PCa, gleason 4+3. T2N1MO (1 lymphatic node of 28). Prostatectomy (Da Vinci) in february 2017. Recurrence in December 2019 (psa:0.21 ng/ml).
PET/PSMA GA68 show the prostate bed and one lymph node were illuminated.
28 session of radiation was given (august 2020) to the prostate area (61 Gy) and the dose increased (63 Gy) to the PSMA uptake area. To the pelvic area (50 Gy) and 62 Gy to the uptake area.
ADT 6 moths.(Casodex+Decapeptyl)
16/09/2020: psa: 0.02 ng/ml (T=21 ng/dl).
04/01/2021: psa:0.02 ng/ml.(T=456).
05/07/2021:Today psa: 0.16 ng/ml (T=508).
11/01/2022: psa: 0.51 ng/ml (T=385)
08/02/2022: PET F18-PSMA: Conclusion: showing no signs morpho-metabolic effects of locoregional or distant tumor recurrence.
I don't know what my MO will recommend if I wait or start treatment. What do you think? What treatment do you think I should start? SOC or more aggressive treatments?
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anpun
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Don't panic. You are still fine. You should probably move on to zytiga. It would be a good next step.
Question, why did you stop casodex after six months? It seemed to be working
Hello a pun! I too was just 53 , six years ago . No surgery for me t-4 ,2 nodes lit up I did lupron and tak -700 ( now not available ) and 8 wks imrt . It worked for me six yrs so far . I wish you the same and better.. works outs a must . Good luck , Stay strong and live healthy.. live for today hombre! ✌️😎
read the trial results and drill down through the specific results if enumerated (often they are not provided in any detail).
as pointed out here and elsewhere, the "lag analysis" for these CTs is almost always far too short and too simplistic to draw meaningful conclusions except for "marketing" or FDA "exemptions".
So you have BCR, biochemical recurrence indicated by rising PSA after curative intent salvage radiation and short term ADT. Sorry you are probably in for the long haul like the rest of us here. You don’t have to be in a hurry to start long term ADT with an advanced AR drug, though that certainly has proven increases survival. Not easy decision though, given the adverse side effects that accumulate with ADT and that eventually fail from treatment emergent resistance into castrate resistant PC. Still, almost all of us end up going down that road. Survival and QOL is the goal.Alternatively, you might get good control for some time, even years, from bicalutamide mono therapy or combined with dutasteride. Worked for me for 4+ years. Another option would be to go after the remaining cancer with a course of docetaxel chemo (better earlier and tolerated better when younger). New research is favoring combining chemo with ADT and abiraterone. Data comes from metastatic at diagnosis, so not really your situation but would discuss it with your MO as combined early therapies appear very effective. You are one of us now. Sorry and welcome. Paul
Hi there - I'm in a pretty similar situation with rising PSA after primary treatments (BCR). I'm still early for this stage (PSA about the same as yours, my last was up to 0.47). Not sure yet on my next steps, but tons of good info in this group. Good luck, lots of therapies are still available.
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Introduction and asking for help interpreting latest scan results and thoughts on future treatment plan please.
Questions about recent scans
Lu-177 in Austria - Report and underlining high importance of both FDG and PSMA PET/CTs 
PLEASE HELP ... REALLY NEED YOUR INPUT ... THANKS !
