post surgery PSA; radiation next?
Posted , 6 users are following.
My brother, 67, had his prostate removed mid-May. On his first follow-up with the urologist they said his PSA blood test was a 0.49. So they're talking about sending him for 39 radiation treatments.
Has anyone been down a similar road (complete prostate removal and then need radiation)? What kind of questions should we ask? (I am involved more than normal as my brother has suffered 2 strokes and he has left side weakness and gets around in a wheelchair).
0 likes, 7 replies
romneyj chris20669
Posted
Hi Chris, PSA is a little high but it is still a little early to be certain. It may be strongly suggestive of the need for radiotherapy but the received wisdom is that it sometimes takes 3 months for PSA to reach its lowest level.
Note that this low level needs to be zero or very close!
His histopathology report should have been discussed by the team by now or will be very soon. He needs to know whether they have a negative margin around the capsule (ie the prostate itself). It would be normal that if PSA remains high there would also have been a positive margin. If the two contradict then this is a contradiction that might be helpful to discuss.
I do wish him good luck. Make sure you have all the data before making decisions.
Romney
ayman78787 chris20669
Posted
Hello Chris,
I had my surgery late March. The doctor tested my PSA late May and it was 0.03. He had warned me that if PSA stays high, we will have to go the radiation way. However, he said he doesn't expect PSA to go down to 0 that soon after the operation.
Now I don't know where 0.5 stands, but it seems too soon to operation time to gauge anyways.
I am not a doctor but this has been my experience.
Also, he said that if we had to go radiation, it couldn't be before Sept/Oct, otherwise too soon.
Best
Ayman
barney34567 chris20669
Posted
Did your doctor tell you the percentage chance that such radiation treatment (RT) would work? You must ask this question in the context of your brother's medical history.
What scan was performed to conclude that RT is the answer?
Before any RT is to be considered, I recommend at least another PSA test say a month after the one he had. Have the PSA tested at another lab.
Then three months after the first PSA test have another test at the original lab.
Roger2Dodger barney34567
Posted
barney34567 Roger2Dodger
Posted
Thanks man. I hope you're well. As for me...I recently had three sessions of thirty mins of RT that failed to stop my PSA climbing. I am now looking at proton therapy or similar. Any option other than chemical castration, better known by its marketing term "hormone therapy" which has been offered.
richard98806 chris20669
Posted
Similar situation. Age 67. RP March. First PSA .15. Dr. shocked. However the PSA was taken 9 weeks post op. Ideal is 10-12 weeks. His PSA seems to be only 8 weeks out. Our plan is to retake PSA in 2 months(which means end of August). If it drops we will go back to observation mode. If it remains the same or increases we will do a PSMA Pet Scan to attempt the location of the cells. AFTER that we will discuss Radiation and hormone therapies as options.
The point here is to not IMMEDIATELY start radiation therapy. Wait, retest PSA then start asking questions of follow up treatment. Include in those discussions are the difficult quality of life questions regarding the speed which the cancer may LIKELY develop and the quality of life that radiation therapy may impact especially in light of previous medical history of strokes and wheelchair bound.
In my case my overall health is very good and I will weigh the recommended treatments based on my follow up PSA and other tests if necessary
chris20669
Posted
Appreciate everyone's comments. Valuable thoughts that we need to take with us to the consult (this Tueday). And I'm not aware of any scan that's been done (yet). It's one of the questions I have down, along with chance of success and others.