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Rising PSA after surgery

acrylates
Posts: 1
Joined: Nov 2010

I am very new to CSN, having just signed up this afternoon.

I had a RP followed by radiation therapy IN 1994, 16 years ago. My cancer was discovered during an annual physical and the PSA was 44 at the time - over 50 when I had the operation.

My PSA has been steadily increasing over the years to where the last test showed a value of 9.5, the highest number. At no time did the PSA double from test to test (typically taken at 6 month intervals), or even after comparing results AT 1-2 yerar intervals. It's reasonable to say it has been increasing at about 0.6 per year.

I've got a doc's appointment in about a week and want to be able to intelligently discuss this matter with him.

My question is, "Anyone out there that has a similar experience and what treatment was involved? Thus far, it's been "watchful waiting." And I am of the opinion that at 0.6 per year I can go along way without any treatment.

By the way, I am 70 1/2 years old.

Your thoughts, please.

Acrylates

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Arcrylates, welcome to the forum and I'm sorry that you are still dealing with these issues so long after your surgery.

As you must know by now, your PSA scores indicate that prostate cancer is still growing somewhere in your body. With such a high PSA at the time of your RP I would suspect that the cancer had spread beyond your prostate even before the surgery. Do you recall what the pathology of your surgery was?

Most urologists consider that a PSA greater than 0.2 ng/ml and rising after a RP is evidence of recurrence. You are way past that point. The question your medical team has to address now is where is the cancer and what should you do about it?

PSA velocity and doubling times are not determined using straight algebraic calculations but rather are based on fitting your scores to a logarithmic scale. If you haven’t done this already, there are some nomograms available (check out the Sloan Kettering website) where you can plug your numbers and dates into a web tool and it will calculate your velocity and doubling times accurately. You very may well be experiencing an indolent form of PCa where watchful waiting is appropriate, although to really decide if this is the case I think you should compare your original pathology to the PSA readings and discuss it with your doctor.

Prostate cancer is inherently metastatic and when it grows outside the prostate capsule it tends to grow faster than before. You may wish to consider some advanced testing techniques which can try to pinpoint where it is your cancer is growing and see if there is a treatment that makes sense for you.

As you probably know, recurrent cancer is treated with radiation or hormones or a combination of both.

Again, welcome to the forum and best wishes for sorting our this situation.

tarhoosier
Posts: 195
Joined: Aug 2006

Ac:
You present an interesting situation. Your tumor is slow growing and has not changed velocity in some years. At this increase you can go years before facing a further decision, assuming these facts remain in play. It is possible that Avodart (dutasteride), Celbrex, and diet could slow this down even more. If you wish to follow your disease closely with the aid of your doctor and delay this decision on initiating further significant therapy (anti-hormone medication) I believe you may do so with limited risk to your health. You have had many years to observe your reaction and I think it appropriate to observe and monitor for the foreseeable future

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