RRP followed by PSA Rise

First test 0.16

Second test a week later 0.17

**** furious and scared at the same time.

lighterwood67 said:

03/20/2018 RP

Thanks for posting your experiences.  I go for my RP 03/20/2018.  I have been posting on the goings on with me on this site.  Will post on mine when they get done.

Good luck, mate.

I hope it goes well.

Be kind to yourself when you get out of hospital and do not overdo it!

C

Vasco

Cheers!

Voice of reason as always.

My concern waiting three months to get a better idea of PCADT is that I am 0.17 with some potentially agressive PCa elements and an initial doubling somewhere between 7 and 9 months post op.

I understand that this places me in a grey area for good long term survivability and also that salvage done under 0.2 stands a far better chance than over.

If I wait three months for another test it may rocket and I could be stuffed.

Thoughts?

C

MAx

You and Vasco are right - get over the panic and learn.

The whole threshold thing like many things seems to have lots of different opinions so I will see what my consultant says and share it.

One thing I need to do is get my head around the various forms of salvage as I am a little confused with some of the abbreviations.

Here goes:

ADT - I understand to be Androgen Deprivation Therapy, medications to reduce T to starve cancer cells. Makes sense

ART - Adjuvant Radiotherapy - I assume to be salvage RT but...

ESRT - Early Salvage Radiotherapy also exists. What is the difference? Also I assume SRT is just the generic term.

What other forms of salvage are there?

I also understand that the above can be applied in various combiations of sequence or parallel for different reasons / effects. Is that true?

Cheers

C

Cheers for that, Grinder!

Hi all

I updated the master subject to be a bit clearer and more sensible

So I saw the urologist consultant today - she was a bit apologetic that I had had the rise (0.05 - 0.16) but seemed to want to reassure me than only a percentage of these are due to BCR and only a percentage of those become an issue - the usual numbers game.

I have a referall to a urology consultant to discuss options - either watch and wait or SRT/SHT. I favour the latter out of the box but my OH is Mrs. Cautious and is reluctant for me to dive in. I need to make sure I listen to her but do what is right for me as I need to be here for them as long as possible.

Only downside as they could not fit me in today it will take several weeks to get to see the onco. I'm hoping I don't get a bigger rise inbetween.

C

contento said:

Hey Cushins, it's normal to

Hey Cushins, it's normal to be worried . I would be too but I doubt very much your psa would skyrocket in a couple of weeks or so. My Gleason 8 took over 6 months to go from

.1 to .2. What does your OH want to wait for ? I assume it's a specific psa threshold ? I don't think it's a bad strategy to wait a bit.

I'll propose 3 reasons

1). A slightly higher psa ( say .2 ng/ml ) is still very manageable

2). It would definately confirm reoccurance

3). Perhaps most importantly, there's a better shot that an mri could locate the cancer. I know from conversations with my radiation oncologist who told me that the success rate of salvage is much higher when they know where the cancer is located. Keep in mind that salvage radiation  would still be givin even if they can't locate the cancer but they have to cover a wider area which would be exposed to more rads than if they knew where the cancer was located ( they could focus a little more ).

also, which of course is not good, if the cancer is located in a distant location other than the pelvis area then you would most likely not receive any radiation but begin HT. I hope this is not your situation.

I know there's mental anguish and I'm sorry for that but I agree with your OH , I would wait a wee bit longer if my doc also agreed.

Hi Contento

I should have clarified - OH is Other Half, i.e. wifey. She is a cautious person whereas I am a boots first into the landing zone typer person. She thinks I should wait and see.

I am divided because as you say waiting means more chance to spot tumours but interventkion below 0.2 is supposed to give better long term outcome.

Best approach os to get to the onco asap and see what they say.

Cheers

C

Vasco

That was badly worded - I meant "had HT and RT (as a discussion point in the previous post I made)" not "had HT and Rt (to start with)". I hope that clarifies things.

Yes, I had RP and the initial results were promising (0.05 with the cancer allegedly contained) BUT as you know, 8 months later it rose (0.16/0.17).

I have been referred to a urology oncologist because I am nearning the 0.2 mark and am still awaiting on an appointment (which I no doubt will have to expedite).

The specific reason I mentioned HT as a precursor to RT as a combined salvage therapy was that lay experts in McMillan and Prostate Cancer (similar folks to you) suggest that in the UK they are now starting to apply HT for up to six months BEFORE RT as there is trial evidence that it increases the success rate. I am guessing the theory is that the HT shrinks / kills tumour which makes the RT more effective over potentially a small application area.

You are right in that there is a risk the cancer becomes refractory early which is why I am trying to see it from all sides to make a risk aware choice.

Hope that makes sense.

Thanks again for the advice and support.

C