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Dramatic PSA jump

concernedson007
Posts: 4
Joined: Mar 2017

I don't know what to do anymore. My father had his prostrate removed in 2006. Starting in early 2016, his PSA began to spike again. He now sits at an alarming 13 yet has had CT/Bone and other scans and they can't find anything. Has anyone else experienced something like this?

Old Salt
Posts: 720
Joined: Aug 2014

Sorry to read that. Your Dad should see a medical oncologist right away. I speculate that (s)he will prescribe hormone therapy and perhaps more.

It looks to me (not an MD) that the cancer has metastasized but that the metastases were too small to be detected by the scans that were used so far. A PMSA scan is more likely to detect small metastases, but in the USA this type of scan is currently only available in clinical trials. I read that one of these is at the UCSF hospital.

The PMSA scan is more readily available  in Germany (and Australia).

concernedson007
Posts: 4
Joined: Mar 2017

Yes, sadly from a few discussions I have heard how common this is. His current oncologist has basically told us to wait an additional 4 months and repeat the same tests again. They have discussed hormone therapy but I don't think my dad nor the doctor are serioulsly considering this. I will look into the PMSA scan!

Old Salt
Posts: 720
Joined: Aug 2014

is what you wrote in the first post. I think it's alarming too and I also think that it is not advisable to wait four months for another exam. Perhaps your Dad should see another medical oncologist for a second opinion.

 

PS: It would be good to have more info. How old is your Dad now?

What was the pathology of the prostate?

Other medical issues (co-morbidities)?

Swingshiftworker
Posts: 1013
Joined: Mar 2010

In order to be absolutely certain (at least as certain as technologically possible), ask for a MRSI/MRI 3T scan to be done on your father. 

This is a spectroscopic scan which when used w/a radioactive dye and a Tesla coil inserted in the rectum during the scan can detect the presence of choline which is  marker for cancer.

See the following research paper for a discussino of the benefits of using this technology in the diagnosis/assessment of prostate cancer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1578527/

I had this scan done on me at UCSF when there was concern of a possible recurrence of my cancer after 3 increases in my PSA, which is indicative of such.  Fortunately, for me, the results were negative and I have been cancer free ever since.

Hope the result for your father is the same.  Good luck!

 

 

concernedson007
Posts: 4
Joined: Mar 2017

Thanks to both of you for the info. 

To give a bit more background: 

My father is currently 71. When his prostrate was removed via the da Vinci system, his gleason score was a 6. He has been fairly healthy since until 2016 ( a little overweight, but I didn't say that). Starting last year, his PSA was tested and the results with 3.1. His onocologist immediately started a round of Cipro and tested again. PSA continued to rise. During summer of 16, he also had a pacemaker put in, so I am not sure if he can do the one test you mention Swingshift since it has MRI at the end. (I will admit I don't know all of the terms). He has had multiple bone scans, PET, CT and bloodwork over the past several months with nothing substantial to report, except that PSA number now sits just over 13. He also had a biopsy of the prostrate canal (not sure of method) but that was also negative. What bothers me the most other than the 10 point increase in less than a year, is his doctor stating we just need to wait a few more months again and do the same tests. 

I did contact Cancer Center Treatment of America yesterday and they are going to take a look at his records for me. 

concernedson007
Posts: 4
Joined: Mar 2017

One thing I did forget to mention is he now has terrible mood swings. Anything sets him off which is very unusual for him as he was very laid back. I don't know if that is just the stress of dealing with this or something else. The doctor tells me that they have checked his brain but considering they can't do an MRI due to pacemaker, I wonder a bit. 

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