Elevated PSA

HillBillyNana

My husband just received the results of his recent PSA test. It is elevated again. 18 months ago it was elevated to <0.3 then a year ago it was .3 and then 6 months it was just under .3 and now it is 0.64. He had a bone scan last week and is scheduled for a Prostacint this week. The initial visit to get the injection is Thursday and then the scan will be next Tuesday. We will see the doctor next Thursday to try to sort this all out. Does anyone have any experience with this that might help us know what is going on or what to expect. We did post on a different discussion and Kongo offered some helpful words. Thanks to all. The best to all of you going through this ordeal.

Kongo

PCa Return
Hi again, Nana:

Sorry that the PSA came in as it did. It appears from the information you provided that after remaining very low since your husband's RP in 2006, his PSA began to rise about a year ago and has doubled in the past six months and is now at 0.64 ng/ml. While there are varying standards across the medical community about exactly what constitutes a biochemical recurrance of prostate cancer after RP(some say >0.2 while others say >0.4), all of them agree tht a PSA of 0.64 means that the cancer has recurred and the doubling time would suggest it is growing.

I don't believe there are any clear standards on evaluating doubling time in recurring cancer and I think you should seek out some second opinions as to what this doubling time means for your husband.

The Prostacint will help your medical team identify where the cancer is growing but many studies have shown that it can take up to 6 years for a recurring PSA to actually manifest itself in metastasis to another organ or bone. If the metastasis is detected by the Prostacint, I've read that it makes a difference in whether its in a lymph node, lung, bone, or some other organ as to potential severity, treatment options, and so forth.

I suspect that depending on if there is a detectable metastasis based on the Prostacint scan the doctor is going to recommend some form of follow-on radiation and possibly a combination of hormone therapy. A clearly defined metastasis can be treated with different forms of radiation (you might want to look at Sonny's recent post titled Hello and Update from Sonny where he is being treated for PCA now in his leg)

If your doctor is the urologist who also performed the surgery on your husband, you may want to also consult with a radiologist and oncologists who specialize in treating recurring prostate cancer.

About 30% of men who have an initial treatment of prostate cancer have a recurrence within ten years so it is fairly common.

Hope this helps.

HillBillyNana

Kongo said:

PCa Return
Hi again, Nana:

Sorry that the PSA came in as it did. It appears from the information you provided that after remaining very low since your husband's RP in 2006, his PSA began to rise about a year ago and has doubled in the past six months and is now at 0.64 ng/ml. While there are varying standards across the medical community about exactly what constitutes a biochemical recurrance of prostate cancer after RP(some say >0.2 while others say >0.4), all of them agree tht a PSA of 0.64 means that the cancer has recurred and the doubling time would suggest it is growing.

I don't believe there are any clear standards on evaluating doubling time in recurring cancer and I think you should seek out some second opinions as to what this doubling time means for your husband.

The Prostacint will help your medical team identify where the cancer is growing but many studies have shown that it can take up to 6 years for a recurring PSA to actually manifest itself in metastasis to another organ or bone. If the metastasis is detected by the Prostacint, I've read that it makes a difference in whether its in a lymph node, lung, bone, or some other organ as to potential severity, treatment options, and so forth.

I suspect that depending on if there is a detectable metastasis based on the Prostacint scan the doctor is going to recommend some form of follow-on radiation and possibly a combination of hormone therapy. A clearly defined metastasis can be treated with different forms of radiation (you might want to look at Sonny's recent post titled Hello and Update from Sonny where he is being treated for PCA now in his leg)

If your doctor is the urologist who also performed the surgery on your husband, you may want to also consult with a radiologist and oncologists who specialize in treating recurring prostate cancer.

About 30% of men who have an initial treatment of prostate cancer have a recurrence within ten years so it is fairly common.

Hope this helps.

Another question
I guess I am just impatient but my husband and I are planning to go on a three week vacation. Supposed to leave Friday. But . . . . he has the second visit of the Prostascint tomorrow and will not see the doctor till Thursday to learn the results and treatment recommendation. My question is: If the doctor recommends radiation, will it need to start immediately or could he hold off for three weeks? I think it is a moot point because my husband will probably want to start any treatment ASAP. And I really don't blame him. But we have plans to make. Cancer is such an inconvenience!!

Kongo

HillBillyNana said:

Another question
I guess I am just impatient but my husband and I are planning to go on a three week vacation. Supposed to leave Friday. But . . . . he has the second visit of the Prostascint tomorrow and will not see the doctor till Thursday to learn the results and treatment recommendation. My question is: If the doctor recommends radiation, will it need to start immediately or could he hold off for three weeks? I think it is a moot point because my husband will probably want to start any treatment ASAP. And I really don't blame him. But we have plans to make. Cancer is such an inconvenience!!

good question
Nana, I would think it would take them a week or so to set up the radiaton plan and do any prep work...nothing happens "immediately." Hope you still get to go on vacation.

HillBillyNana

Kongo said:

good question
Nana, I would think it would take them a week or so to set up the radiaton plan and do any prep work...nothing happens "immediately." Hope you still get to go on vacation.

I hope so too
Yes, we have a wonderful trip planned. We will go see Jerry's daughter for a week. Then two days on the Oregon Coast. Then drive down the Oregon/California coastline on 101. Plan to see several of my cousins - some of whom I have never met. We are going to go through Yosemite National Park. Then head home. Surely the cancer will understand and give us this time. We have fought this cancer thing for a long time. I had uterine cancer when I was 32, Jerry's first wife (my very good friend), fought ovarian cancer for 4 years before it got her. Then on our second anniversary, Jerry walked in our bathroom where I was cleaning my wound from a lumpectomy on my right breast and said 'happy anniversary'. Three years later almost to the day he was recovering from RP. We have managed to keep our heads up and keep on with our life for the most part, through the surgeries, chemo, radiation, and the end is not yet. So I am really hoping we can go on this trip. Other than our bouts with cancer, we are very healthy for 65 and 71. I will let you know what we find out as soon as we do.