spike in PSA 4 yrs post surgery
Hi,
I am 76 yrs old. I underwent surgical removal and radiotherapy of prostate cancer several years back. The PSA levels had more or less been low, there was once a slight uptick but the doc prescribed some medicine that made them come down. But recently there was a spike in the PSA (>3) and my doc is suggesting a PET scan followed by either hormone therapy or orchidectomy.
I am not sure what to do. Has anyone else faced this situation or have advice?
Thanks,
John C.
Hi
thanks for reaching out. While I do hope our community members respond here with their personal experiences, I wanted to share these articles from one of our advocates: https://prostatecancer.net/living/psa-after-surgery and https://prostatecancer.net/living/treatment-decision-monitoring I can understand your concern, when does your doctor want to do the PET Scan? Jill, team member Hello,
I am fairly new here and have not posted much at all, but I feel compelled to suggest that you do a lot of research on hormone therapy. On my doctor’s suggestion I started Lupron Depot, a testosterone blocker. I was not told of any side effects. I was not yet a member of this group. I regret not having done my homework. The side effects, for me, are pretty severe. I’ve only been getting injections for 9 months, with 9 more to go. I do not know if an orchiectomy would cause the same side effects or not. It would be a good question to ask, I think. I hope you get guidance and I wish you the best.
DaveDennis E. Golden I would recommend that those new to Lupron start with a one month injection for the first three months like I did. That way, if there are severe side effects and it's intolerable you can stop or switch to something else without having to wait a year for side effects to dissipate. They initially wanted to give me a full six month treatment at once, but I insisted on month-to-month. I would agree. I had ADT (lupron depot) plus Olaparib (Lynparza) for a 6 month trial before my surgery. They gave me a 6 month dose - the good news is I didnt have to get a shot every month the bad news is there is no going back.. You can't unwind a 6 month shot and honestly I wasn't a fan of the side effects of the Lupron so its prob a good thing I got the 6 month shot bc i might have reconsidered continuing. Now having said that, it def WORKED - my PSA dropped very quickly and remained very low for the entire 6 months until my surgery. So the positives are ADT worked (at least it did for me) and quickly drove my PSA levels down - the biggest negative (beside injection site soreness) were obviously the side effects which for me were: fatigue, hot flashes, and loss of sex drive.
You might want to check out the following on here for some additional insights ...https://prostatecancer.net/forums/hormone-therapy ... Dennis(prostatecancer.net TEAM) thank you for that.
I was interested in your comment that your doctor had previously prescribed some medicine that made your PSA come down. It would be important to know what that was. The mention of a nameless medicine made me think that you probably need a little more information and a clearer understanding of the possible future directions of your cancer. I agree that a PSMA Pet Scan is indicated to identify any significant sites of cancer near the site of your prostate removal or at sites more distant. However, then and only then, should you carefully craft a plan for treatment. A treatment such as orchiectomy can be effective at slowing the disease but you have to ask yourself how well you can handle physically and emotionally such a decision. I would strongly recommend reaching out to a support group or to others you may know that are going through this cancer. Such support may help you make a list of critical questions for your physician. But most of all, know that there is an incredible tool box of new and effective treatments to keep your cancer at bay for a long long time! So agree with you Jim - there are a lot of ways to treat this
