Prostate removed PSA at .72 after 15 years at 0.

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KennyWoj
KennyWoj Member Posts: 1 *
edited April 2022 in Prostate Cancer #1

My father had his prostate removed due to cancer 15 years ago. PSA at zero for 12 years. Started to rise slightly and now is at .72. Doc wants to do 39 sessions of radiation using RapidArc machine AND hormone therapy to reduce testosterone levels. Sited some study a few years ago that rate or recurrence after 15 years was better when you did both. Dad is 77yo and very active.

I don’t want him to do the testosterone stuff. Too many side effects and sounds like it would be worse and more debilitating than just radiation. And can’t find any studies describing anything about using both and difference in recurrence with one or both. Anyone have any insights?

Thanks.

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  • Clevelandguy
    Clevelandguy Member Posts: 1,028 Member
    #2
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    Hi,

    It was me I would do some scans(bone,PET,MRI) to figure out how large the tumor is. If it is very small you might want to do active surveillance for a while to monitor growth. At .72 he could possibly go for years without the need for any medical interaction and live out the rest of his life as long as he is monitored via scans every so often.

    Dave 3+4

  • Old Salt
    Old Salt Member Posts: 1,345 Member
    edited April 2022 #3
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    To give somewhat reasonable advice, we need to know more.

    Has the cancer been located? It appears that the Doc (hopefully he is a Radiation Oncologist) has decided that there is cancer (left) in the pelvic bed. Has that been confirmed? If the cancer has metastasized, irradiating the area around the prostate makes little sense.

    We also need to know how long the hormone therapy is supposed to last. If it is for a short period (3 months?), the therapy is usually well tolerated.

    PS: Good advice also from David 3+4

  • VascodaGama
    VascodaGama Member Posts: 3,662 Member
    #4
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    I agree with above comments. You need to locate the metastasis (if any) to decide on a therapy. A PET is a good step forward.

    Regarding the treatment, you should take into consideration that all therapies have risks and cause side effects deteriorating the quality of life. Avoiding them would be the best if one can. Apart from that, your dad is 77 and most probably will start confronting the typical illnesses of old ages.

    The combination treatment of radiation plus hormonal is nowadays the typical in recurrences from prostatectomy but, while the radiation component is administered to kill the bandit, the hormonal treatment is palliative and wouldn't have any killing effect. The purpose of the hormonal is to improve the efficacy of the radiation.

    You can discuss with his doctor in having radiation alone if the bandit is located at the prostate bed. However, if the metastases is at far places (bone, upper chest lymph nodes, etc) or widely spread, then radiation wouldn't be the best option and the hormonal would be preferred.

    The PSA of 0.72 ng/ml is very low. I would wait keeping a vigilance on the progress as commented by Dave above. The treatment suggested by his doctor will work the same even if the PSA gets much higher close to 2.00 ng/ml.

    Best wishes and luck in this continued journey.

    VGama

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