BCR what to do? Prostate cancer feedback
Hi, I was diagnosed in Nov. 2002 with Grade 1 Gleason 6. Had RP Feb 2003. For 10 years my PSA was 0. In the 11th year my PSA went to 0.3 then dropped to 0 a year or two latter. Started going up again. The last 9 years it was stable at 0.3 ish up and down 0.34, 0.36,0.3 etc. In 2025 it went to 0.48 then down to 0.42. PSMA scan negative. My urologist says keep monitoring. Radiologist radiate the prostate bed and lupron for 6 months or just radiate.
My concern is side effects. I am very active 73 year old. Any thoughts and feedback would be great! Thank you guys for your help. Needless to say I am scared!
Comments
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Sarge22,
I go with your urologist. You may officially be at a considered BCR PSA level, however many clinicians hold off treatment until .5 to 1. Since nothing even shows yet on your PSMA Pet there is no target for the Radiation as you are probably aware that two schools of thought are emerging regarding when to begin treatment after BCR, one being the PSA driven and the newer Image driven based on the advent of the PSMA Pet. I have read the PSA needs to be somewhere between 1 and 2 before the PET might pick it up for specific targeted radiation. At 73 I would want to continue my active quality of life without the side effects of radiation and hormone therapy until absolutely necessary if its believed the same outcome is achieved. With your urologist recommending continued AS while your Radiologist recommends the radiation, on the Radiology side their is financial incentive off the Radiation while your Urologist does not have any financial incentive. That does not mean your Radiologist is wrong in his recommendation and in his belief in that he thinks that is what he truly believes is best for you, and that is why even now if questioning what treatment approach will be best, don’t hesitate to get a 2nd opinion
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Hi,
If it was me I would wait until the PET scan picks up something, gotta find it to kill it. If you irradiated the Prostate bed now, the cancer might not be there and you can only use radiation so many times in an area from what I’ve been told. The choice is up to you but why not enjoy a few more treatment free years and face the music when the PET scan identifies something.
Dave 3+4
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https://csn.cancer.org/home/leaving?allowTrusted=1&target=https%3A%2F%2Fwww.google.com%2Furl%3Fsa%3Dt%26rct%3Dj%26q%3D%26esrc%3Ds%26source%3Dweb%26cd%3D%26ved%3D2ahUKEwjlgIKAhKOAAxW6m2oFHebnCNMQwqsBegQIEhAG%26url%3Dhttps%253A%252F%252Fwww.youtube.com%252Fwatch%253Fv%253D-ZXDohxylg0%26usg%3DAOvVaw2YI7sJ0VG3QjqJ4p-w0qfm%26opi%3D89978449
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take a look at this you may want to have a consultation with dr robert reiter out of ucla before you do any of that radiation they don’t have a clue where it is. You may be doing that radiation for nothing. I would see caution that’s for sure and get a second opinion.
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