Oncologist meeting options?

User

Posted 03 Sep 2026 at 14:22

Hello, This morning I received a phone call asking if I can meet the Oncologist tomorrow morning. My psa reached 0.2 which is when it was posted for review.

I had surgery in Dec 2016 and it became detectable Dec 2021 but was 0.21 in August.

Last time I was offered immediate RT to the prostate bed, or to have a psma scan then RT which is what I chose.

It has increased a bit faster and I'm inclined to ask for a psma scan which will take 3 months and will coincide with my next psa test and then have RT perhaps in January.

On the other hand RT without a scan now seems a bit more of a comfortable option or look for an earlier psma scan. Also I could wait a bit longer as the psa went down last time.

I'm interested in what others would do in this situation. Would you have the scan first, proceed directly to RT, or wait a little longer to see what the PSA does? And are there other questions you think I should be asking the oncologist?

Edited by member 03 Sep 2026 at 16:48 | Reason: Not specified

User

Posted 03 Sep 2026 at 18:05

Hi, Peter.

If I were in your position, I'd just continue to be monitored. You're heading to your eighties and although your PSA is rising, it's only increased by 0.06 in 14 months. Personally, I'd wait until I was at least 0.4 before having a PSMA scan. IF it ever reached that level and IF there are any rogue cells remaining the scan is more likely to locate them. Having said that I'm a bit of a risk taker and you may prefer to act now.

The decision is yours, mate.

Good luck with whatever you decide. 👍

Edited by member 04 Sep 2026 at 11:06 | Reason: Typo

User

Posted 03 Sep 2026 at 18:28

Hi Peter,

My PSA was 0.21 in March 2026 and I went for the scan. I had the scan in May 2026 and they found nothing. I have an additional condition called Ulcerative Colitis which means that to have salvage radiation therapy could be a very tough experience as this would irritate my already inflamed bowel. So after discussion with my Oncologist we agreed to postpone any treatment till I reach 0.5. My latest reading is 0.24, so I am still headed in the wrong direction. I am not going to let that get in my way and I am determined to make the very most of every day and to this point I am doing just that with the help of my amazing wife.

Whatever you choose, please keep letting us know how you are doing and we will keep cheering you on!

User

Posted 03 Sep 2026 at 19:41

Hi Peter

I had RALP in 2021.

After a couple of years my PSA reached 0.2. My onco said a PSMA scan at that stage may be inconclusive and recommended I take a pre-emptive approach and have RT to the two most likely areas; the pelvic bed and lymph nodes. I took her advice and had the treatment in 2024 followed by 12 months Decapeptyl. So far so good. Next PSA test later this month. Fingers, toes and everything else crossed.

Peter

User

Posted 04 Sep 2026 at 09:07

Given the slow rise I'd be waiting and going for the psma option. The scan would give the oncologist a specific area to target and with LINAC machines that means they can potentially use a narrowly focused, higher intensity beam.

Maybe you could ask your oncologist thinks about the above as against RT without a scan?

Jules

User

Posted 04 Sep 2026 at 11:41

Microcolei

I think you've made a good point. Husband saw an oncologist in charge of the RT department. He explained to us how accurate the machines are these days and how the dose works.

It took a snapshot each day just to refine the accuracy of the aim. I think these are standard now.

The accuracy and areas were decided by husband PSMA PET scan. So yes it is useful to have a definite area to aim for.

User

Posted 04 Sep 2026 at 13:34

Take the scan, if nothing found wait until 0.4 for another?

As you are in your 70s you have to start balancing risk / reward

So I would be asking what difference to life expectancy the two options offer.

User

Posted 04 Sep 2026 at 19:32

This sounds a sound plan

User

Posted 04 Sep 2026 at 20:02

Wish you all the best Peter

User

Posted 05 Sep 2026 at 07:04

Originally Posted by: Online Community Member

I'd reach an age where hormones would keep me going.

Having been through HT after RT and at the age of 79 now, I wouldn't be happy going back on to hormones, even for 6 months. I won't go into a rant about HT as its effects vary from person to person but it's a pretty blunt instrument.

If you have a psma scan and it picks something up I'd hope your oncologist [is your "consultant" an oncologist or a urologist] might reconsider RT as an option.

As a matter of interest, why did the consultant fairly emphatically recommend against RT?

Jules

User

Posted 05 Sep 2026 at 11:40

Hi again, Peter.

I'm not medically trained, but from what I've learned about the disease, your new treatment plan seems spot on.

You've had to deal with troublesome, fluctuating and perplexing PSA results for sometime now. It must be worrying. I hope that these readings start to stabilise at very low levels and give you some respite.

Good luck, mate. 👍

Edited by member 05 Sep 2026 at 16:51 | Reason: Typo

User

Posted 05 Sep 2026 at 12:52

Cheers Adrian,

The consultant works with big numbers. It went from 0.1 to 0.2, whereas I look at what happened in between which can be worrying. My Christmas gift is a psma scan result on the 10th anniversary of my op. All the best, Peter

User

Posted 06 Sep 2026 at 00:15

Originally Posted by: Online Community Member

I thought there's no point pushing as we'll re-assess in December. Regards Peter

There seems to be some sort of rule about pc treatment that means it always happens around Christmas time.

Fingers crossed and all the best for you Peter.

Jules

User

Posted 06 Sep 2026 at 23:48

Thanks Adrian, excuse my interruption please Peter.

Going strong here. PSA stable 5 years after RT, 3 years after end of HT and I've had the time between psa tests extended as a special reward. Must update profile!

Jules

Show Most Thanked Posts

User

Posted 03 Sep 2026 at 18:05

Hi, Peter.

The decision is yours, mate.

Good luck with whatever you decide. 👍

Edited by member 04 Sep 2026 at 11:06 | Reason: Typo

User

Posted 03 Sep 2026 at 18:28

Hi Peter,

Whatever you choose, please keep letting us know how you are doing and we will keep cheering you on!

User

Posted 03 Sep 2026 at 19:41

Hi Peter

I had RALP in 2021.

Peter

User

Posted 04 Sep 2026 at 09:07

Jules

User

Posted 04 Sep 2026 at 11:41

Microcolei

I think you've made a good point. Husband saw an oncologist in charge of the RT department. He explained to us how accurate the machines are these days and how the dose works.

It took a snapshot each day just to refine the accuracy of the aim. I think these are standard now.

The accuracy and areas were decided by husband PSMA PET scan. So yes it is useful to have a definite area to aim for.

User

Posted 04 Sep 2026 at 12:40

All true, Antoinette.

The point my onco was making was that at a level of 0.2 the PSMA scan may not find all the abnormal spots.

I am sure this has been discussed several times before with people sitting in both camps.

Not sure there is any firm evidence as to which is better.

Peter

User

Posted 04 Sep 2026 at 13:34

Take the scan, if nothing found wait until 0.4 for another?

As you are in your 70s you have to start balancing risk / reward

So I would be asking what difference to life expectancy the two options offer.

User

Posted 04 Sep 2026 at 13:41

Would be a brave onco to give an answer to that question francij1.

User

Posted 04 Sep 2026 at 19:25

Hi All, thanks for the comments, at the meeting the consultant offered just about everything but added fairly emphatically she didn't recommend RT to the prostate bed. She said my rate of psa change was so low that I'd reach an age where hormones would keep me going. It was suggested I could also have hormones for 6 months then go off them for 2 to 3 years. It made me nervous about the occasional step changes in psa but a psma scan is scheduled for late this year which was said to have a 50% chance of finding anything, although I've read less at just above 0.2, but I'll take it from there.

I was fairly happy with this as it puts off any onorous treatments for several months to hopefully no long term effect. Cheers Peter

User

Posted 04 Sep 2026 at 19:32

This sounds a sound plan

User

Posted 04 Sep 2026 at 20:02

Wish you all the best Peter

User

Posted 05 Sep 2026 at 07:04

Originally Posted by: Online Community Member

I'd reach an age where hormones would keep me going.

Jules

User

Posted 05 Sep 2026 at 08:49

Hi Jules,

I agree. I don't want to go on hormones. RT without a scan was not recommended as I might be able to go a lot longer without it. So a psma scan in 3 months is to be done. Further scans were said to be possible, and RT without a scan if I wanted it.

I thought there's no point pushing as we'll re-assess in December. Regards Peter

User

Posted 05 Sep 2026 at 11:40

Hi again, Peter.

I'm not medically trained, but from what I've learned about the disease, your new treatment plan seems spot on.

Good luck, mate. 👍

Edited by member 05 Sep 2026 at 16:51 | Reason: Typo

User

Posted 05 Sep 2026 at 12:52

Cheers Adrian,

User

Posted 06 Sep 2026 at 00:15

Originally Posted by: Online Community Member

I thought there's no point pushing as we'll re-assess in December. Regards Peter

There seems to be some sort of rule about pc treatment that means it always happens around Christmas time.

Fingers crossed and all the best for you Peter.

Jules

User

Posted 06 Sep 2026 at 09:36

Originally Posted by: Online Community Member

There seems to be some sort of rule about pc treatment that means it always happens around Christmas time.

Indeed, Jules.

I was first diagnosed Yuletide 2020. One of Santa's little helpers, wearing a mask and a rubber glove, went up my chimney and gave me a surprise. 😁

Ho, ho ho. Merry Christmas.🎅

As if that wasn't bad enough, a couple of years later, on Valentine's Day, of all days, I had RARP, which left me impotent. 😁

Cupid's arrow was well off target that day. 💘

PS: It's great to see you posting more frequently again, mate. You went through a quiet spell and I was beginning to fear that all was not well 'down under'

Edited by member 06 Sep 2026 at 10:00 | Reason: Additional text

User

Posted 06 Sep 2026 at 09:48

That's a double whammy Adrian. My op was on November 5th. In retrospect, it seems to me that when I was lying in my hospital bed and looking out the window at the firework displays, the whole of Hertfordshire was cynically celebrating my soon to be discovered impotence.

User

Posted 06 Sep 2026 at 10:42

Originally Posted by: Online Community Member

My op was on November 5th.....................the whole of Hertfordshire was cynically celebrating my soon to be discovered impotence.

The day your 'banger' became a 'damp squib'. Very cruel timing.

It's a pity that they don't do RARPs on Easter Sunday. It may have have increased our chances of bringing things back to life. 🙂

If its raining, I'd certainly avoid having a catheter removal on St Swithin's Day. You'd likely end up very wet for the next 40 days!

Apologies Peter, for derailing your conversation. I really must grow up. 🙂

Edited by member 06 Sep 2026 at 14:42 | Reason: Additional text

User

Posted 06 Sep 2026 at 23:48

Jules

User

Posted 07 Sep 2026 at 16:22

Hi Peter,

that sounds a sensible plan.

What were the other options you were offered? Anything beyond what you have described?

All the best Al.

Notification

Join the online community now.