After RP and SBRT PSA raising

[Odon]

Hi, I had RP in 2014 PSA 5,17 Gleason 3+4.

In 2017 I had 7 SBRT treatments. After it, slowly PSA raising until 0.57 now. Any advice or experience in this condition?

[GP24]

My advice is to provide a detailed history of your disease in your profile. The information you provided is not sufficient to provide good advice.

What happened after the RP, how did the PSA value develop? Why did you decide for SBRT and not IMRT, what area was radiated? How did the PSA value develop after the SBRT radiation? Any hormone therapy yet?

[Tall_Allen]

When you had the salvage SBRT, was it to the prostate bed only or did it also include the pelvic lymph nodes? Have you had any kind of imaging since 2017?

[Odon in reply to Tall_Allen]

I am 66 . After Rp in 2014 my PSA was undetectable for 2 years and it

began to rise in 3 years until 0.32. PSMA PET/CT Ga 68 found 2 little

points in my pelvic area that was treated with 7 SBRT treatments. After

it PSA 0.19. In 2 years arrived at 0.52 but PSMA PET/CT, and MRI didn't

find anything. No hormon therapy until now. Now I am wandering what would be the next step. ADT or just watching and waiting ? This is the advice of my oncologist. Just now I am choosed waiting.

Unfortunately (I am living in Romania) We do not have so many treatment

possibilities like in the western society and Heath insurance don't

cover anything. Thanks for your advice.

[Tall_Allen in reply to Odon]

Thanks. You have systemic prostate cancer and require systemic treatment is my opinion.

[Magnus1964]

Maybe it's time for ADT drugs. You can get a lot of good quality life with these treatments.

Also have you had genetic testing yet to find if you have any abnormalities. If so you could qualify for some of the gene therapies.

[Hidden]

You are still considered undetectable. When PSA rises above 0.1, then it’s time to consider alternatives. You made a decision, ride with it and stop worrying. Good luck.

GD

[Odon in reply to Hidden]

Sorry my PSA is 0.57

[Hidden in reply to Odon]

Whoops, I missed read. Me bad.... horse of a different color now. Let ask now, are you on Lupron/Eligard? If not, why not? There is something going on. You might have a discussion with your medical oncologist about micro-metastates. There are those, and I am one included, that little unseen metastatic cells are traveling through the lymphatic and vascular system looking for a place land, colonize, and divide. I bring this up as my research medical oncologist told me that it mattered not which primary treatment I had, it was too late and explains why I was Stage 4 about ten months after treatment. In the alternative, one could wait and see. However, if you do that I would do as I did, monthly PSA and T blood draws ti stat on top of developments. Good luck....

GD

[j-o-h-n]

O Don are you listening?

Give us more info of your bio..... All information is voluntary but it helps us helps you and helps us too......Thank you!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 06/08/2020 5:42 PM DST

[Odon in reply to j-o-h-n]

I am 66 . After Rp in 2014 my PSA was undetectable for 2 years and it

began to rise in 3 years until 0.32. PSMA PET/CT Ga 68 found 2 little

points in my pelvic area that was treated with 7 SBRT treatments. After

it PSA 0.19. In 2 years arrived at 0.52 but PSMA PET/CT, and MRI didn't

find anything. Now I am wandering what would be the next step. ADT ot

watching? This is the advice of my oncologist. Just now I am waiting.

Unfortunately (I am living in Romania) We do not have so many treatment

possibilities like in the western society and Heath insurance don't

cover anything. Thanks for your advice.

[j-o-h-n]

Thank you for your response. You may want to copy and paste it in your home page for future use by you and by other members here. Is there anyway you can make it here in the US for second opinions? Or you may be able to do "face time" with a doctor here. Ask the group here if they know of any doctors who will "face time."

Mult noroc, sănătate bună și bună umor.

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 06/09/2020 2:39 PM DST

[Odon in reply to j-o-h-n]

Thank you John for the advice.

[Odon]

Hi every body, I am living in Romania, with prostate cancer since 2014. Can anybody advice me a doctor in USA for a chat via "face time"? With not really high fee. Thanks.

[jdm3]

Prostate Oncology Specialists in California will do phone consults. Not cheap! I think initial consult is USD$1200 plus lab reviews, etc... But they are good.

[Ralph1966]

If you don't want to start hormonal therapy now then wait and repeat PSA. Also why not take another PSMA PET/CT scan to see any metastasic lesions.

Your Gleason score is less than 8 so it is not much aggressive type.

Calculate your PSA doubling time it will give an idea about PCa progression.

Lupron injections should be affordable and consider it as the next level of treatment.

[Odon in reply to Ralph1966]

Thanks. I already did it. PSA 0.62, PSMA PET CT GA68 negativ in January. I started Casodex 150mg and Tamoxifen 10mg. Until now just small side effects.