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Persistent PSA climbing

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barney34567
barney34567

As you all know, after primary treatment such as radical prostatectomy or RT, the PSA should fall to zero or an "undetectable level". 

Mine did not. Mine is officially "persistent" as opposed to "bio chemical failure", which is a rise of the PSA after a documented fall after initial treatment.

I has surgery in 08/16.

Six months after a radical prostatectomy I had SBRT. 3x30 min sessions. Zero side effects. No nausea, no burning, no nothing.

And of all, things,  a negative response by my PSA. It escalated!

What has a better chance of controlling the PSA with the minimum cost to my quality of life? 

Radiation Therapy such as SBRT?

Radiation Therapy such as EBRT?

Proton therapy?

Clinical trials of new meds?

ADT? (That is "hormone therapy" or as my oncologist calls it "castration"wink

A combination of some of the above?

Note the more I read about ADT, the more I wonder what risks I take by not following any treatment for a period of time?

Note I am 50.

Thanks in advance  for your replies.

0 likes, 9 replies

9 Replies

  • richard98806
    richard98806 barney34567

    Posted

    Very intersted in these responses. I had my RP March  2017.  First PSA was .15.   Dr was suprised, me too.  I started asking questions about what next and he said there is some sort of scan (I forgot the name)  that should pinpoint where the left behind cells may be, so  'we are not shooting in the dark'.  He then said, "let's not get the cart before the horse".  Let's retake the PSA in 2 months and see where we stand.

    That is where I stand.  I researched some material, but to be quite frank I gave up.  Mentally I was very prepared going into the surgery but I had this silly notion that other than temporary urinary incontinence and longer ED issues, the cancer would be gone and I would live another 15 years or get hit by a bus or something like that. Anyway I still have another 6 weeks before my follow up PSA and do my best to stay positive trying to avoid that occaisional meltdown.

    I am 67.

    Hang in there Barney

    • ayman78787
      ayman78787 richard98806

      Posted

      Richard, just like you, I had my RP in March. PSA on May 20th was 0.03 and my doctor had already told it is not expected to be down to 0 that soon after the op. Checked again 20th of June: <0.01. Doctor is happy but I haven't had the chance to speak to him about it yet.

      My point is it doesn't seem to go down to 0 or undetectable that soon after the op... it seems

    • barney34567
      barney34567 richard98806

      Posted

      The scan you're referring to is the PSMA PET CT or a similar scan. I had the PSMA scan.

    • barney34567
      barney34567 ayman78787

      Posted

      I understand that anything 0.05 is undetectable. Some physicians are happy with anything under 0.1

      I agree that rarely does it fall to zero.

    • richard98806
      richard98806 ayman78787

      Posted

      the good news for you is your PSA started lower than mine and your 2nd PSA went down.  I am holding my breath to see the result of follow up PSA
  • richard98806
    richard98806 barney34567

    Posted

    Regarding my research of ADT, it is something I want to avoid, though it sounds like a logical thing to do.  Chemically castrate to kill the cells.  HOWEVER, during my original fact gathering of what treatment I wanted to proceed with at the point of diagnosis,when I spoke with the Radiation DRs they advised that the hormone therapy would likely be part of the radiation treatment.  The possible side effects concerned me.  Not the ones that go away after a year or so such as man boobs, low energy levels, hot flashes, core muscle weakening and mood swings.  Rather the statistical long term increase of heart problems and stroke. 
    • barney34567
      barney34567 richard98806

      Posted

      thanks for your response.

      your understanding of the literature is correct. I too hear that RT plus ADT works best, but for how long?

      Your point on heart issues and stroke is serious. But my question is, what will come first: the cancer returning after RT and ADT or the heart and stroke issues?

    • richard98806
      richard98806 barney34567

      Posted

      I guess it is the roll of the dice. Further research will probabaly help to see how the dice land.  They say prostate cancer is slow growing, but when it metastasizes does it remain slow growing?  Obviously age is a major factor. Quality of life. More research, more analysis of statistics.  Well, I am trying to keep my head clear till my second PSA
    • ayman78787
      ayman78787 richard98806

      Posted

      Yes, keep your head clear, hang in there and keep the faith. It will be fine I believe. My doctor expected it to be higher 2 months already op
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