Prostate cancer returned twice

NancyJacobs Member Posts: 4 Member
edited September 19 in Prostate Cancer #1

My husband had his prostate removed (RRP) in 2004. In 2010 his PSA increased and he had radiation and hormone therapy. His PSA has been very low or undetectable since then. Now in 2023, thirteen years later, his PSA level has doubled in the last six months. What are the chances that it has metastasized? Twice we were told he was cancer free…now this. I’m 71 and my husband is 75.


  • Clevelandguy
    Clevelandguy Member Posts: 866 Member


    If it was me I would get a PMSA PET scan and a bone scan. Both of these would be good at spotting any spread. If they find anything on the scans you can address at that time with various forms of radiation. Hormone therapy is another option depending on how your husband feels about the side effects. Based on other survivors here, it’s not that uncommon to find nothing on the scans. Hope for the best!

    Dave 3+4

  • Old Salt
    Old Salt Member Posts: 1,115 Member

    Good advice from Dave IMHO.

    I hope you both will overcome this setback.

  • On_A_Journey
    On_A_Journey Member Posts: 57 Member

    Good luck, Nancy.

    I believe that the chances of a PSMA PET Scan picking anything up increases with a higher PSA. Could you tell us what the actual PSA number is? If it has doubled from say, 0.03 to 0.06, I wouldn't be worried at all - it might have just been an erronous result.

    I am also living with prostate cancer recurrence and my PSA is currently over 0.50, but the same scans have not picked anything up yet.

  • NancyJacobs
    NancyJacobs Member Posts: 4 Member

    Thank you everyone. My husband’s PSA went from .3 to .6 in six months. He did get a PMSA PET scan. It showed metastasis in some of the pelvic lymph nodes. His doctor said that radiation was not an option because he had radiation in that same area previously. They are going with hormone therapy.

    He didn’t really talk about a prognosis. We talked more about treatment. So I don’t know about his prognosis. When his PSA numbers doubled last time and they did radiation, nothing showed up on his PMSA PET scan. So I’m nervous about it showing up in his pelvic lymph nodes. I’d always heard that if the cancer gets in your lymph nodes that is more or less the beginning of the end which is discouraging.

  • On_A_Journey
    On_A_Journey Member Posts: 57 Member

    Thanks for responding so quickly Nancy! I wish I had done the same myself to your original post. Sorry.

    At least the scan did show something. Compared to me, it is a very early detection and will maximize the effectiveness of further treatment. If cancerous cells have been detected in nodes, then yes, radiation is the normal treatment for that.

    It doesn't make sense to me that your husband had radiation to his pelvic nodes previously without it showing up on a scan first, or am I misunderstanding? I had 'blind' salvage radiation to my prostate bed 6 months after my prostatectomy because my PSA didn't drop to anywhere near zero, but radiation is not directed to nodes without confirmation of scans first. I am not experienced enough to know why radiation can't be applied to the same nodes again. I'm also speculating that maybe, the nodes can be removed surgically?

    That said, hormone treatment will again knock down the PSA (and thus, tumor growth) for at least a few years before progression to the bones in a worst case scenario, and then there are other treatments available, and it is a slow disease anyway. You two can look forward to many years together yet, I'm sure. Together, you are doing the right thing by not ignoring it.

    I completely understand your concern about 'the beginning of the end' but realistically, that happens from the day we are born... 😉

    Good luck with everything. Thinking of you.

  • NancyJacobs
    NancyJacobs Member Posts: 4 Member

    Thank you so much! You know far more than I do. Your words were extremely encouraging. I just found this excellent video that explained a lot to me as well. Evidently these newer scans show so much more than the PET Scans of the past.

    I don’t know that this site will allow me to share the link, but I’ll give it a try. You might find it interesting.

    Thanks again for your encouragement.