Prostate Cancer Survivors






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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.
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.

PSMA Test & Rising PSA 1 year after robot assisted radical prostatectomy

PSMA Test Results below ===:
(Iliac bone lesion has been there since 2005)

PELVIC LYMPH NODES: No adenopathy.
BONES: No suspicious osseous lesion.
Unchanged ill-defined right posterior iliac bone lesion without uptake on
prior bone scans, probably reactive.

Comments? Proceed with doctor recommended ADT & radiation?