PSA still up whats next
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Archives1
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I'm also guessing radiation or a PET scan is next. Depends how your surgery and follow-up pathology report went. I think it's best if your PSA is below 0.1 after RP. Hopefully you have an appointment to see your urologist soon to confirm your course of action. Mine PSA after 6 weeks, is too high, but hopefully it comes down. If not, my doc says I'll be taking a PET scan.
Earlier today I saw someone on this site say that compared to surgery radiation is "a walk in the park." From one Larry to another, hope it all goes well!
LarryP
Earlier today I saw someone on this site say that compared to surgery radiation is "a walk in the park." From one Larry to another, hope it all goes well!
LarryP
Archives1
Staff member
I suggest creating a login with Health Unlocked and searching for Prostate Cancer Treatment forums. You sign up for the different communities to get emails about newsfeeds/communities.
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Terry
Archives1
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Prior to my RP, my PSA was around 15. Four months after prostate removal, PSA had dropped to 0.5 which I thought was pretty good but the Dr. did not think so. He wanted it basically 0 or what they term as non-detectable (ND).
I was scheduled for radiation about three months later and the Dr. also put me on a Lupron shot regimen (every 6 months in the butt). By the start of radiation, the PSA had continued to drop from what was 0.5 to 0.2. After radiation treatments (around 30 treatments as I remember) the PSA dropped to 0 and has remained at 0 so far (5 years now). They indicate that the longer it remains at 0, the ore likelihood of long-term success.
Radiation was definitely easier than the RP surgery and did a good job in reducing the PSA. I do think though that it impacts continence issues since I still go through 3 to 4 Depends a day regardless of my attention to Kegels. But, at age 70 and being retired, I can deal with that and just keep telling myself that dealing with continence issues is better than the cancer alternative. (Most days I take that approach but some days not so much).
As others have said, Urologist input is critical for something as significant as this.
Best of luck,
I was scheduled for radiation about three months later and the Dr. also put me on a Lupron shot regimen (every 6 months in the butt). By the start of radiation, the PSA had continued to drop from what was 0.5 to 0.2. After radiation treatments (around 30 treatments as I remember) the PSA dropped to 0 and has remained at 0 so far (5 years now). They indicate that the longer it remains at 0, the ore likelihood of long-term success.
Radiation was definitely easier than the RP surgery and did a good job in reducing the PSA. I do think though that it impacts continence issues since I still go through 3 to 4 Depends a day regardless of my attention to Kegels. But, at age 70 and being retired, I can deal with that and just keep telling myself that dealing with continence issues is better than the cancer alternative. (Most days I take that approach but some days not so much).
As others have said, Urologist input is critical for something as significant as this.
Best of luck,
Archives1
Staff member
For what it is worth, my first two PSAs after surgery were undetectable. Then, it was 0.023. The urologists explained that tests have gotten more sensitive. 5 years ago, they would have waited to see PSA rise to 2.0 before considering radiation. However, the research hospitals indicate that “salvage radiation” after RP is best done as soon as PSA is detected, which indicates that the RP missed something. So, 4.5 months after RP, I started 40 sessions of salvage radiation plus the Androgen Deprivation Therapy (ADT)shots. My PSA has been undetectable since the end of the radiation a year ago. Hope this helps.
Archives1
Staff member
The PSA # indicates that there is cancer inside you somewhere (i.e. the Prostate) and the PET scan detects cancerous tumor cells to help gauge cancer spread (metastasis) or weather it is confined to just the prostate. I believe this allows them to fine tune their radiation treatment program (how much radiation, where they aim it, etc.)
Archives1
Staff member
Unfortunately it means that the surgery didn't remove all of the cancer cells. Due to that I assume they will be giving you an Aximin PET scan which is a specialized, very high resolution scan to detect any cancer cells that were left after surgery. Depending on the results this will give the doctors an idea of the best course of action.
In my case it was Androgen Depravation Therapy (i.e.chemical castration) using Orgovyx, plus a special medication Xtandi, which stops cancer cells from even being able to use any testosterone. Note that even with the ADT treatments there is still a small amount of testosterone made by the thyroid glands so Xtandi is used to deny any cancer cells access to that. Then finally I had salvage radiation to hopefully kill anything left over.
You would typically be on the ADT treatments for about two years and that is kind of the critical point as to whether all of the previous treatments have really killed all of the cancer or if it has started to come back.
In my case it was Androgen Depravation Therapy (i.e.chemical castration) using Orgovyx, plus a special medication Xtandi, which stops cancer cells from even being able to use any testosterone. Note that even with the ADT treatments there is still a small amount of testosterone made by the thyroid glands so Xtandi is used to deny any cancer cells access to that. Then finally I had salvage radiation to hopefully kill anything left over.
You would typically be on the ADT treatments for about two years and that is kind of the critical point as to whether all of the previous treatments have really killed all of the cancer or if it has started to come back.
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