Rising PSA after 7 years

Wapiti104
Wapiti104 Member Posts: 1 Member
edited February 2023 in Prostate Cancer #1

October 2013 64yo after routine physical tested 10.2 PSA. 3 weeks later had a biopsy in office, first mistake. Came back with a G8 and T3b in November. Put off surgery till after the 1st of the year. Did not want to deal with this over Thanksgiving and Christmas. February had RP, catheter for 8 days, after removal dry nights but small leakage during the day. Monthly tests that showed an uptick from 0.07 to 0.20 in 90 days. Met was RO and came up with a plan. 6 month shot of Eligard and couple of month later started 39 SRTs. ADT was very hard on me, Uro said I would have to be on this for probably 5 years. 2nd 6 month shot, I said I was opting out. How would I know if SRT did it's job. Luckily it must have worked the combo of the two. Fast forward, over 7 years of undetectable <0.05 being tested every 6 months. My last test results for PSA and testosterone, only my T was checked. Back for labs and my PSA came back 0.11 and need to come back in 4-6 weeks to be retested. Not sure what the plan maybe if it rising. I am 74 and my latest T was 140, never recovered with the highest after ADT in the 250-300 range. Side note, while on ADT I developed gynecomastia with painful lump in left breast. Fun going to get mammograms on top of everything else. Not sure if ADT is in my future but also not sure if I will start if recommended. I was also told there was 80% chance from my aggressive type that it would likely showed up again. Sorry for being long winded and hope I make some sense. Low T causes brain fog, at least with me.

Comments

  • On_A_Journey
    On_A_Journey Member Posts: 125 Member
    #2

    Firstly, welcome! Secondly, you're post made sense, so don't worry about it.

    Whether you go back on to ADT or not is your choice of course. The thing I noticed is that your testosterone level never recovered to what it was before. To me, that means that if you go on ADT again, your side effects might not be as bad as the first time around. The way I think about it is the higher the T, the more dramatic the effect will be when it is reduced. If it's already low, then you might not actually feel much difference.

  • Josephg
    Josephg Member Posts: 443 Member
    #3

    I've been there and experienced all of that, including gynecomastia and the mammogram. I consider you fortunate for having 7 years of remission, as I had less than 3 years of remission.

    When my PSA rose again to 0.98, my Oncologist ordered a PET scan, and it found a tumor in my pelvic bone. I had an SRBT radiation dose of 30 grays on the tumor and surrounding areas, and I started a 2 year regimen of Lupron, Zytiga and Prednisone. I was also prescribed Venlafaxine to reduce (somewhat) the intensity of the hot flashes. Fun, heck No! But, to do nothing was a slow death sentence, and I still had way too much to live for.

    Fast forward 2 years (70 years old), I completed the hormone cocktail regimen last month with both PSA and Testosterone being undetectable over that period of time. Now going forward, the quarterly blood draws will consist only for measuring PSA and Testosterone, and I will live my life to the fullest, until the PSA starts to rise again, hopefully a long time from now. As my Oncologist continuously states, we will view my PCa as a continuing 'condition' which we treat as needed for as long as we can, and I am OK with that.

    I wish you the best of outcomes on your PCa journey.

  • VascodaGama
    VascodaGama Member Posts: 3,700 Member
    edited February 2023 #4

    Hi, 

    We are in the same boat Navigating through the Darkness.

    I am 73 now but my story started when I was 50, in 2000. After failed RP and a sort of “blind” SRT, I embarked on a regimen of ADT programmed to be administered intermittently, which was started in 2010.

    This increase of your PSA doesn’t signify yet recurrence. Typically such status is given when the increase is verified in three consecutive tests post remission. Hopefully it goes down again and you avoid the nasty effects of ADT.

    In any case, you can now check on the sequential oligometastatic treatment, recommended for failed IMRT cases. Such requires PSMA-PET scans to identify and locate the tiny cancerous spots.

    To such extent, I would recommend you to allow the PSA to increase to levels above 0.70 for avoiding false negative scans.

    Best wishes and luck in this journey. 

    VGama 

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