Recently diagnosed with Gleason score of 9

SV

Is this a bad test result?

Does this mean the cancer is back?

Standard Range	1/7/20	2/14/20	9/16/20	12/8/20	12/8/20	3/10/21
Total PSA <=3.101 ng/mL	1.950	0.180	<0.008	<0.008	<0.008	0.130

 

VascodaGama

SV

SV

The PSA was "masked" while on the ADT 's effects. These effects can last months to vanish and so is the masquerade on the PSA. It usually bounces back a little. In any case, recurrence from radiation therapy  is recognized after three consecutive increases of the PSA from a nadir.  In your shoes I would wait for the next periodicals (3-month) tests to draw conclusions. 

VG

SV

VascodaGama said:

SV

SV

The PSA was "masked" while on the ADT 's effects. These effects can last months to vanish and so is the masquerade on the PSA. It usually bounces back a little. In any case, recurrence from radiation therapy  is recognized after three consecutive increases of the PSA from a nadir.  In your shoes I would wait for the next periodicals (3-month) tests to draw conclusions. 

VG

Thanks for the ray of hope!

Thanks for the ray of hope! So this means that maybe this PSA rise is a false alarm?

SV

PSA now jumped from .13 to

PSA now jumped from .13 to .29 in 25 days. Guessing that the news grows worse?

Clevelandguy

More testing needed

Hi SV,

I have to agree with Vasco, if it was me I would wait another two or three PSA tests to see which direction the trend line is going. Since you had radiation you might bounce around a little for sometime in the future. PSA bounce is fairly common with radiation treatments.  No need to panic yet, hope for the best(lower PSA readings).

Dave 3+4

SV

Clevelandguy said:

More testing needed

Hi SV,

I have to agree with Vasco, if it was me I would wait another two or three PSA tests to see which direction the trend line is going. Since you had radiation you might bounce around a little for sometime in the future. PSA bounce is fairly common with radiation treatments.  No need to panic yet, hope for the best(lower PSA readings).

Dave 3+4

Thanks. I understand that if

Thanks. I understand that if I still had a prostate a slight bounce is normal. But since I don't have a prostate shouldn't me PSA be zero forever? It was my understanding that the only thing that makes PSA is prostate tissue.

Old Salt

Yes

Since you had surgery, I agree that your PSA should be very low.

Unfortunately, it appears not to be, but I would follow up, as ClevelandGuy suggested, and get another test in 1-3 months.

If there really is an upward trend, you would have to consult a medical oncologist once again. 

 

Clevelandguy

My bad

Hi,

Sorry I missed the fact you had surgery but from what I understand if you are under .2 in your PSA reading you are in remission.  Like Old Salt said, with surgery your PSA should be very very low or undetectable.  I would still give it a few more tests to determine if you are trending upward.  If yes then back to the doctors for more consults on your next step.

Dave 3+4

SV

Thanks guys. Urologist moved

Thanks guys. Urologist moved 90-day PSA testing to 30-day testing. RO also ordered a PSMA scan at UCLA. Trouble is that first available appointment is not until mid-June. Anyways got on the cacellation waitlist. RO was concerned at the doubling time. Original PET scan indicated a spot on my right pelvic bone that had a high probability of being cancer. When getting Proton Radiation last June I asked the RO to zap that spot just in case. I figured that while they are in there cooking me they might as well nuke that spot. I forgot what his answer was.

Not looking forward to more Lupron and radiation. Ho hum...

SV

PSMA

I got on a cancellation list for a PSMA scan at UCLA and just scored an appointment for this Friday. Previous PET scan last year prior to treatment indicated a suspicious spot on my pelvic bone. I'm guessing this is the problem. How serious is metasis on the pelvic bone?

Max Former Hodgkins Stage 3

SV said:

PSMA

I got on a cancellation list for a PSMA scan at UCLA and just scored an appointment for this Friday. Previous PET scan last year prior to treatment indicated a suspicious spot on my pelvic bone. I'm guessing this is the problem. How serious is metasis on the pelvic bone?

Pelvic

Any metastasis of PCa is serious, but if it is identifiable in just one spot, localized RT might be used as a pallative (as you noted above).    Your PSA in general does not indicate metastasis, but this is a generalization and not authoratative.  The oncolgists will have to determine the cause of the spot, which could be a great many different things.  Usually, metastatic PCa has high PSA with a strong doubling rate, showing that the pony is out of the barn.

SV

Max Former Hodgkins Stage 3 said:

Pelvic

Any metastasis of PCa is serious, but if it is identifiable in just one spot, localized RT might be used as a pallative (as you noted above).    Your PSA in general does not indicate metastasis, but this is a generalization and not authoratative.  The oncolgists will have to determine the cause of the spot, which could be a great many different things.  Usually, metastatic PCa has high PSA with a strong doubling rate, showing that the pony is out of the barn.

Thanks. I had my PSMA scan

Thanks. I had my PSMA scan yesterday so I guess we will know more on Monday.

SV

What does this indicate?

SV

 PSA went to .39

 PSA went to .39

SV

What does this indicate?

1/7/20	2/14/20			12/8/20	3/10/21	4/6/21	4/28/21
	1.950	0.180			<0.008	0.130	0.290	0.390

 

SV

Back to radiation

I consulted several oncologists here in So Cal and the consensus was to radiate this newest microscopic lesion asap but due to the nature of this singe lesion they agreed more ADT would not be necessary unless more lesions pop up down the road. New lesion is located in the pubic bone outside of the field of prior radiation.

SV

Now I'm faced with two

Now I'm faced with two treatment options--proton like I did the first time or SBRT.

VascodaGama

Cyberknife

SV,

Some survivors posted here before about the success in using Cyberknife for spot radiation. This is a sort of EBRT particular to a type of machine that delivers high doses (hyperfractionate) in one goal. I hope that this time you eliminate the bandit for good.

Best

VG

SV

Thanks amigo. I've opted for

Thanks amigo. I've opted for the SBRT at UCLA. Both doctors agreed that the outcomes are identical in my case, the main difference is SBRT is 3-5 treatments and Proton is 15-20. This was a significant issue with a multi-hour commute for both.

Josephg

SRBT

SV,

I recently underwent SRBT for a PCa lesion in my pelvic bone.  I had 3 treatments, totalling 30 Grays.  Side effects were almost non-existent, having only some slight tiredness about 1 week after the 3rd treatment, and this slight tiredness lasted about 1 week.

I wish you the best of outcomes on your PCa journey.