disappointed and worried

User

Posted 26 Sep 2025 at 10:09

Had prostatectomy option in 2023 after biopsy found aggressive Gleeson score 8.

It was thought that all traces of cancer had been removed.

Earlier this year there was concern PSA level had been gradually rising and cancer returning.

Had PET scan but after prostatectomy traces are microscopic.
So had radiotherapy over 7 weeks (My-July) but PSA level has been rising since significantly since.
Just had 2nd PET scan.
Seeing consultant in next 2 weeks to get results and see what next.

Not sure what next but perhaps hormone therapy and/or 'concentrated' radiotherapy over shorter time.

Be very interested if anyone else had had similar history.

User

Posted 26 Sep 2025 at 12:13

Hi Andy,

Welcome to the forum, mate.

I'm very sorry to hear that your prostatectomy was not totally successful and that the follow up radiotherapy has also not got rid of the problem.

Was the prostatectomy robotic?

Did you have H/T with the salvage radiation treatment?

Do you know what your PSA was prior to surgery. What was your Gleason score and cancer staging? Did you have any positive margins? What were your post op PSA levels following the operation, and at what level did they start salvage treatment. Do you know your current PSA levels? Have they established exactly where the remaining cancer is?

I'm sorry to fire so many questions at you, but they are relevant.

There are a few fellas on here that are in a similar position to yourself. I'm sure that they soon be along and help out. 👍

User

Posted 26 Sep 2025 at 16:30

And2253, ,was it a PSMA pet scan and do you know what tracer was used . What do you call a significant rise. What was included in the scan.

My PSA rose very quickly after a PSMA pet scan,see my profile. I also know of someone with a rising PSA who had a scan that found nothing until they included the skull, which then found bone mets in the skull. We also have a member where they didn't see anything until his PSA hit 200.

Thanks Chris

User

Posted 26 Sep 2025 at 18:20

Perhaps RT was given to the Pelvic Area, including lymph nodes, where cancer cells are more likely to go. If microscopic formations can in due course be identified elsewhere, it may be possible to treat these specifically with RT if there are only a few. But if this is considered not an option, it then comes down to treating systemically with HT, chemo, or other drugs.

Barry

User

Posted 29 Sep 2025 at 09:31

Hi Adrian,

A bit more info:

Da Vinci Robotic Surgery

PSA prior to surgery was 4.5

Original Gleason score was 4+3 but after biopsy was found to be 4+4

Staging: pT2cNxR0

No H/T during radiotherapy.

Undetectable PSA after surgery.

rising from <0.014 in 23, 0.019 in 6/24, 0.036 in 9/24, 0.11 in 4/25, 0.133 in 5/25, 0.348 in 9/25 (radiotherapy completed in mid 7/25)

Not known as yet if spread to bones. Had PET scan last week. Seeing consultant next week.

User

Posted 29 Sep 2025 at 09:36

Hi chris, Yes was a PSMA PET scan - had 2 now and MRI, eyes to below pelvic area.

User

Posted 29 Sep 2025 at 10:04

Hi Andy,

Thanks for those details, mate. 👍

Was there any particular reason that you didn't have hormone treatment with your salvage radiotherapy? I believe the general consensus is that a combination of the two is more effective.

As I said earlier there are folk on here who are in a similar position to you and hopefully they pop in and offer some advice.

Very best of luck with your next consultation, mate, and with any ongoing treatment.

User

Posted 29 Sep 2025 at 11:34

Thanks Adrian

It wasn't suggested I should have H/T?

Another point have been hearing much in the press about Abiraterone. Consultant suggests that this is offered in conjunction with H/T. Be interested to hear if others had this.

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