PSA continues to increase after treatment

nickles44

Last Jan I was diagnosed with a PSA of 14. My biopsy had a Gleason of 8-9 on one half of my prostate, the other side was normal. I had multiple scans and MRI's but no cancer outside the prostate was found. I had seeding followed by 44 radiation treatments. My PSA went to 15 and then 2 months later dropped to 14. Unfortunately two months later it is now 29. Has anyone had or know of a similar experience. I think the plan is probably more MRI and scans and some form of hormone treatment to encapsulate any cancer that has escaped.

Kongo

Options
Nickles,

Welcome to the forum and I'm so sorry that you're having a tough time with this pesky PCa. Without knowing anything about your pathology other than your Gleason 8-9, it is likely that your high risk cancer had already escaped the prostate gland when you were treated. Prostate cancer tends to grow faster once it leaves the prostate which is probably why your PSA is heading north again.

Hormone treatment may well be in the mix of options your medical team will want you to consider but it doesn't really "encapsulate" the cancer and is not considered curative. What hormone treatment does is to block the testosterone in your body which prostate cancer needs to grow. Eventually, PCa becomes resistant to these types of drugs and your PSA will rise again, evidence that your prostate cancer is growing.

You need to discuss a variety of post treatment salvage options with your medical team. Given your history of treatment with brachytherapy, further radiation options may be limited or perhaps not. Only your radiologist can help you sort through this.

Best wishes as you sort through your options and please keep us informed of what you learn and which course you decide to follow.

mrspjd

Kongo said:

Options
Nickles,

Welcome to the forum and I'm so sorry that you're having a tough time with this pesky PCa. Without knowing anything about your pathology other than your Gleason 8-9, it is likely that your high risk cancer had already escaped the prostate gland when you were treated. Prostate cancer tends to grow faster once it leaves the prostate which is probably why your PSA is heading north again.

Hormone treatment may well be in the mix of options your medical team will want you to consider but it doesn't really "encapsulate" the cancer and is not considered curative. What hormone treatment does is to block the testosterone in your body which prostate cancer needs to grow. Eventually, PCa becomes resistant to these types of drugs and your PSA will rise again, evidence that your prostate cancer is growing.

You need to discuss a variety of post treatment salvage options with your medical team. Given your history of treatment with brachytherapy, further radiation options may be limited or perhaps not. Only your radiologist can help you sort through this.

Best wishes as you sort through your options and please keep us informed of what you learn and which course you decide to follow.

curative?
Kongo,
Curious about your statement re "curative" in the post above, not that I necessarily disagree or agree with it. What, if any, treatments might you consider to be curative for PCa in the absence of metastatic disease?

Kongo

mrspjd said:

curative?
Kongo,
Curious about your statement re "curative" in the post above, not that I necessarily disagree or agree with it. What, if any, treatments might you consider to be curative for PCa in the absence of metastatic disease?

Curative
Hi, mrspjd

I used the term "curative" within the context most cancer physicians use when they embark upon a treatment designed to eliminate the disease from the body or place it in permanent remission. Curative treatments include surgery, radiation therapy, proton therapy, HIFU, Cyrotherapy and so forth. By indicating that HT was not curative in the above post I was drawing upon a rather large body of work that indicates that HT slows or sometimes shrinks cancer but does not eliminate it or force it into remission. One very concise explanation of this effect can be found elsewhere on the American Cancer Society website (the host of this forum) at the link below.


http://our.cancer.org/docroot/CRI/content/CRI_2_4_4X_Androgen_Suppression_Hormone_Therapy_36.asp

As to your question about whether any treatment actually results in a cure is, as you well know, a subject of some controversy. My personal, non professional opinion is that there is no cure for prostate and other cancers that are inherently characterized through metastasis. I am sure others may have differing opinions and as I don't wish to hijack this thread, perhaps that topic might be better addressed in a separate thread.

Best

mrspjd

Kongo said:

Curative
Hi, mrspjd

I used the term "curative" within the context most cancer physicians use when they embark upon a treatment designed to eliminate the disease from the body or place it in permanent remission. Curative treatments include surgery, radiation therapy, proton therapy, HIFU, Cyrotherapy and so forth. By indicating that HT was not curative in the above post I was drawing upon a rather large body of work that indicates that HT slows or sometimes shrinks cancer but does not eliminate it or force it into remission. One very concise explanation of this effect can be found elsewhere on the American Cancer Society website (the host of this forum) at the link below.


http://our.cancer.org/docroot/CRI/content/CRI_2_4_4X_Androgen_Suppression_Hormone_Therapy_36.asp

As to your question about whether any treatment actually results in a cure is, as you well know, a subject of some controversy. My personal, non professional opinion is that there is no cure for prostate and other cancers that are inherently characterized through metastasis. I am sure others may have differing opinions and as I don't wish to hijack this thread, perhaps that topic might be better addressed in a separate thread.

Best

Kongo
I would tend to agree that ADT/HT, in and of itself, MAY not be curative. However, in combination with one of several of the txs you cited, and used with proper up to date medical supervision for higher risk PCa, perhaps on an intermittent schedule, it may be more effective as "curative" or with curative properties. As indicated, there may be no PCa tx that is 100 % "curative" based on the insidious nature of cancer, although we all have to believe that curative txs exist. While the ACS is our host for the CSNetwork, and is an excellent source for very general broad-based PCa info, we all know too well their recent track record and public statements in regard to PCa, and that they are not the most up to date resource for researching info beyond the most "basics" of the disease. I agree that any further discussion deserves it's own thread, and I apologize to the thread author for going off-topic, as sometimes happens on this discussion board.

Kongo

mrspjd said:

Kongo
I would tend to agree that ADT/HT, in and of itself, MAY not be curative. However, in combination with one of several of the txs you cited, and used with proper up to date medical supervision for higher risk PCa, perhaps on an intermittent schedule, it may be more effective as "curative" or with curative properties. As indicated, there may be no PCa tx that is 100 % "curative" based on the insidious nature of cancer, although we all have to believe that curative txs exist. While the ACS is our host for the CSNetwork, and is an excellent source for very general broad-based PCa info, we all know too well their recent track record and public statements in regard to PCa, and that they are not the most up to date resource for researching info beyond the most "basics" of the disease. I agree that any further discussion deserves it's own thread, and I apologize to the thread author for going off-topic, as sometimes happens on this discussion board.

Agree Completely
Mrs,

Agree with all your sentiments. My feelings about a "cure" for prostate cancer are mostly esoteric in nature and the practical result of most modern treatments makes the issue moot as they extend life so long that we end up passing on from some other factor other than prostate cancer.

tarhoosier

mrspjd said:

Kongo
I would tend to agree that ADT/HT, in and of itself, MAY not be curative. However, in combination with one of several of the txs you cited, and used with proper up to date medical supervision for higher risk PCa, perhaps on an intermittent schedule, it may be more effective as "curative" or with curative properties. As indicated, there may be no PCa tx that is 100 % "curative" based on the insidious nature of cancer, although we all have to believe that curative txs exist. While the ACS is our host for the CSNetwork, and is an excellent source for very general broad-based PCa info, we all know too well their recent track record and public statements in regard to PCa, and that they are not the most up to date resource for researching info beyond the most "basics" of the disease. I agree that any further discussion deserves it's own thread, and I apologize to the thread author for going off-topic, as sometimes happens on this discussion board.

Curative?
For men who have failed their primary treatment for prostate cancer, Androgen Deprivation Therapy (ADT, alternatively HT) may be prescribed. This treatment is palliative and not curative as a prescription. The definition of cure is flexible. For a man of 70 who has small amounts of slow growing cancer then "cure" is not relevant. For a man of any age with serious medical conditions "cure" is not relevant. For a man morose and suicidal "cure" is not relevant.
For the rest of us the idea that a disease can be fought and won, forgotten and put behind us, is a daily source of irritation. Winning and losing are hot, hard words. I choose to avoid daily disappointment and see my disease as Lee saw his mission in Virginia; To fight with the best of my abilities, to assemble the resources at my command and marshal them with every intent of continuing the battle as long as possible and hoping that, with divine intervention, victory may be, someday, in sight.

mrspjd

tarhoosier said:

Curative?
For men who have failed their primary treatment for prostate cancer, Androgen Deprivation Therapy (ADT, alternatively HT) may be prescribed. This treatment is palliative and not curative as a prescription. The definition of cure is flexible. For a man of 70 who has small amounts of slow growing cancer then "cure" is not relevant. For a man of any age with serious medical conditions "cure" is not relevant. For a man morose and suicidal "cure" is not relevant.
For the rest of us the idea that a disease can be fought and won, forgotten and put behind us, is a daily source of irritation. Winning and losing are hot, hard words. I choose to avoid daily disappointment and see my disease as Lee saw his mission in Virginia; To fight with the best of my abilities, to assemble the resources at my command and marshal them with every intent of continuing the battle as long as possible and hoping that, with divine intervention, victory may be, someday, in sight.

Thanks
Tarhoosier,
We, men and women together, are all in this battle, some on the front lines, others as the support. Thanks for your inspirational post.
Best,
mrs pjd