PSA still elevated after prostatectomy and radiation
Hello team. I'll start by saying this chat room is a real blessing for me. Thank you all. In January 2022 I was 65 years old and my PSA jumped to 11.7. My urologist did a biopsy which revealed 9 of 12 positive detections and a Gleason of 9. Follow-up X-rays, bone density, and cystoscopy were all clear. My urologist recommended prostatectomy and I agreed. In August 2022, my prostate was removed. There was a detection on the margin with a Gleason of 7 (4/3). Fortunately, 11 lymph nodes were removed along with seminal vesicles and all were non-detect. Several months later my PSA was 0.3. It was still 0.3 a few weeks later during the confirmatory test. My oncologist recommended 38 radiation treatments (EBRT) to prostate bed and I agreed. It's now been three months since radiation ended and my first PSA test is 0.6. My oncologist says don't worry yet, "let's take another PSA in a couple of months." I want to believe this is just a radiation bounce and my PSA will start to fall, but this waiting game is not how I'm wired. I want some decisive action fast. Has anyone else encountered this situation (i.e., PSA doubling after post-prostatectomy radiation)? I'd love to hear from anyone who's been down this road.
Been down a similar road. Gleason 9 in 2013 - 2 positive cores and surgeon said he got it all. And pathology showed no signs of spread. Five years later in 2018 my post op PSA rose to 1.3 and I underwent 8 weeks of radiation and hormone therapy . Yes your PSA can bounce up after treatment . At the time I was told it can take from 18 months up to 2 years.
It is truly a waiting game and while i was not wired that way - Prostate Cancer (PCa) does what it wants to do and there was not muchIi could do to change it. While frustrating over time I learned to roll with it. Right now my PSA is up again ...some 10 years later and once again ... it's a waiting game to see what develops. Hang in there ... I hope this helps in some small way. Dennis(ProstateCancer.net TEAM)Thanks Dennis. Yes your insight is very helpful. Everyone’s personal experience and perspective gives me more wisdom.
Hi
. If your PSA remains elevated you may want to speak with your doctor about a PSMA PET scan which can spot recurrent prostate cancer down to the 0.2 PSA level. For more info check out https://prostatecancer.net/clinical/psma-imaging-scan and https://prostatecancer.net/treatment/psma-targeted-pet-imaging. If nothing else, it may help put you at ease and if there is an issue it would catch it early and it allows for very targeted treatment. Best, Richard (ProstateCancer.net Team)
Thanks for that advice and link. I’ve been thinking that the PSMA will be crucial. I’d like to remain optimistic but I don’t believe my 0.6 is going to fall substantially without further active treatment. We will see.
I look at it this way - if it can be treated lets treat it - I recently read Dr Charles "Snuffy" Myers book --- "Beating Prostate Cancer Hormonal Therapy and Diet" in which he states his belief that vitamin E and D can be very helpful for men dealing with prostate cancer - Does it work ?? I have no idea, yet i decided to carefully increase my intake - Dennis (ProstateCancer.net TEAM)
