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By CommunityMember96fcf4

1 min read

Rising PSA leads to a biopsy

I had symptoms of bph for 20 years. My PSA had been rising slowly. It was 3.6 and then my primary care said they didn't do the PSA tests much anymore so went a couple of years without further tests. Covid hit and dr. appointments were not convenient and I missed annual physicals for a couple of years. My wife talked me to a physical this year with a local dr and he did PSA test. It came back at 8.68 along with a referral to a urologist... biopsy came back as cancer in 10 of 12 samples. Gleason scored at 9.

Choosing prostatectomy as a treatment

Surgery seemed to get it as margins were clear and no indication it had gotten beyond the prostate. The first PSA after surgery was near 0. Only 4 months post surgery bladder control very slowly beginning to come back. Mostly feel okay but it is still in the back of my mind... I was told there was a greater than 50% chance it would come back at some point. I don't know if that means 6 months or 6 years. Life is going on as before. Depression had been under control, but not so much now. Getting back to work shortly after surgery and finally getting back to doing things I enjoy is helping. A retirement is an option, but not a good option.

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Richard Faust Community Admin
Hi <inline-mention username="CommunityMember96fcf4" user-id="3266614"/>. First, let me say that it is great that it seems your cancer was contained and the surgery had clear margins. Second, it is completely normal to have fears of a recurrence. That said, if you find this fear impacting other aspects of your life do not hesitate to seek some professional help. I want to share with you this article from our editorial team on coping with the fear of recurrence (<a href='https://prostatecancer.net/living-coping/recurrence-concern' target='_blank'>https://prostatecancer.net/living-coping/recurrence-concern</a>) and this video from our contributor <inline-mention username="Dennis Golden" user-id="3259730"/> on battling prostate cancer being equal parts mental: https://prostatecancer.net/video/mental-challenges. I also want to note that estimates you were given for recurrence are high, with most research stating 20 to 40%. This large study concluded: "On average, we found a man undergoing radical prostatectomy for localized prostate cancer can expect about a 1 in 4 chance of biochemical recurrence:" https://ascopubs.org/doi/abs/10.1200/JCO.2022.40.16_suppl.5090#:~:text=Conclusions%3A%20On%20average%2C%20we%20found,9%20years%20after%20incident%20metastasis. I don't want to downplay the significance of these numbers, but I do want to let you know that we have a number of men here who have had treatment for recurrence and are doing quite well since. I hope this information is helpful and please know that people here understand. Best, Richard (ProstateCancer.net Team)
1. CommunityMember96fcf4 Member
 <inline-mention username="Richard Faust" user-id="3268931"/> - where do I find good information on what else, if anything, I should be doing besides monitoring? I see so much information about a variety of tests and such that might suggest different options for treatment…and don’t really have a lot of face time with my doctor to discuss and there is so much information to sort through. Recommendations on where to start? Thanks 
2. Richard Faust Community Admin
 Hi <inline-mention username="CommunityMember96fcf4" user-id="3266614"/>. First, I do want to note that monitoring for any rise in the PSA is the most important thing you can do to catch a recurrence early. That said, there are genomic tests that can be used post prostatectomy. This article goes into further detail: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674810/#:~:text=The%20Prolaris%2C%20OncotypeDx%20and%20Decipher%20tests%20are%20available%20for%20biopsy,be%20used%20after%20radical%20prostatectomy. In the conclusion it notes that "The Prolaris, OncotypeDx and Decipher tests are available for biopsy tissue, and the Prolaris and Decipher tests can be used after radical prostatectomy." Another thing that may take your mind off of the potential for a recurrence is to focus on the recovery and what you can do about any continuing side effects. How is the recovery going? Best, Richard (ProstateCancer.net Team)