit of weight I’ve put on around my waist. But if it doesn’t happen then it’s not the end of the world- there’s many people in a worse position to me.

Ps- the wine was more enjoyable tonight !!

Thank you both.

Philip of EDGERTON

On balance, I’m sure you’re right as I become a bit anxious just before I get the latest 6 monthly PSA result ( as perhaps many of us do ) and so moving to 3 monthly will only make me a bit anxious more frequently. So why put myself under more stress?

I also need to tell myself that the consultant is the expert, not me, and so I really should do as he recommends.

Just another question - the trigger for me to be aware that the cancer is returning/ reawakening is a PSA of 2.01. Would a consultant start me again on HT at that level or wait until the PSA reaches say 10? Or would he do a CT scan first?

Thank you and others who have responded to my concerns.

Philip of EDGERTON

I finished zoladex over 18 months ago. After 6 months my PSA was about the same as previously ( presumably because I still had zoladex in my system ?) 6 months later it marginally increased to 0.13 which was very pleasing.

Now 6 months later it has increased to 0.46. My cancer nurse has said that she will report it to the consultant and ask should he take any action.

I expect him to say no as I believe the trigger reading to take action is a PSA of 2.

How concerned should I be with this increased PSA from 0.13 to 0.46 in 6 months?

I’d be grateful for any views or experiences of increasing PSA after finishing zoladex

Thank you

Philip