High First Post RP PSA test

Ignore my earlier post on Sapper's thread. I started the HT a few weeks before RT commenced. Six months of HT is fairly tolerable. Loss of libido is somewhat inevitable. I had no hot flushes but Bicalutimide does tend to cause breast budding and sore nipples (Gynaecomastia). This started after about 2.5 months. I was prescribed Tamoxifen to try to counter this. It helped with the tenderness but it took about six months after HT for the physical symptoms to return to normal. Bladder and bowel urgency became a bit of a problem towards the end of radiotherapy. They took a while to return to normal. We are all different so don't take it as read that you will suffer the same side effects. Please keep posting to let us all know how you progress with your second treatment.

Hi Chris,

As I reported the first 3 month post RP was 0.31. So today, 2 weeks later , I had another PSA test for confirmation and it was 0.42. So it’s going up fast . I met with the radiation oncologist today and the plan is to have another PSA test in 2 weeks , where it should definitely be .5+ and then have a PSMA scan within days. At that time start HT and have a MRI/CT scan to map the radiation. Then start radiation and/or see the medical oncologist if there is metastasis outside the pelvic region. This is the plan for now.

Hope you are well. Cheers Des

Thanks for the update Des and best of luck with your further treatment.

Hi Chris,

To recap:

3 months post RP PSA: 0.31

2 weeks later : 0.42

2 weeks later : 0.35

2 days later : 0.39 ( confirmation test)

I had been hoping to get 0.5 to get PSMA scan and more accurate radiation. But feel I have been playing roulette with high risk factors ( Gleason 9/ extracapsular extension / seminal vesicle invasion) and today told my radiation oncologist I wanted to start hormone therapy and radiation now. I feel calmer now there is a plan.

Cheers Des

No problemo

Take care Des

Hi Des,

Theres always a risk with T3b staging and having RP…presumably they made you aware of that when you were given the options by the MDT. I was also T3bN0M0 but in Scotland they wouldn’t offer me surgery because they feel that there is too high risk of requiring SRT and they don’t see the point of you suffering the side effects of 2 different treatments. I’m not sure I agree with this argument, I would still have gone for surgery given the option, knowing that if they didn’t catch everything that I had a Plan B. My Plan B having gone down the HT/RT route is HT for life….which is a scary thought.

All the best with your SRT!

Derek

Edited by member 07 Jun 2024 at 21:14  | Reason: Not specified

Hi Everyone,

Finished 37 salvage radiation sessions to the prostate fossa about 5 weeks ago. Don’t want to jinx it but things went pretty smoothly. Have been on Lupron Depot for 4 months, hot flushes being the most noticeable side effect( much to my wife’s amusement). 

I’ve read about castrate resistance and that its onset can be more rapid for patients with aggressive PC. So it seemed to me counter intuitive to make PSA testing less frequent as the probability of CRPC becomes more probable over time. My oncologist has agreed to keep me on quarterly PSA testing from here on. 

The other issue which they are so far less acquiesent to is the idea of a Decipher test. I know from my post RP biopsy that I am high risk. Reading about the decipher test and its confirmed ability to stratify risk of future metastasis I think it would be useful to know where I am on that risk scale specifically. For instance if the  Decipher test says I am very high ie close to 1.0 then It would be an additional datapoint which might help make better decisions after my 18 month Lupron ie extend the Lupron or something else balanced against side effects and QOL.

I f anybody has experience or ideas about the Decipher test as a datapoint I would appreciate hearing about it.

Thankyou Des