Hello to all,
Is there anyone who had their prostrate removed but PSA is increasing?
Oncologist wants to try a new hormonal drug. Radiation was administered after surgery. PSA is increasing.
We appreciate your feedback.
P.S. Edited profile: “Last CAT Scan was November 2023 - Showed no metastases
Thanks!
About 30% of the patients have a rising PSA value after surgery. This is called a recurrence. The usual treatment for that is radiation of the prostate bed, called salvage radiation. A chemo after surgery is uncommon for prostate cancer. What is the name of the new drug the MO recommends?
You should really write the diagnosis (Gleason score, PSA value,etc.) and your treatments after diagnosis into your profile. This avoids wrong answers because otherwise the answers have to be based on assumptions.
We appreciate you taking the time to respond. Such knowledge, thanks!
We are in Canada. I have fo confirm with the Oncologist if the Gleason Scoring System is used.
I have attached some testing results.
Thanks
It is used.
I am in Quebec and my Gleason score was 4 + 3 = 7 Grade 3 (Unfavourable .
Thanks! We have added this to a list of questions/request - Gleason score.
The Gleason score or the newer ISUP grades are used worldwide. It should be mentioned in the pathology report after biopsy or surgery. Also, what was the PSA value before surgery and has the cancer already affected lymphnodes or bones?
The testosterone level is normal, it varies a bit during the day. The PSA value should trigger salvage radiation, without knowing additional facts yet. I still cannot believe he got chemo yet, do you know the name of the drug used?
Thanks for responding. We will ask them to see the pathology report after biopsy or surgery.
The PSA value before sugery was high (he “thinks it was 14). He then got a biopsy and was given 2 options : Prostrate removal or Chemotherapy. He chose prostrate removal, followed with radiation. He never took any medication to date.
P.S. His dad died from this cancer, hence the option to remove, which he regrets.
You have to ask for the pathology report? You should be given that and the pre-operation data: psa, testosterone. and other blood testing results automatically. Should never have to ask! Removal or chemo? Something is not making sense. We need all his data to offer help in understanding. 14 is not very high, some have had in the hundreds or more. Mine was 20.62.
No one can answer your question without more information. Your profile is blank. What is your current diagnosis? Newly diagnosed? Recurrent? Castration resistant? Do you have metastases? How many? Where? Why were you given chemotherapy after surgery? (that is very unusual)
Thanks! We got a response earlier, which was much appreciated.
In response to your questions: There are no metastases. Diagnosed in February of 2020 - surgery procedure followed after biopsy.
Chemotherapy was not given after surgery, rather radiation. Radiation was administered at the tip where the prostrate was removed to kill any remaining cancer cells.
Thanks
It sounds like he got surgery for high risk prostate cancer and was given salvage radiation when PSA continued to rise. Is his PSA still increasing? If so, he is probably being offered some kind of hormone therapy to keep the remaining cancer in check.
That's what we learned from you so far:
- diagnosed in 2020 with a PSA of about 14 ng/ml.
- surgery followed by radiation to the prostate bed
- no hormonal therapy nor chemotherapy
- PSA value has risen to 0.5 ng/ml
- it seems that your oncologist wants to start with hormonal therapy now.
My recommendation: wait with hormonal therapy until the PSA value got up to e.g. 4.0 ng/ml and avoid the side effects of hormonal therapy for now.
Try to learn more about prostate cancer: pcf.org/patient-resources/
Wow! You are very knowledgeable re: Prostrate Cancer, terminology etc. We are grateful that you have taken the time to respond.
We concur with your recommendation - waiting until PSA reaches up to 4.0 ng/m. The Oncologist wanted him to wait until his PSA gets to 2.0 ng/m before starting hormonal therapy so he can enjoy his quality of life for a longer period of time.
Thanks for the link to gain further knowledge on prostrate cancer.
Why not request a PSMA PET/CT Scan before 4ng/ml is reached.
We have noted this, and will make the request. Thank you!
If he did not get chemotherapy, you might want to edit your original post to reflect "radiation" instead of chemotherapy. Others may look at your post and not see the correction in your comments.
Thanks for noticing the oversight. Edited, thanks!
Yep, Just add info to your bio. (Age? Psa number? Gleason number? Treatments? Meds? Treatment center(s)? Date of operation(s)/treatment(s) and etc.) All information is voluntary. Thank you!
Good Luck, Good Health and Good Humor.
j-o-h-n
You forgot the Ice Cream Scoops/ bowl NUMBER!!!
LOL................ Daily brain freeze........(tray number? Don't tell me you've spent time in the joint with Bubba?)
Good Luck, Good Health and Good Humor.
j-o-h-n
Thanks!
No.... Thank you......
To remind you, nothing concerning Pca is a phenomenon....so a rising Pca after a RPD is/was a nothing burger to many of us...... Hang tight....
Good Luck, Good Health and Good Humor.
j-o-h-n
I had prostate removal in 2011. PSA returned after initial good signs. Radiation failed to reduce it and they eventually discovered it had spread to my lungs. After 6 sessions in 2001 I went on to Abiaterone and am still going! PSA now minimal 0.46.
”P.S. His dad died from this cancer, hence the option to remove, which he regrets”
Treatments to date seem spot on for conservative, standard of care approach. Unfortunately it seems the PCa may be metastatic, but you should NOT regret or second guess anything you’ve done so far. This condition is entirely heterogenous; no reason to dwell on prior treatments or decisions.
You can check my profile for one path progression and treatments might take. I had a similar diagnosis and initial treatment plan at age 53. In considering hormonal therapy, you might want to research and discuss Darolutamide monotherapy in lieu of more commonly prescribed ADT regimens (Lupron or Degarelix). Might not be an option in Canada though.
Thank you!
We will check your profile re: treatments etc., and will do some research on Darolutamide Monotherapy
Have a great day!
Ask your MO about a PSMA scan to determine where the lesion(s) are. It may be possible to eradicate them. It does seem like you are headed for ADT +/- chemo.
Sure! We will do that, thanks - Added to the list of requests for our upcoming Oncologist appointment.
Have a great day!
PSA Gradually increasing. 
PSA increasing during radiation treatment
PSA increase. 
'Other stuff' that increases PSA values 
