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Post Prostectomy

Judith A's picture
Judith A
Posts: 2
Joined: Jul 2014

Nov. 13, 2014   PSA-5.22  Enlarged prostate.      Age 57

Nov. 20, 2014.  PSA-5.41

Feb. 12, 2014.  Radical Prostectomy  Gleason Score 7 (3+4).  One percent of prostate involved.  Lympth nodes, seminal vesicles, and margins were clear.  Excellent recovery - no incontinence or erectile dysfunction.

June 2, 2014.  PSA-2.6

June 3, 2014-  PSA-3.?

June 24, 2014.  Bone Scan - negative

july, 19, 2014.  CT Scan - Abd. and Pelvic - negative

Our surgeon is perplexed and has referred us to an oncology radiologist.  

My question is what could cause PSA to rise so high?  I jokingly asked the surgeon if my husband had two prostates.  

We would appreciate any input.  

                       

Swingshiftworker
Posts: 818
Joined: Mar 2010

This is not something you want to hear but the only reason for post-RP PSA #'s so high is a failed RP.

After a successful RP, the PSA readings should be basically undetectable -- 0.1 or less.  The reason being, if all of the prostate tissue has been removed, there is no tissue left to generate PSA -- prostate specific antigen -- that can be dectected w/a PSA test.

So something is obviously not right. 

If you can get your doctor to do it, the best "test" to get would be a combined endo MRI/MRSI scan using a Tesla coil, which will show if there is any cancer remaining in the region of the prostate and it's location. 

Otherwise, your only choice will be to indure post-RP radiation treatment (usually IMRT) of the suspect tissue, which involves 40 or so treatments (5/day over 8 weeks) in order.  However, w/o an MRI/MRSI scan, the radiation oncologist will not know exactly where any cancer remains and will just try to hit the entire region (indiscriminately in a shotgun approach) in "hopes" of killing any remaining cancer.

Good luck!

 

Yank31's picture
Yank31
Posts: 31
Joined: Dec 2013

Judith

Like your husband, I may me facing salvage radiation therapy in the not-too-distant future. You have to remember that RT is a second shot at a CURE, not just controlling the PCa. This is the reason I chose the surgery: I wanted the 2nd shot at a cure in case the operation failed.

Good, luck.

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