increase in psa 7 years after seeds

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  • buff0057
    buff0057 Member Posts: 4 Member
    #22
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    Is EBRT an option?

    I am awaiting a followup appointment after the PMSA-PET scan.  Results indicate:

    1.  There is focally increased PSMA expression compatible with locally

    recurrent prostate cancer.

    2.  Status post brachytherapy of the prostate gland with increased
    radiotracer uptake at the anterior prostatic base right of the midline

    with an SUV max of 5.1.

    Would EBRT or cryotherapy potentially be an option for treatment?
  • VascodaGama
    VascodaGama Member Posts: 3,651 Member
    edited October 2021 #23
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    Get second opinions before deciding

    Yes, both therapies are used in recurrence cases from brachytherapy. However, EBRT is preferred if the cancer is located too close to the bladder (the base area of the prostate gland).There have been many cases of bladder injury in cryotherapy. I think you should discuss in your next meeting with your doctor about the details regarding the therapies particulars and the side-effects involved in each type. Surely EBRT seems to be preferred as per the PETs results, but radiation of areas previously radiated influence the dose planning and areas to be covered. Low doses of radiation do not kill cancer. You should consult a radiotherapist before deciding.

    Another item for conversation will be on adding ADT which should be started two months before RT.

    What is your PSA histology?

    Have you checked the testosterone levels?

    Best,

    VG 

  • buff0057
    buff0057 Member Posts: 4 Member
    #24
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    My PET scan indicated a small area with increased radiotracer uptake. Subsequently, I have had an MRI, and an MRI guided biopsy of the prostate. The pathology findings / diagnosis for 16 samples was: "Benign prostatic tissue showing prior radiation effects".

    One sample from the targeted area stated: "demonstrates some scattered glands to be positive for basal cell markers (p63 and CK34BE12) and negative for AMACR expression, thus supporting the morphologic impression that these represent benign prostatic glands".

    I find this a bit confusing with regards to my PSA and PET scan results. I assume pathology is somewhat subjective and am wondering how to approach this. I have not met with the university urologist yet.

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