Seems like after a recurrence of Gleason 9, psa 20, after both external and hdr brachytherapy the medical system has chosen to have me wait until the cancer spreads before doing anything more than offer surgery, turned down before so why now, and ADT.
Appears like they want it to spread so they can offer more options. Money? Hope not. Am I wrong? Suggestions?
So your PSA has risen above nadir+2 after completing adjuvant ADT? Have you had a PET scan and/or biopsy to detect where the cancer is?
No, as I say in additional posts offering more details they are available but not deemed necessary.
This is the only post of yours. Perhaps you may want to add a profile.
Salvage surgery after radiation results in incontinence in over 50% of the cases. It will probably be futile in your case because the PSA is caused by metastases outside the area they would plan to treat with surgery.
A PSMA PET/CT is very sensitive and will show where the cancer is. You can get it done here:
healthunlocked.com/advanced...
After that you can get the mets treated like this:
healthunlocked.com/advanced...
Fantastic reply, GP24.
Noted scans are available here also. Three doctors, HDR urologist, Radiation doc, and Oncologist all offer nothing other than ADT. Well oncologist did offer surgery but added that none in my situation that didn't do surgery at first ever choose it the second time.
Forgot to include all biopsy needles found 5+4 for Gleason 9. Some perennial invasion too.
"my issue is that there seems to be no additional treatment options other than salvage surgery until mets happen then there are several"
These mets have already happened, they are just too small to detect them with CT/bone scan. The more sensitive PSMA PET/CT will detect them, however.
Continue with ADT and combine additional treatments with that.
Greeting teach.... Please tell us more info about yourself: i.e., age, location, psa/gleason scores, treatments to date, treatment center(s), doctor's name(s)? All info is voluntary but helps us help you and helps us too. Thank you... (apple in the mail)....
Good Luck, Good Health and Good Humor.
j-o-h-n Monday 09/23/2019 4:27 PM DST
I am 71 now, 4 yrs after initial diagnosis. My psa before treatments, 25 sessions of IGRT, two sessions of HDR, all during 24 months of ADT. Psa dipped to 0.19 then after 18 months reached 0.84 then 3 months later 1.00, 3 more months 1.69 and finally 3.39 another 3 months later. The rapid rise cause me to return to hormones.
CT and Bone scans clear but no different treatment options. Psa last checked at 0.46 a month ago.
Thank you for your reply....
Good Luck, Good Health and Good Humor.
j-o-h-n Tuesday 09/24/2019 8:56 PM DST
Humor abounding, and positive attitude even more so.
Thanks.
You've got my vote........Humor is my hobby...
Good Luck, Good Health and Good Humor.
j-o-h-n Wednesday 09/25/2019 5:13 PM DST
John is right more information is needed. What you're saying doesn't sound right.
I have posted more details on me but my issue is that there seems to be no additional treatment options other than salvage surgery until mets happen then there are several.
Have you considered the new Darolutamide which is a blocker just approved by F D A for hormone sensitive non metastatic disease.
Did not know about it. Will check with my oncologist after some research.
Thank you very much.
Hey teacherdude70,
What testing and imaging have you had? If in the prostate FLA or HIFU can ablate it. FLA and HIFU are even used for lymph nodes.
You might message Oct18, a member on HU. There is more than one approach to take.
Currumpaw
According to my scans has not escaped the prostate capsule.
Hey teacherdude70,
HIFU was approved by the FDA in October 2015 for treatment of prostate tissue. Of interest to you the FDA run study in California, that to my knowledge, used HIFU to treat men who had radiation as a treatment for prostate cancer and then had recurrence. I believe the study was done in 2009. Time passed and the FDA looking at the results gave it approval. It may buy you some extra years, years with a better quality of life than the other treatments ---if it is contained in the capsule. HIFU is used to ablate lymph nodes too.
Currumpaw
Thanks,
I have reached put to my oncologist about this just yesterday so will km see.
I have read that the side effects are significant compared to what I have already been through.
Hey teacherdude70!
I don't know about the side effects associated with HIFU when used as a treatment for recurrence after one has had radiation as the initial treatment for prostate cancer. As a first treatment choice for prostate cancer the side effects for HIFU are minimal especially when compared to other treatments. The very best imaging techniques should be employed to determine the location of your cancer. The location will determine if you are a candidate for HIFU.
Currumpaw
Good information. I sent a note to my oncologist about hifu and will follow up on a request for a PET scan. They have not mentioned it.
A nurse friend did however. Wonder why not noted.?.
Teacherdude,
I found myself in a similar situation last year. Recurrence after initial radiation years ago.
A PSMA PET scan found mets that an Axumin scan and bone scan had missed. 4 nodes and 1 bone met as well as recurrence in prostate area.
I had a Tulsa Pro ultrasound done on the prostate and stereotactic radiation done to the mets. While not curative, it did knock the cancer back a lot.
All the best
Not only 2 above nadr, while on ADT, but doubled twice in 6 months.
Still say that unless spreads or not responding to ADT there are no treatments. Bone scans and CT scans clear. No biopsy or PET scan.
Bone mets and no Recommendes treatment 
PCa/Treatments and Immune System
Lower PSA but rib mets pain
Life expectancy with or without treatments?
Two for Chemotherapy, Both My Wife and I, Her with TNBC and Myself now with PCA Liver Mets 
