PSA raising 1 year post RP

Sandra, a few years ago it would be salvage RT when the PSA was around 0.2. More recently some guys are having PSMA scans before SRT, although there are circumstances where having SRT before exceeding 0.25 is recommended.

Hopefully some of the scholars will be along to explain the significance of the particular cells you mention. 

Perhaps a call to the number at the top of the page could give you some reassuring info.

Thanks Chris 

Thanks Mark and Chris for your reply, 

What  worries me is the jump in 1 year from 0.01 to 0.02 then 3 month and it was 0.18.

Mark I think yours was quite steady.

I would love to hear about other similar cases

Many thanks 

Sandra

Hi Sandra,

We’re in a similar position in that my husbands PSA started to rise around 14 months after surgery. He did have a positive lymph node initially which was removed during surgery along with 13 others.

I’ve been having his psa checked every 6 weeks and these are the latest figures:

0.029(was the first rise above undetectable)

0.044

0.115

0.164

I got a shock when it more than doubled in 6 weeks but then the next one didn’t….this might be the case for your husband. It will be interesting to see what the next one is…there could be other reasons for this sharp rise 🤞🏼

It’s so hard not to worry and the waiting doesn’t get any easier. I want everything done yesterday! I’m slowly finding out it’s really not that easy with this disease though and unfortunately there are times when we have to wait and feel in limbo. We’re going away for a few weeks (been unsure whether it’s the right call) and we’re going to see where we’re up to when we return.

Really hope all will be ok and you get some answers soon x

hello, i (raoul) am new in the forum and in a similar situation:

48, gleason 7 (3+4) pt2c, negative margins

my psa after surgery (rp, aug 2021) was stable about 9 months  0.01 ng/ml

then started to rise 0.02 (10 months post rp)

after 13 months  0.03 ,

0.03 again after 16 months (dec 2022)

0.05 after 19 months, 3 months after that it was 0.05 again, that was at the end of may 2023

but because my oncologist is on holiday and i was unsure i took a psa by myself in a different lab 2 weeks after the last test and it was 0.068 (panic), i tested again 0.07 in another lab from the urologist. the uro told me that testresults maybe different, but i am quite anxious now cos i have to wait till my oncologist  is back from holiday and the next meeting we have on 5th sept,  then psa will be done...

Edited by member 24 Jul 2023 at 13:59  | Reason: Not specified

Readings less than 3 months apart apart especially from different labs are probably a waste of time. Readings that are 0.002 apart are the same for all intents and purposes.

So I would suggest you give yourself a break and try to stop worrying about PSA until your next official test and appointment.

Sorry to hear this Sandra. As Chris said in a much earlier post it is either salvage RT or PSMA scan. It is either a few cells left behind in the prostate bed, or it is distant mets. A PSMA scan may be able to prove one way or the other. The problem with the scan is it has very limited availability and the radioactive tracer is hard to produce so waiting for a scan may delay things.

A rise from a low number is often just in the prostate bed. The rise seems to have a doubling time of three months that is uncomfortably fast.

Thank you Dave for your reply, you absolutely right the doubling time is concerning, we did not expect this.

In regards to PSMA, would you think if we go abroad and have this done, NHS would take this in consideration, as in the here in the UK the price for it is unaffordable if we privet, to gain time.

Thanks 

Sandra

I don't know too much about NHS bureaucracy and foreign scans. I would think the NHS would be happy to use all the information available. But if the scan is in an electronic file and the software is incompatible it may not work, or if it it written in a foreign language it could have issues and be misinterpreted.

Another issue is the unreliability of the isotope, I think in this country people often have the scan cancelled at a couple of hours notice, so you may have a few trips to the foreign country.

The following is only guesswork:

If you can get the PSMA scan I can see three possible outcomes: only in the bed, one or two mets, many mets. I would assume the three treatments would be SRT to bed, SRT to bed and target mets, No SRT just HT and chemo. I think the scan will delay things by months I think I would just accept SRT to the bed, hope for the best and if the worst happens deal with it later.

I have had 2 PSMA scans done ,one NHS and one through my insurance. My second scan picked up a new tumor and residual cancer in the first tumor. My local genesis centre could not treat both areas in the same session and the option was a 220 mile road trip to be treated at another genesis centre. 

It is not just the oncologist's experience but presumably it is also the experience of the physicist who actually writes the treatment plan.

My NHS oncologist is the same guy I see privately, he did say I could not keep switching between NHS and private.

Thanks Chris 

Hi Franc

Thanks for your answers and reply, I just went through the report and you are right it does mention: 

" Cribriform/intraductal type architecture present"

What it means then, I thought it was just cribriform present

Any advice on this please 

Thanks 

Sandra

Hi Franc

Thanks for you reply, thank you to everyone one replying, you can not imagine how your opinions and experiences are valuable.

Franc in your last phrase you said "option" did u mean it or did mean opinion?

Thanks

Sandra 

I had a RARP 9 months ago. Pathology Gleason 9 (4+5), Grade 5. I understand that.

Extraprostatic extension left posterior - radial distance 1 ml - haven't got a clue what that means, googled it, still non the wiser???

Invasive micoacinar adenenocarcinoma - not a clue???

Since then had 3 monthly PSA checks - first < 0.02, second <0.05, third <0.02. The first and third checks were done at one hospital the second at another. I've been told that I've got a 50% of recurrence.

I've also been told that these readings are all classed as 'undetectable' and only a rise to 0.2 would cause possible further treatment.

Edited by member 24 Oct 2023 at 13:42  | Reason: Typo

Thanks Chris and Decho for sharing.