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Rise in PSA post Radical Prostectomy and 8 weeks of Radiation

kelly whittemore
Posts: 2
Joined: Feb 2012

Hi all, first time on..

I was diagnosed 12/09 biopsy showed 4 positive of the 12 being 47 at the time we decided on surgery. PSA was 4.5 gleason was 7 or 8. 1/09 when going through the surgery it was proven I had no margins on one side and leakage in the prostate bed. Prostate and 24 lymph nods removed. Prostate was very impacted and nerve sparing was a issue. I then went on to 37 radiation treatments. over the last 2 years my PSA was looking good 4/11 it was .01 last week I went in 1/12 and it has rised to .1, dr. seemed a bit concerned and is having me tested again in 2 months. Also last year I had a full body bone scan with negative results. I didn't think much about it but for some reason I now can't stop thinking about. Thanks to anyone that replies. Like most of you I am father and grandfather, I am 49 years old and just want to be sure I am around to see it all happen.

kelly whittemore
Posts: 2
Joined: Feb 2012

couple of more data points post surgery my PSA was .5 in 2/10 after readition .3 6/10 gradually reducing to .01 in 4/11 "all test performed at the same lab".. then you see my previous note

tarhoosier
Posts: 181
Joined: Aug 2006

Kelley:
This is way beyond where you are and what you are interested in today. However, there is a trial with Provenge Immune Therapy for men such as you. Clinicaltrials.gov and Provenge will take you there. It is an interesting option for men who may have thought they took their last shot.

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Kelly, welcome to the forum. Most urologists consider that a rising PSA after RP that is greater than 0.2 is technically biochemical recurrence. After radiation, it is generally considered to have recurred if it rises 2 ng/ml above nadir (or the low point). Since you have had both I would think that a PSA score that continues to rise above 0.2 is cause for concern.

I'm wondering if you received hormone treatment in conjunction with your radiation treatment and if not, why not? If your PSA continues to rise I am sure your medical team will talk to you about HT.

Best of luck to you.

K

amccann415
Posts: 8
Joined: Oct 2008

I am in the same situation, I had surgery and radiation, now my psa is rising. very interested to see if any one else has experienced this.

Old-timer's picture
Old-timer
Posts: 109
Joined: Apr 2011

I believe, based on my experience, the slight rise in PSA may turn out to be nothing but a momentary blimp. My prostate cancer returned 13 years after RP. I then underwent radiation (with PSA at 1.16). After four more years, my PSA had climbed to 20.4. That was three and one-half years ago. At that time, I went on hormone thearpy. After three months, my PSA dropped to <.01 and is still at that level after three and one-half years.

I recommend that you relax as much as possible as you wait for the next PSA reading.
Should it be moving up, HT seems to be a viable next step. I talked my urologist into waiting until the PSA reached 20.4 to begin HT. That worked out great for me. I realize that I am much older than you. Your youth is bound to be a major factor as you make decisions re treatments. I'm 85. Because of my age, I have less at stake should I take risky chances!

By the way, my wife and I will soon welcome our second great grandchild.

My best wishes for you and your family.

travelinman5775
Posts: 1
Joined: Feb 2012

Hello all, I'm 54 y/o, had RP on 11/17/11 including removal of seminal vesicles. Gleason score was 4+4=8. all lymph node pathology negative. I had my first post-surgery PSA test yesterday and results show it as 0.38. I see my urologist tomorrow, but from what I've read (Dr Walsh's book) I will very likely need radiation therapy of the prostate bed. Any input at this point would be appreciated. Obviously was hoping for a score at least 4x lower. Also wondering what the best interval of time would be for subsequent PSA tests. If I'm in the wrong discussion, please let me know as well. Thank you and God bless.

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Welcome, travelinman. You've found the right place. Sorry that your post surgery PSA was so high. I do agree with your doctors that radiation is a smart course to follow at this point. Obviously you want to follow the directions of your medical team but I suspect they will get you back at the three month point after you've completed your treatment.

I suggest you also discuss with your doctors the possibility of taking hormone therapy in conjunction with your RT as most studies indicate this has a higher success rate than radiation alone.

Thanks for sharing your story.

K

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