Biochemical Recurrent PCa

[KeyboardGuy]

Doing OK, this is just to introduce myself.

My story: Grandfather and Uncle had PCa, so I started getting PSA at age 40. Biopsy confirmed presence of PCa in March 2009.

PSA history: 2.9 (Oct 04), 3.7 (Dec 05), 2.79 (Nov 07), 4.54 (Jan 09), 4.9 (Feb 09)

05/18/2009 - Robot-assisted (daVinci) laparoscopic radical prostatectomy by Michael Esposito, M.D. and Vincent Lanteri, M.D. roboticurology.com/ both nerve bundles spared

Surgical Pathology: Prostate gland 51.8 grams; Gleason score 3+3=6; Pathologic stage T2c, N0, Mx; Left/Right Pelvic lymph nodes clear (no tumor present); No presence of extra-capsular invasion; No margin involvement

05/26/2009 - Catheter and incision staples removed

05/30/2009 - Started Viagra 25mg 3x/week

07/06/2009 - 1st post-surgery PSA <0.1.

PSA started creeping up slowly around 2013 and hit 0.20 in early 2017.

12/22/2020 - Latest PSA 0.37 but pretty stable over last year.

[Tall_Allen]

If all they found when they did the whole mount pathology was GS 3+3, you may be OK to just monitor PSAs annually:

prostatecancer.news/2017/11...

You can get an Axumin PET scan, but with your low PSA, it isn't likely to show anything. If your PSA eventually gets over 0.5, you can get a PSMA PET scan then (which should be widely available by then) and biopsy to see if there has been any grade progression. If there is eventual grade progression, you can have salvage radiation at that time. If no grade progression, just acctive surveillance.

[KeyboardGuy in reply to Tall_Allen]

I agree that getting a scan at this stage would not provide any useful information. As long as my PSA remains relatively stable (my doubling time is around ten years), I should be fine. But I will continue to monitor it.

[Shooter1 in reply to KeyboardGuy]

10 yrs!!! All clear margins, a dream come true...just watch it...

[addicted2cycling in reply to KeyboardGuy]

At 3+3 there is virtually NOTHING TO WORRY ABOUT as Active Surveillance is becoming more the NORM BEFORE any radical treatment takes place.

[BillNIttles]

So glad to hear you are doing well. Your experience sounds very similar to mine: a lot of Pca in my family - father and all my uncles, diagnosed at 44, gleason score 3+4 but reduced to 3+3 after rp and biopsy, clean margins etc, no ed.

Unfortunately, my Pca reoccured within a year and continues to this day, with salvage radiation, chemo, and adt in the mix. My psa doubled in 2 months last fall, then no change for 2 months, so weird.

Very wise of you to keep up with it, your path looks good.

[KeyboardGuy in reply to BillNIttles]

Yes, very similar, as my post-biopsy Gleason was 3+4, while my post-surgery Gleason was 3+3. I am fortunate to be part of a local UsToo support group, where the group leader attends national conferences and is up to date on all the latest PCa treatments and trends. It was the group leader who referred me to Dr. Charles Drake at Columbia/Presbyterian in NYC. Dr. Drake (a leading immuno-oncologist specializing in prostate cancer) advised me to exercise more and cut back on meat intake, which I attribute to my PSA velocity becoming more "level" since I first saw him. He has since cut back on his patient load, and I started seeing his protégé, Dr. Jessica Hawley, at my last visit in September.

[j-o-h-n]

Every now and then.... hit the PSA check key...............Regards and keep posting here.....\

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 01/05/2021 10:15 PM EST

[MateoBeach]

You can get a PSMA PET scan now, with the PSA above 0.20 at UCLA. I would do that promptly. If there is no cancer outside the pelvis it may be curable by Salvage Radiation therapy (SRT or SBRT). Fortunate to have a slow growing form of PC with the Gleason 6, but it is still cancer and is growing.