PSA Rising Dx 06/2022 PSA 864.42 to 01/2023 <0.06 now no longer undetectable, I won’t see DR until next month, What will the Dr do?

[Shorehousejam]

Diagnosed 07/01/2022

PSA 942.40

Gleason 8 ductal without large cribform gland / Gleason 9 4+5 after Davinci RP w/ LNR

cT3b CN0 cM1b

Gleason 8/9 Stage 4 Grade 5 : 4+5=9

Low Volume

High Grade

ypT3a YPT3a

3 lytic lesions resolved to 1 mild avid lesion

Biopsy 15 samples

4 adenocarcinoma

11 benign

Low volume

High grade

Triplicate Therapy

Firmagon @28 days,

Zytiga with Prednisone Daily,

Metformin 500mg Daily

Docetaxel Chemotherapy @ 6 sessions

Taltz monthly injection for severe plague psoriasis

VIT D2 @6 weeks, once a weeks, 50k units, Temporary

No Prolia or Z Acid for bones,

As my teeth need work

Germline - No Brca but BLM missing copy mutation

The Tumor Genomics were an-

Oncomine targeted panel from transperineal MRI guided biopsy 07/2022

Tier 1

Tier 2 Variants in p53 and CDH1

Tier 3 in DNMT3A, HRAS, WT1

Had Davinci Radical Prostatectomy with Lymph Node Removal on 03/14/2023

Only 8 Lymph Nodes Removed, according to operating urologist surgeon that is what he saw to remove, all negative for PCA.

Remained undetectable for only 15 months, this sucks…

So, MSK Medical Oncologist states I’m Oligo Metastatic will do an MRI and see what’s going on, previous 3 CT Scans all dated since 07/2023 mass, then reoccurrence then a mass, but a little smaller…other Medical Oncologist wants to wait to radiation if at all or possibly until raise or find possible a lymph node I guess in a psma pet scan.

How much higher than PSA 0.19 do I wait for a pet scan?

Went to a Major Cancer Hospital in New

Prostate Specific AntiGEN (PSA)

0.19 ng/mL

[0.00 ng/mL - 4.00 ng/mL]

Nov 7, 2023

0.11ng/mL

<=3.99 ng/mL

Oct 10, 2023

0.09ng/mL

<=3.99 ng/mL

Sep 7, 2023

<0.06ng/mL

<=3.99 ng/mL

Aug 8, 2023

<0.06ng/mL

<=3.99 ng/mL

Jul 6, 2023

<0.06ng/mL

<=3.99 ng/mL

I have a reoccurrence mass on my prostate bed MO doesn’t want to radiate yet probably not at all.,.

Doesn’t that defeat the purpose of having my prostate remove?

Positive Margins

Micro Bladder neck positive

Micro positive along bladder wall

Am I missing something?

[MoonRocket]

Everyone is different. If you go to soon, you won't find it, if you wait till it reaches 1, can handle the wait? Only you know your self.

[Shorehousejam in reply to MoonRocket]

Ok so I just wait…still figuring all this out…

But it looks like it’s rising if one month was

<0.06 to 0.09 to 0.11 in a month

Above is That’s approximately 90 days…

[MoonRocket in reply to Shorehousejam]

So, when I BCR'd, I went from <0.04 to 0.3 in 90 days, 15 days later it was .51. I estimated it was over 0.7 when I went for my Pylarify PSMA pet scan. Nothing..zilch. restarted Eligard. Now adding xyandi after it started creeping up from .2 to .5 over the last year. I was going to wait a little longer but I could tell by my MO's expression he wanted me on the xtandi. So I'm starting xtandi as next Wednesday.

[Shorehousejam in reply to MoonRocket]

I have a reoccurrence mass on my prostate bed MO doesn’t want to radiate yet probably not at all.,.

Doesn’t that defeat the purpose of having my prostate remove?

Positive Margins

Micro Bladder neck positive

Micro positive along bladder wall

Am I missing something?

[MoonRocket in reply to Shorehousejam]

I'd want to know why the MO doesn't want to radiate the prostate bed and pelvic area...seems that would be prudent.

[Shorehousejam in reply to MoonRocket]

He feels adt systemic therapy is enough

[Grandpa4]

I think he wants to make sure it has not spread outside the field of radiation. He does not want you to experience the side effects of radiation without any chance for benefit. It PET negative then yes.

[Trying-Times]

Have you been seen by RO yet?

[Shorehousejam in reply to Trying-Times]

A consultation, yes by 2, both different opinions

[gsun]

Sounds like you didn't need a RP. It's outside the prostate bed.

[Kevinski65]

Is there a grade 5?

[Shorehousejam in reply to Kevinski65]

Yes, Stage 4 Grade 5 : 4+5=9

Gleason 8/9

Low Volume High Grade

[Nfler]

most won’t show till it hits .2 and like grandpa says they want to make sure it hasn’t spread outside the bed. Also I’ve had great results incorporating ivermectin with adt, psa dropped from.50 to.11 after just two weeks whereas psa wouldn’t drop below.50 after 7 months of adt. Mof it worked so well I got off adt completely n use ivm cbd primarily and my dx and trx was very similar to yours…

Psa has dropped 10 months continuously since I dropped adt

[Shorehousejam in reply to Nfler]

With a rising psa you took all ivermectin?

[Nfler in reply to Shorehousejam]

It was a declining psa but the adt is just ridiculous to b on, it was going to kill me if the cancer didn’t. I had read so much on ivermectin, I was willing to give it a chance n thus far it’s just worked wonders in keeping the cancer n psa in check. My Mo said if there was cancer in the body, psa would def b rising not going the other way like it is…😁

[Shorehousejam in reply to Nfler]

Great for you brother

[Kevinski65 in reply to Nfler]

How much ivermectin?

[Nfler in reply to Kevinski65]

I was taking 60 mg/ week (15 mg4x/wk) and added 100 mg of cbd oil along w turmeric n zinc at 50 mg daily. I’m down to 24 mg /week now n psa continues to go down, now at.95