CSN Login
Members Online: 14

Husband's PSA is now .18 post RP 8.5 years ago

JulieUSA
Posts: 4
Joined: Jul 2009

My husband Paul is now 71.5 years old and had a regular RP 8.5 years ago and the doctor said the pathology reports said the cancer had penetrated his urethra, but that is was possible since it was on the border all it may have been cut out due to where he had to cut. For the past 8.5 years, Paul's PSA tests have come back non-detectable. Then four months ago, his PSA came back .18, and now four months later, it is still .18. Doctor said there may be some cancer there or the .18 could be caused from something else. Went on to say that since it had been non-detectable all these years until four months ago and did not go up any higher four months later now, he took that as a good sign, yet seems confused and baffled about it. He brought up the subject of radiation saying Paul may benefit from it and if he wanted to get it he would not be against it. He sounds like he leans towards it yet he wants it to be Paul's idea to do it because he does not come out and say I recommend you have radiation.
He is a very reputable well established urologist and considered to be one of the very best, so go figure.

We had thought after all these years of good PSA's we stood a strong chance of being out of the woods and now we almost feel like we did 8.5 years ago when Paul was first diagnosed. We do not want to waste valuable time and do nothing if there is any chance this could shorten his life.

There are other concerns as Paul is a type II diabetic which is managed well without meds now, is a stroke survivor, and is on Plavix. Not sure how he would do with radiation or if he may effect his quality of life with permanent side effects if there were any damages to his bladder or/colon.

So many questions running through our heads on what we should do or should not do and if or when. Any input would be greatly appreciated.

Julie

gleason9
Posts: 6
Joined: Jul 2009

Have you discussed Lupron as an alternative?

JulieUSA
Posts: 4
Joined: Jul 2009

No, the subject never came up when the doctor called. However, immediately after Paul's RP back in early 2001, Paul was put on Lupron for a short period and then taken off of it. Radiation had been discussed back then as well but at the time was recommended to wait and see how his PSA did and then act accordingly if need be. I believe the doctor's hesitancy with radiation at that time could have been due to the fact Paul was a diabetic and was still on meds for it at that time. We have a consultation appointment scheduled with the urologist in a couple of weeks so we can address out concerns, so maybe we will learn more by then and know more about what all to ask the doctor by then and will include asking about Lupron, etc. Thanks.

Julie

lshick's picture
lshick
Posts: 63
Joined: Apr 2009

The thing that jumps out at me is that, even though he's had a rise in his PSA, it's been stable for 4 months. There are lots of definitions of "recurrence," but as far as I know, he doesn't (yet) meet any of them. Something like half of guys whose PSA reaches 0.2 after surgery never have it rise beyond that.

I would think that you need to establish a "doubling time" for the PSA, and again as far as I know, they don't start that calculation before you reach 0.2. You might have a look at
http://www.mskcc.org/applications/nomograms/Prostate/SalvageRadiationTherapy.aspx

and also the "Treatment Decision Tools" link in the left column of this page.

Good luck.

Larry

JulieUSA
Posts: 4
Joined: Jul 2009

Larry, thanks for responding and for your encouraging input; it was very helpful.

Julie

gkoper's picture
gkoper
Posts: 174
Joined: Apr 2009

Have you considered scans...CT/bone to spot any recurrence in your husband?
George

JulieUSA
Posts: 4
Joined: Jul 2009

Yes, we plan to ask about that when we see the doctor in two weeks to be on the safe side.
Thanks.

Julie

Subscribe with RSS
About Cancer Society

The content on this site is for informational purposes only. It is not a substitute for professional medical advice. Do not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Use of this online service is subject to the disclaimer and the terms and conditions.

Copyright 2000-2014 © Cancer Survivors Network