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What Now ?

diggerdon
Posts: 12
Joined: Nov 2017

PSA has been at zero for 2.5 yrs, in Sept. it had risen to .84. Urologist said it could be an unknown spike but will recheck in 3 mos. Yesterday I retested and it came back at 4.95, I'm definitely in trouble here. Get a bone scan on Monday and hormone shot on Tues and then my urologist is handing me off to the doc in Denver that did my RP via DaVinci. I'm in uncharted waters here, will a PET scan show where the cancer is or are they going to biopsy all of my internal organs to find the answer?

Old Salt
Posts: 720
Joined: Aug 2014

It seems to me that you should run to a radiation (or medical) oncologist.

The DaVinci guy could advise you of course on what the next step should be in his eyes, but the follow-up from unsuccessful surgery is typically some form of radiation therapy; perhaps (!) combined with chemotherapy.

Hormone therapy is appropriate considering the scenario you have given.

The pathology report on your prostate is especially relevant now. Could you please copy the report for us so that we can advise you better?

 And NO, they won't biopsy your internal organs. Various scans are available to localize the cancerous sites.

Clevelandguy
Posts: 441
Joined: Jun 2015

Hi,

Got to agree with Old salt on this one, need to find the cancer first with the best scans available then hit with radiation.  Cyberknife, Proton radiation,Chemo, maybe?

Dave 3+4

contento
Posts: 76
Joined: Jul 2017

diggerdon, sorry for your situation. I would want to see a medical oncologist at this point and not my surgeon ( urologist  ). Hormone therapy  is almost certainly in the cards and hopefully the doc will want to locate the Pca probably with a specific MRI protocol. Radiation could still be a possibility of cure  especially if the Pca is in the pelvic area that was not previously radiated. There are guys on this board that have been through this or knows someone who has and hopefully they will respond and provide you with their experience. Good Luck.....contento

diggerdon
Posts: 12
Joined: Nov 2017

Thanks for your input. I've added my initial biopsy numbers to my post

 

diggerdon
Posts: 12
Joined: Nov 2017

Contento, thanks for your imput. You're right, lots of people that will share their experiences, tremendous people and a great source of hope.

 

diggerdon
Posts: 12
Joined: Nov 2017

OLD SALT, thanks for your interest, it is greatly appreciated. Following is my initial biopsy.

Had my prostate removed the first part of March, 2014. Following is the lab report dated Jan 24, 2014.

PSA 11.31 ng/ml, T1c, DRE normal.

Left side

Base Adenocarcinoma 7(4+3) 100%

Mid “” 7(4+3) 30 %

Apex Benign

Lat Base carcinoma 7(3+4) 100% right side nodes were all benign

Lat Mid “” 7(4+3) 90 %

Lat Apex “” 7(3+4) 100%

There was also a note concerning left base tumor, indicates perineural invasion.

Treatment after surgery was 46 radiation visits and 2 yrs. of Lupron Depot.

VascodaGama's picture
VascodaGama
Posts: 2989
Joined: Nov 2010

I am sorry for the increase of the PSA. I wonder the protocol of your treatment. Was it the "mother of all therapies" that includes RP plus adjuvant RT?

Were there apparent findings of extra prostatic extensions in your initial diagnosis?

I hink that a PET scan have more chances in finding cancer than a MR I because of the high PSA. Try discussing the matter with your doctor before taking the hormonal shot.

Best,

VG

 

diggerdon
Posts: 12
Joined: Nov 2017

Vasco, my follow-up treatment after RP was 46 radiation visits, 2 yrs. of hormones

VascodaGama's picture
VascodaGama
Posts: 2989
Joined: Nov 2010

Dig

Can you explain the meaning of the follow up RT. Was it decided before RP or was it administered as a salvage therapy?

Do you have the reports of image studies? I am trying to figure out your doctor's opinion on the location of the cancer. Your next step will depend much on what has been initially found, diagnosed and decided.

VG

 

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