My case high PSA post prostatectomy

jpeters88
jpeters88 Member Posts: 4 *
in Prostate Cancer #1

Hi I’m 48 years old. Diagnosed with prostate cancer in Oct 2024. Had surgery in Dec 2024. PSA score pre surgery (radical prostatectomy) was 19. Had lymph node involvement. Gleason 3+4. 10 out of 21 nodes that were removed were positive for cancer. Odd thing was the cancer seemed to be near the wall of the prostate and so spread to lymph nodes sooner bc only a small portion of prostate tested positive. And the lymph nodes involvement was on the same side as where the prostate cancer was located.
Now 60 days post op PSA was 6.6 last week.
This week 10.3. Discussing hormone therapy and radiation treatments with my Doctors this week.
My pet scan from last October only showed hot spots in my prostate and lymph nodes. But how likely has this spread to bone by now?
I’m also scheduled for another PSMA pet scan on March 4, but obviously the waiting and not knowing is awful.

Comments

  • Clevelandguy
    Clevelandguy Member Posts: 1,265 Member
    #2

    Hi,

    Just to let you know the metastatic cancer might not be visible on the PET scan due to the small size of the tumor. Several folks here had negative PET sans but increasing PSA so it could take a few scans for the cancer to show it head. But when it does you can attack it with some form of external beam radiation. Good luck…….

    Dave 3+4

  • jpeters88
    jpeters88 Member Posts: 4 *
    #3

    thanks

  • swl1956
    swl1956 Member Posts: 194 Member
    #4

    Sorry it wasn't a one and done for you. I'm in the same boat. Started ADT for a few weeks now and will be beginning IMRT soon. Yes, the waiting is stressful but it seems to be routine for Pca journeys. I wish I could say the worry becomes easier, but in my experience I can only say it's not quite as intense because I've accepted my plight and going forward educating myself about treatments to the best of my limited ability. There's lots of tools to fight Pca which is hopeful. Hang in there! Odds are you'll be OK after treatments

  • Old Salt
    Old Salt Member Posts: 1,585 Member
    #5

    Yes, like you (and sw1956) wrote, I believe that radiation plus hormone therapy will be recommended.

    Very unfortunate that you have to face this situation at such a young age!

  • Steve1961
    Steve1961 Member Posts: 656 Member
    #6

    himimdont know what part of the country you are from but if can yiu get a hold of a dr robert reiter from ucla California i suggest you do .. he has posted many YouTube videos some of which I have posted if you can go back and look. He performed a surgery where they injected die into the night before when they go in the affected lymph nodes or glowing. That way, they know exactly which nip nodes to remove and the ones around it as well, they’ve had very much success with it. Hopefully, you can get a hold of him and maybe you could have this done before you do radiation and hormone treatments. I wish you the best may be. There are other surgeons in your area that are performing the surgery hopefully I can find it and I will post it. If not look up Dr. Robert Reiter on YouTube and you will see the video it’s a game changer.

  • Steve1961
    Steve1961 Member Posts: 656 Member
    #7

    https://youtu.be/-ZXDohxylg0
  • Steve1961
    Steve1961 Member Posts: 656 Member
    #8

    please watch this tgis man saved my life

  • jpeters88
    jpeters88 Member Posts: 4 *
    #9

    thanks Steve I will check that out

  • VascodaGama
    VascodaGama Member Posts: 3,731 Member
    #10

    Hi,

    The typical salvage treatment after failed surgery is a combination of radiation plus hormonal, starting with the hormonal. The protocol is fixed to handle the prostate bed, imagining that the cancer is there.

    In any case, I think that you should wait for the results of your next PSMA PET exam before starting the salvage to have the PSA high enough to assure any detection of metastasis in far lymph nodes as well as in bone. Particularly in your case, where they have dissected already 21 lymth nodes supposedly at the prostate region. The 68Ga-PSMA PET would be a good bet. The newer PET would be compared to the previous giving a better chance to locate targets for the radiation or dissecting instead of shooting arrows in the dark.

    Prostate cancer doesn't spread overnight. You have time to look for the best.

    Discuss the matter with your doctor and get second opinions after the PET exam.

    Best wishes

    VG

  • jpeters88
    jpeters88 Member Posts: 4 *
    #11

    thanks for the responses folks

  • Steve1961
    Steve1961 Member Posts: 656 Member
    #12

    Woth reoccurance step two would be guided radiation and hormone treatment, but as we all know the best way to get rid of cancers to get it out of your body please take a look at that video and look at the new and latest procedures every now and then they come up with new ways to battle this disease. It’s very promising, at least this way you can make an informed decision

  • Wheel
    Wheel Member Posts: 194 Member
    #13

    Steve,

    That is a great video actually showing the future of salvage treatment especially after surgery. In the past it certainly was Radiation and Hormone treatment after a rising PSA. This shows what is becoming of PSA driven treatment and image driven treatment. Treating in the past has always been the PSA driven giving you all the side effects without truly any targeting of what is causing the increase in the PSA. Dr Reiter does state generally the PSMA Pet does not pick up until the PSA is .2 but does show the benefits of waiting until even a 1.0+ waiting for it to be shown on imaging and if it just a node or two to be so surgically directed to remove those in surgery and have more years no side effects from Radiation/Hormone treatment. Clearly in patients whose disease has metastasized outside of the lymph nodes this would not be the course of treatment but for many seeking salvage after surgery remission failing I know I would pursue this new innovative protocol at UCLA. It’s like the latest DaVinci single port, Retzius Sparing, Puboprostatic ligament sparing prostatectomy technique. Thank you for sharing this video.

  • Steve1961
    Steve1961 Member Posts: 656 Member
    #14
    https://csn.cancer.org/discussion/comment/1721097#Comment_1721097

    absolutely modern medicine and technology at its best …seriously ..if the C is localized to the area where prostate was imwould definitely try this .. dr reiter is an expert surgeon UCLA fantastic hosptial hopefully more drs and hospitals will be doinf this as well…it excites me
    Because I did my treatment in reverse I’ve already had a radiation and I can’t do it again and I am just so afraid of the dreadful hormone treatments from what I hear it destroys a man but now there’s hope and have another surgery. I got to wrapped up and was worried sick about having prostate surgery. It wasn’t even that bad at all.

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