Prostate cancer shows it ugly face for the third time

By jlocklear

1 min read

In March of 2007, I was diagnosed with prostate cancer. In September 2007 I had a Prostatectomy to remove my prostate. For ten years my PSA was 0.1. In September 2017 my cancer came back my PSA was 0.2 and in January of 2018, I went through 39 treatments of Radiation. All was fine the next three years. In January 2021, my PSA was .04. My doctor then told me that we would do a wait and see if my PSA would lower or rise. Now I don't know what to do. Has anyone been through the same?

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Richard Faust Community Admin
Hi <inline-mention username="jlocklear" user-id="4124466"/>. Your concerns about the returning PSA numbers are certainly understandable. Has your doctor given a reason for waiting to see what the PSA level does? I ask because the debate within the medical community is whether to begin treating recurrent PCa at 0.2ng/ml or 0.1 (see our contributor Len's discussion of rising PSA after prostatectomy here: <a href='https://prostatecancer.net/living/psa-undetectable' target='_blank'>https://prostatecancer.net/living/psa-undetectable</a>). If you are looking at treatment you may want to ask your doctor about the PSMA test, which is the current gold standard on finding recurrent PCa (you can find more information here: <a href='https://prostatecancer.net/clinical/psma-imaging-scan' target='_blank'>https://prostatecancer.net/clinical/psma-imaging-scan</a>). This test is newly approved in the U.S. and thus difficult to get. You may also want to ask about the Axumin test, which is also very good at locating recurrent PCa (see here for more information: <a href='https://prostatecancer.net/clinical/axumin-early-detection' target='_blank'>https://prostatecancer.net/clinical/axumin-early-detection</a>). Finding and treating recurrent PCa early can make a huge difference in treatment outcomes and side effects. Wishing you the best and please feel free to keep us posted on how you are doing. Richard (ProstateCancer.net Team)
Dennis E. Golden Moderator & Contributor
I am in a somewhat similar situation. Underwent a Prostatectomy in 2013 for a Gleason 9 and and they thought they got it all. Did the 39 ERBT radiation in 2018 along with the 6 month Lupron shot when my post PSA reading reached 0.13. Our urologists now suggest follow up treatment for rising PCa after surgery to begin prior to a patient reaching 0.1 vs the older standard of 0.2. So far I have not seen a rise for a third time ... but you never know. In many respects we are dealing with super sensitive numbers and readings. How soon is too soon to seek additional treatment is a tough question and yet finding it early is beneficial on many levels. Please keep us up to date on your journey as you can. I did try the links listed but for some reason they did not work for me. Not sure if this is due to the new system or my computer - you may want to copy and search directly. Dennis(ProstateCancer.net Team)
jhenrymaine Member
My situation and dates are remarkably similar to yours. Prostatectomy in 2007 at age 44. Radiation in 2017 (with Lupron) when PSA hit 0.37. Now, four years later, may PSA has risen again to 0.70. My urologist said there is no huge rush for me since my numbers are still very low , and my doubling time is long. I understand I may be referred for a PSMA or Axumin PET scan when PSA hits 1.00. I live in Maine, and the local oncology practice in Portland has a collaboration with Dana-Farber in Boston. So I feel OK about getting good information for round #3. Even so, at age 57, I'm not thrilled with the idea of going on Lupron again. My next PSA if in July. I don't expect to hit 1.00 with the PSA, but probably by summer 2022. So I'm trying to stay healthy and watch my stress (yeah, in a pandemic!). My urologist told me, "Jon, this is going to annoy you more than it will kill you." He was right!
Dennis E. Golden Moderator & Contributor
jhenrymaine Similar - surgery in 2013 and then I saw a rise in PSA. Lupron was not my favorite either. My so called 6 month shot given prior to radiation in 2018 lasted almost 14 months. The last 2 months were manageable with just occasional hot flashes. Early on I had a ceiling fan installed in bedroom ( This was in addition to having an air-conditioned home) The fan really helped manage the night sweats. I gained almost 25 lbs while on Lupron. The pounds did come off once the Lupron wore off ... but very slowly. Lots of exercise (bike riding 20+ miles several days a week, walking and staying focused on a Mediterranean diet helped. Interesting timing on this response ... I went in for a follow up PSA blood test today - As always fingers crossed - hope no increase ... Dennis(ProstateCancer.net Team)
Dennis E. Golden Moderator & Contributor
jhenrymaine You have to love these MD's who have not had the disease, have not undergone the treatment (just to see what it is like )and who tell us to just relax. Not long ago we had a surgeon who was diagnosed with PCa. He attended pre-surgery support group and later attended follow up education meeting. It was interesting to see how he developed a much better understanding for patients going through a prostatectomy after he had walked the path Dennis(ProstateCancer.net team)