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Re: Rising PSA 1 year after robot assisted radical prostatectomy

Many out here fully understand your concern. This is a tough place to be especially after such a short time in it. As you probably already realize, there is no one correct answer. Listen to others and make your own decisions. BUT - DO NOT PANIC! I am seven(?) years out from my treatment and though I am not assured of the cure, it is no longer such a forefront fear. Maybe that is good and maybe that is bad. Get your PSA checked at regular intervals and keep track to see any definite and/or fast trend. Your .11 is not a sign of failure but needs to be watched for a trend. My PSA has risen to .16 from a .11 in six years. This lab always seems to be about .05 higher than the other lab I go to so each lab is different also. The VA lab only goes as far as .1 and so far it has stayed below that threshold there.

So, yes it is a gamble of sorts. My outcome after RP was uncertain from pathology with a fairly rapid first year advance from .09 to .13 so I opted for the "kitchen sink" option of radiation. Did it work? Hopefully, but no guarantee in this game. Radiation is easy but not to be taken lightly. It can cause its own problems years down the road I am told. Don't know if this is helpful to you or if it just throws another angle at you to decipher. Hang in there, if I can be any help, contact me, Jon.

Rising PSA 1 year after robot assisted radical prostatectomy

Pre-surgery Gleason 4+3
June 25, 2020 Radical Prostatectomy (Robotic)
Surgical pathology Gleason 3+4
All good. PSA 0.0 for 13 months.
Then...
1/28/21
.00
7/29/21
.11
9/8/21
.14
10/5/21
.23
10/11/21
.22
10/25/21 PSA test scheduled
11/5/21 PSA test scheduled
NM 10/9/21 - All good.
Waiting to see if I can get PSMA.
Surgeon surprised considering all seemed to be low risk.
No tests done yet (we're starting) but, after my request, referred me to radiologist.
Radiologist states 2 consecutive +.2 PSA readings should trigger hormones (6 month) + radiation. Not a matter of if but when. And no matter what tests show, prostate bed radiation is a given. Added if I wanted to start now because of my anxiety he would. (Not sure if he was serious.)
Do you have any thoughts?
Being treated at Cancer Center of Excellence

Re: Rising PSA 1 year after robot assisted radical prostatectomy

Yes, it appears there is reason for concern after your rising numbers in the last few months. Time to get serious about the next move. I have no knowledge of what a PSMA can do but anything that might give more clues as to what and where the problem is before doing the radiation might help "steer" that treatment to the trouble spot more accurately. I know a lot of docs. prefer to do hormones before radiation to try shrinking the problem. I have no knowledge there either as I did not have that. Just went straight to radiation of the prostate bed. Don't fear the radiation. It just takes up some of your time each day. I still have seen no side effects from it but was told by the radiation doc., when/if they show up in my 90's, to see him and we will have a drink over it. Radiation is the last chance for a cure so go for it. Jon.

Re: Rising PSA 1 year after robot assisted radical prostatectomy

Thank you for the good, solid, and encouraging advice.

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