Hi all -
I had RP surgery 2 years ago
Gleason 3+4 post op path report
Possibility of seminal invasion
Over the last 2 years, PSA readings have fluctuated from 0.00 to .07. That range fluctuated both up and down within the 2 year period. Suddenly today, I got a result of a .22 PSA - quite concerning since my PSA reading day was .03 three months ago..... I have an appointment with oncologist next Friday. Does anyone have any insight on this? I’m new to the group.... Thanks!
I hope you will visit with a radiation oncologist rather than a medical oncologist because this may still be curable. But jump on this quickly - results are considerably better at low PSAs:
pcnrv.blogspot.com/2016/09/...
Yes I am.... This looks scary
Actually, all the time before your biochemical recurrence bodes well. If you want some idea of the chances that salvage radiation will be successful, fill out the following nomogram:
My medical oncologist and radiation oncologist work together on my case. It’s nice knowing they both have my best interest in mind.
Exactly, you forgot something, the patient has to document these concerns, for instance, get a notebook, write these down, ask what can do they beides standard of care (SoC) before visit. Perhaps, just knowing that they know what SoC - is a great start!
I was going to create a "bill of life" for prostate cancer, but first we should create a template for patients, created by us here. Then they can measure the response, establish based on our experiences .
Just a checklist, for example, a (possible) diagnosis of prostate cancer requires consult beyond an Urologist, especially if a surgeon, we can really help many, ASCO and AUA cannot provide this guideline, like us patients can...
Sure, I"ll take the next (superbowl) weekend to draft a working document here, always good to start somewhere, then the community can work it up and release version 1 when ready.
If I had this document when initially diagnosed, had a chance for a cure, mind you, I'm in the Boston area, but my first and second team docs were Urologist surgeons, they both did not refer me to an oncologist.
Hope this gets many likes...
Thanks all - so after reading all the responses, it appears that after the .2 threshold for one PSA reading, BR is evident? In this situation, I would considered somewhat serious or advanced?
Well, you highlighted my point, did not know what I needed from my docs. The Urologist Surgeons will recommend Radical Prostatectomy, what about Brachytherapy or/and Radiation, you assume patients will all research treatments, perhaps we don't...
Since you indicate "possibility of seminal vesicle invasion" (which would imply pathology that was also non-organ confined and likely positive for extra-capsular involvement), you would benefit by reviewing the following document before meeting with your oncologist.
Adjuvant and Salvage Radiotherapy after Prostatectomy: ASTRO/AUA Guideline
auanet.org/guidelines/prost...
This document was very helpful to me in making my decision to proactively do adjuvant IMRT treatments 3 months after surgery. I had all three negatives mentioned above in my final biopsy.
Good Luck - Be Well - cujoe
I guess I am doomed...my team is a uro, a Gator, and a alligator snapping turtle
Yeah, but when you get hungry you can have some snapping turtle soup and chase it with some gator blood. That is, if you can wrestle the gator away from Nalakrats.
Hi, your story is a lot like mine. After two years my PSA started going up. When this process starts it can be a rough ride. You need more information on your PSA. At least 3 readings will tell you a lot. Is it a slow rise or fast one? Is it a new cycle point or a steady rise? Is it a new lab or sample error? Just like your regular PSA it can cycle or slowly rise over time.
I have been beat by my Doctors that it is not the number but the change in the number. In fact most of them tell me that PSA is not important after a certain point. They then get excited when my PSA Doubling time get to 90 days or lower. Don’t get too disappointed if they don’t do too much right now. They will wait for more information on your numbers before jumping to conclusions. There are sites to calculate your doubling time, but you need 3 reading to get good information.
Doubling time only tells you that something is changing. Don’t get fixated on the number but how fast it is going up. My Bother-in-laws father had a PSA in the 500’s but it took him 20 years to get there. I would have caught up to him in less than a year. My fastest time was 42 days.
Pace yourself, you have a long road ahead of you. Get to know you cancer and how it works. It is different for everyone. If your DT gets below 90 days start pushing your Doctors harder. I’m 9 years into this nightmare and it took a long time to learn not to jump at every little move of my PSA. (Gleason score 8 See profile for history). I’ve been lucky to respond well to treatment. However when the treatment fails it fails badly. Good luck and try not going crazy with your new life.
This is a really good site with lots of information. People here have a lot to give and are very knowledgeable. You got a lot of good advice.
1st PSA after RP
Creeping PSA after RP
First Big Jump in PSA After 20 Years.
Three months after RP to test PSA?
