Slowly Rising PSA - Getting Nervous - Advanced Prostate...

Advanced Prostate Cancer

22,372 members28,135 posts

Slowly Rising PSA - Getting Nervous

raisin123 profile image
11 Replies

It seems in the last 4 months it has been rising more. Doctors are waiting until in gets to the standard 0.2 before starting radiation. I do understand why they need to wait as the PSA isn't high enough yet for the risk/reward of treatment.

03/17/2023 0.029

04/22/2023 0.032

08/23/2023 0.046

12/07/2023 0.082

History

PSA of 20 in April 2022

Bone Scan Negative April 2022

CT Pelvis/Abs Negative July 2022

Biopsy Gleason 7(4x3) 8 of 12 cores. July 2022

RALP September 2022

Pathology Report Sept 2022- Gleason 9(4x5), Grade 5, Stage pT3b (Seminal vesicle invasion) , Positive margins 3mm, Lymphovascular Invasion,Extraprostatic Extension

Written by
raisin123 profile image
raisin123
To view profiles and participate in discussions please or .
Read more about...
11 Replies
6357axbz profile image
6357axbz

could be they are waiting till PSA is sufficiently high to get a good psma scan to positively identify any mets

Tall_Allen profile image
Tall_Allen

They are blindly following the results of this:

prostatecancer.news/2019/09...

BUT, those trials had inadequate samples of men with high risk pathology like you. Subsequent studies suggest that for men with Gleason 9 and stage T3, there is an advantage in doing salvage radiation ASAP. Maybe email them the following and then meet with them to discuss:

ascopubs.org/doi/full/10.12...

raisin123 profile image
raisin123 in reply toTall_Allen

I have an appointment at the end of January I will bring that up to him then. thanks

Tall_Allen profile image
Tall_Allen in reply toraisin123

I suggest emailing the link to him before the meeting. Surprising a doctor with new data at a meeting is never a good idea.

Justfor_ profile image
Justfor_

Almost same pathology and course here. Instead of following up with blind sRT, I elected gaining some time with adaptive Bicalutamide dosing. Just passed successfully the 2 year mark. Will see for how long it will go on working. Documenting my doings month by month in a thread entitled: "An engineer's Bicalutamide maneuvers".

London441 profile image
London441

I also had as close to same pathology as you that I’ve seen, except undetectable PSA post op and 4+3 held up.

However, I did have several saturated cores with 80% pattern 4.

I chose a very aggressive clinical trial of whole pelvic RT, abiraterone and 18 months ADT. I remain undetectable and drug free since the RALP in June of ‘19.

I wasn’t too enthusiastic about the ADT, no one is. But I knew what I needed to do to handle it well and did pretty easily.

I really like being drug free and having full return of testosterone for over 2 1/2 years now. We’ll see if it lasts, but I am prepared to the best of my ability to accept wherever I’m taken. .

PSMA scans weren’t available to me back then, they are to your advantage now. I would choose a different treatment path today if I had to do it all again but if I were you I would likely still try to nail it early. You have some seriously adverse features there, as did I.

Great luck to you!

raisin123 profile image
raisin123 in reply toLondon441

thanks I am doing another test around January 20th and then my radiologist appointment on the 22nd. If it continues to rise I will try to talk them into early treatment.

London441 profile image
London441 in reply toraisin123

You don’t have to ‘try to talk them into’ anything. You are piloting the aircraft.

raisin123 profile image
raisin123

Not sure about other areas but here they have protocols they have to adhere too. I’m just glad to have some doctors I can go to. You can wait up to 7 months to see doctors here.

RMontana profile image
RMontana

I have two articles that may be of interest;

First, PSADT doubling time has to be considered; yours is shorter than 15 months. Use this to your advantage to predict what's coming and act sooner than later.

healthunlocked.com/active-s...

Next, the percent of GS 4/5 in your biopsy matters...you dont state it but take a look at these predictive values...

healthunlocked.com/active-s...

Good luck. If I could go back I would have acted sooner and prevented this disease from progressing outside my prostate...that is key to a good outcome. Get the facts and act as soon as you think you need to. Rick

fast_eddie profile image
fast_eddie

Despite a clean PET scan my PSA has been slowly rising too. I haven't been on ADT meds for six years. My urologist decided to put me on what I call 'ADT lite' -- finisteride. We'll see how that is working when I get my next PSA test in January.

"Finasteride, a specific and competitive inhibitor of 5α-reductase enzyme Type 2, inhibits the conversion of testosterone to dihydrotestosterone (DHT). In adults, DHT acts as primary androgen in prostate ..."

ncbi.nlm.nih.gov/pmc/articl....

Not what you're looking for?

You may also like...

Rising PSA after radiation and ADT

Hi All, I was diagnosed with PCa in April 2022 (Gleason 3+4). My PSA was 28. I was given a 3...
John347 profile image

PSA keeps rising

My PCa timeline:April 2022 - DX with PCa, Gleason 3+4, PSA 18 Jun 2022 - PSA 28, given 3 month shot...
John347 profile image

PSA rising slowly since Nov 2022

PSA was 10.4 in April 2021 A PSMA Pet scan showed 3 mets on T9 T10 and L1 and started Zolodex in...
Ian996 profile image

PSA Rising

Asking for a friend of my father this time. He had surgery in december 2022 and everything was...
TheTopBanana profile image

post prostatectomy psa

hello. I Had surgery June 13 2023 biopsy showed Gleason 8. Psa 13 perineal invasion seminal...
Elkguide profile image

Moderation team

Bethishere profile image
BethishereAdministrator
Number6 profile image
Number6Administrator
Darryl profile image
DarrylPartner

Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.

Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.