PSA rising 6 month post Operation - Advanced Prostate...

Advanced Prostate Cancer

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PSA rising 6 month post Operation

Gisey
Gisey

My husband is 57. He was Gleason 8 with PSA 6 and we decided on operation.

RP done on feb 20 - all contained, nothing on lymph nodes - the report we were hoping for. 6 months after the operation PSA is rising and already 0.24. We are seeing a radiation oncologist to start SBRT. would you recommend any scans ?

Is this the right treatment?

10 Replies
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When the PSA value rises after surgery, radiation of the prostate bed is the usual treatment. It is mostly done with IMRT which takes about six weeks to radiate. I would prefer IMRT in this case.

Gisey
Gisey in reply to GP24

Thank u. Will check.

It might show nothing at that low PSA, but he can get an Axumin PET scan to rule out distant metastases . There are a few places where he can get and pay for a more sensitive PSMA PET scan.

SBRT is being tried experimentally for salvage radiation, and it may be a good idea during the pandemic to limit the number of treatments. Here is a discussion of the clinical trial at UCLA:

prostatecancer.news/2018/01...

Gisey
Gisey in reply to Tall_Allen

Thank you. The doctor mentioned that COVID-19 is not an issue with radiation. Is that not the case ?

Tall_Allen
Tall_Allen in reply to Gisey

Going to the hospital for 40 treatments has greater risk of infection than going to the hospital for 5 treatments.

My husband had a similar situation to yours. RP and then a gradually rising PSA. He started radiation when his PSA hit .3 . He just finished 35 treatments of VMAT radiation to his prostate bed only.

It's important to find out from your RO if they are going to radiate your husbands prostate bed only or do his whole pelvic area? Also will they give your husband ADT?

I would definitely get some kind of scan prior to embarking on all this. An Axumin scan as Allen said. If you can get a PSMA scan that would be better but insurance will not pay for that.

Gisey
Gisey in reply to fluffyfur

Thanks. They want to radiate the entire bed area. According to the RO it makes sense to try and address the entire area in one go.

If your dad has any bowel issues, the higher radiation dosage of SBRT may not be the way to go. In your shoes, I'd get a scan and a second RO opinion. Good luck.

Here I go again...... Old post of mine. (after rpd)

I had 8 weeks of salvage radiation to "the bed". 5 days a week (not weekends) for 8 weeks minus 1 day for a total of 39 sessions. The actual radiation was like getting an x-ray by my dentist. I never had any side effects during the whole 39 sessions. However 2 years later my left urinary tract was "fried" as per my urologist (or from passing prior kidney stones he was not sure). So I had to have a urinary stent placed up my urinary tract (through my willy which is really nothing - sounds terrible but it's nothing) to aid in passing my urine (which was never a problem anyway). So I had stents in and out every three months for many years and now I'm stent free, However today 15% of urine from left kidney and 85% from right kidney, but not a problem. So make sure you get a good radiologist. Also I don't know if this would apply to you but guys here recommend "A PADDLE" to be inserted for protection of parts of your body. Make sure you ask your R.O. about the paddle and make sure you ask here on this forum before getting fried.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 09/03/2020 7:45 PM DST

Thank you !

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