Increasing PSA post Treatment

User

Posted 15 May 2025 at 11:12

Originally Posted by: Online Community Member

Paid for a PSA test yesterday (clinical lab), the result was 2.181 from 2.816 five days earlier, delighted as you can imagine. Will be having an 'official' PSA test at the oncology centre next week.

Geoff

User

Posted 16 May 2025 at 04:21

Excellent news Geoff and maybe a plateau.

The PSMA test might be put on hold now, preferably forever but it's certainly looking good for now.

Jules

User

Posted 20 May 2025 at 15:40

PSA test today but not good at 2.878.

I know different lab results can vary but from 2.181 to 2.878 is a large difference.

The recent tests were:

6.5.25. 2.490. Local lab

9.5.25. 2.816. Oncology lab

14.5.25. 2.181. Local lab

20.5.25. 2.878. Oncology lab

In the past the results have been very close, in fact the oncology lab was usually lower.

Waiting for a call back from oncologist but does anyone have any ideas about the different results.

Geoff

User

Posted 21 May 2025 at 05:09

Different labs can give different results, so really you should only compare results from the same lab, which gives you a slight decrease in the local lab figures over about a week and a slight increase in the figures from the oncology lab but there's really not enough there to come to any conclusion from either set of results. Dave suggested earlier that your recurrence figure could be a bit over 3.0, so you're pretty close to that now.

Clearly this is causing you anxiety and that's very understandable with your psa at doubtful level. Your oncologist is going to be the one who decides if it's time to do some scans and if he's following up with the suggestion of bone scan with PSMA PET scan it should clarify where you stand and maybe that will give you some peace of mind?

Jules

User

Posted 23 May 2025 at 11:23

Talking to oncologist Monday, would the psma scan be better than having a bone scan followed by pet scan followed by the psma scan. I may be able to pay for the psma scan for faster results

Geoff

Edited by member 23 May 2025 at 11:41 | Reason: Not specified

User

Posted 11 Jun 2025 at 10:47

Just had the psma pet scan results but oncologist is unavailable so don't understand results, perhaps someone can shed some light.

Highly psma expressing presacral LN metastasis

Thanks for any replies

Geoff

Edited by moderator 11 Jun 2025 at 10:49 | Reason: fix formatting

User

Posted 11 Jun 2025 at 17:55

Hi Geoff,

It would seem the high uptake of PSMA where indicated would be Metastasis in Lymph Node in the area between the Sacrum (Lower Spine and the Rectum but likely not showing as spread elsewhere). You need to check this with your Oncologist and ask how it could best be treated. Very sorry should your Oncologist confirm this is the case.

Barry

User

Posted 21 Jun 2025 at 12:19

Had meeting with oncologist in the week, to my suprise he answered my questions without being grumpy albeit with some politicians type answers.

Just to summarise psma scan showed one local lymph node with high psma uptake and psma uptake in the prostate - cancer cannot be excluded.

The lymph node was not zapped during the RT so could be treated now. The question for me is there cancer in the prostate with a "cancer cannot be excluded" report. I have asked if I can have an MRI scan or biopsy to be absolutely sure and I'm waiting to see urologist. I would prefer MRI as I have mild radiation proctitis and don't want to make it worse.

There are Google results from different institutions reporting that BPH can result in a false positive for psma scans in 30% of cases (I had BPH confirmed at my original biopsy)

I would appreciate any thoughts to help me decide.

Geoff

User

Posted 22 Jun 2025 at 03:04

There are different ways of playing this but in your position I would ask my Oncologist if I could have a Multiparametric MRI scan to check whether this points to anything within the Prostate. Should this be likely but reachable without tracking previous radiation paths, maybe some more radiation could be given to this before or after biopsy and to the Lymph node which needs treatment anyway. I would have thought you would wish to avoid Prostatectomy if treatment is needed and RT might suffice.

Another option would be to just get the infected Lymph Node radiated and follow up with a couple of PSA tests to see what this drops the figure to. A good result might then enable you to defer investigation of the Prostate if or until the PSA calls for further investigation.

Your best way forward is to discuss the possibilities with your Consultant.

Barry

User

Posted 22 Jun 2025 at 07:27

I was diagnosed with T3B N1 M0 prostate cancer with a PSA of 252 in January 2022, I have had full pelvic radiation, chemotherapy and was put on hormone therapy for three years. I had my last injection nine months ago (it was six monthly).

My PSA soon became undetectable but now it’s 0.2, I was told it will go up when the hormone treatment stops because I still have a prostate but it needs to stay below 2.

To come to my point, is a rise to 0.2 too high this soon after my last injection, or about right?

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