psa rising after rp

Hi Raoul13. I've recently returned from a mountain walking holiday in the Austrian Tirol. A beautiful and spectacular area but it was rather exhausting in the current heatwave. In the UK they don't normally attempt a PSMA scan with such a low PSA. I had a PSMA PET scan a few months after surgery when my PSA was around 0.4. It didn't show any indications as to where the residual cancer was hiding. However to cut a long story short, I eventually had salvage radiotherapy to the prostate bed along with six months hormone therapy. That was 9 months ago and currently my PSA remains undetectable (fingers crossed).

Your PSA readings are still very low and only rising slowly. Your post RP histology is also good, as it is indicating the cancer was entirely contained within the prostate. Hence it is unlikely to have spread further afield. It's probably just a few cells left over in the prostate bed which have started a recurrence. 

to JedSee,

i read your profile, and i have/had the same pelvicfloor issues after surgery (regarding the functional things...)i took me more than a year to recover, but i did more or less if you want to exchange or write me, how does this work? because i cant yet send you a message cos i m new here ...

Edited by member 24 Jul 2023 at 11:42  | Reason: Not specified

thanks Dave i will read it soon

Thanks Raoul13,

I have sent you a private message, as you have requested.

Best wishes,

JedSee.

Thanks Raoul13,

I had hoped that by sending you a private message you might have been able to reply, but it seems that the administrators of this website know best 😀.

Take care of yourself.

JedSee.

Ok, thank you  Dave

Hi Raoul13,

It's impressive that you did your own digital rectal examination and your urologist said it made a difference.

At very low levels a small change in psa can show as a big effect.   For example 0.025 might be recorded as 0.02.  0.026 might be recorded as 0.03.  The increase from 0.05 to 0.07 might not be as small an increase but it might not be as large as well.   I kept telling myself these things when my psa rose.

The other factor is that you said you did your last psa test yourself.  Do you mean you went to a different hospital.  It's recommended that psa tests are done by the same laboratory as the calibration might be different and the results can be a bit different, so if that's the case the 0.07 would not be directly comparable although it could be indicative.

It tends to be said that a psma scan has a low chance of finding anything at 0.2 and my hospital is adamant that 0.5 is the point they'll do it.  So having a scan at 0.03 is optimistic although not unknown. 

When you say you had a panic attack during the scan I don't know if there's anything to help that such as a tranquiliser or even a mild anaesthetic. It's all part of the balance in decision making.  However it looks like you're going to be given treatment without detecting it.  These decisions are often personal or oncologist guided and it's never easy.  

All the best, Peter

From my experience of pin-prick PSA tests that you send off to be analysed, they are always different, by quite a large margin, from those extracted by syringe from your arm. For example, on 25/03/18 my pin-prick PSA was shown to be 6.26, but one in May 18 taken by a doctor via  a syringe was found to be 3.58. Similarly, a pin-prick PSA reading on 06/01/21 was recorded as 7.54, but the doctors extraction on 10/03/21 came out at 5.32.

Ivan

Edited by member 30 Jul 2023 at 17:58  | Reason: Not specified

I think the premise is that orchiectomy will last for as long as first-line HT would have done but with slightly fewer side effects. When it fails, second line drugs such as Abi, Enza or Apalutimide would still be available

Hi Lyn, thanks for your comment although I think it's a reply to what I wrote on another thread around the same time as writing on this.  Peter

Something weird going on - not sure either it is the forum or my phone??? (Or too many orifices?)