I had my RP last January but the cancers had sneaked out to my lymph node already (no other met) so my PSA was always detectable. I started hormonal therapy last April and my PSA went down right away. It had been that way till this week ( PSA was up and down, the lowest was 0.02, usually was 0.05.). Today's reading is 0.285 that worries me. I phoned my doctor to see if I should be on Zytiga or so to control my PSA ( I receive shot of Diphereline monthly and on Casodex daily) but he said it is still all right. I remember I read somewhere saying if PSA goes up to 0.2.., its time to do something. Can some one share your understanding and experience to see what should I do ?I am 81. I am not ready to die yet. Thank you.
PSA at 0.285: I had my RP last January... - Advanced Prostate...
PSA at 0.285
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Re-test to be certain. "Measure twice, cut once", useful advice not limited to carpenters only.
Thank you, Justfor. I will ask my doctor to order a re-test if he will. Often doctors are not that sensitive to human suffering either psychological or physical. Actually, i phoned him for that and he said the insurance may not cover that. I wonder if PSA will go up and down from time to time.
I take monthly PSA tests. The public healthcare system here prescribes up to one every 3 months. But, the cost is low, i.e. 14 Euros or about 15 USD, so no problem paying out of pocket for the remaining 8 per year. As you may understand with more than 60 test undertaken, two of which proved erroneous on retest, I have developed some personal assessment "guidelines":
a) Any test deviating more that +/- 30% from my projected estimate needs to be retested next day with a different lab.
b) Less than 20% variance between the same or even different labs is considered as normal.
I had an RP in January 2022. The cancer had spread to 1 lymph node. I was put on Eligard in April 2022 and abiraterone (zytiga) in June 2022. I stayed on both drugs for 24 months. I also had 32 sessions of radiation to the prostate bed and the pelvic lymph nodes. I think that treatment is pretty standard for when PSA persists after an RP
I did not have radiation because of the serious incontinence after the RP. I still have leakage when walking. I wish I could go through the standard treatment if I could. Thank you Alturia for sharing your experience.
I know what you mean. I was incontinent for about 8 months after the RP and was ecstatic when I finally got continent. Then about 3 or 4 months after the radiation the incontinence was back with a vengeance. Urologist and physical therapist have told me that the only solution is an AUS but I'm not ready for more surgery so I have learned to live with pass
Why didn't you get salvage radiation?
I always appreciate your response. Do you think at my age I can still risk the possible side effects of salvage radiation such as urination bleeding and colon damaging especially I still have some leakage issues ? I will discuss with my doctor about it.If he can arrange it perhaps I should try. Another question I have is in regard to Gleason score. Mine is 10. Does that mean the metastasis is more likely making the prognosis gloomier?
"... Do you think at my age I can still risk the possible side effects of salvage radiation such as urination bleeding and colon damaging...?"
I think that would be from poorly-done radiation, and much less common now than in years past. The equipment and ROs are better.
At age 78 I had 20 IMRT without spacer for the prostate, and at age 80 I had 30 IMRT for pelvic nodes. I had no discomfort, and now at age 81, no side effects from those radiations.
I thought the trigger level for concern about PSA rising after treatment was 2 points above nadir, not 0.2.
Hi, I too have the cancer in the lymph node, I started on casodex and lupron, but for about 5 of the total 11 years 9 months I have been on Zytiga 500mg, Lupron, 3 monthly and prednisone 5mg. My PSA like yours wouldn't stay low and continued to rise, but it had fallen steadily and remains indectable.
If I was you I would get another blood test done and if the PSA is still rising, insist on Zytiga.
I wish you well.
hi
My husband was in the same situation like you. He has got salvage radiation afterwards. His treatment finished in 2018. His psa is 0.005 now
My poorly suggestion is:
Always get tested in the same place if possible. Get tested again. Talk to your doctor about radiotheraphy if psa is getting higher.
Good luck
PSA can be affected by your activities; having sex, riding a bike, exercise, etc. I've heard it also varies by the time of day. I definitely would test again. It's still very low!
zytiga is now available cheap on costplusdrugs.com
Salavage Radiation of prostate bed and pelvic lymph nodes beoiuggt my PSA to <0.01.
My understanding and experience is to not give this beast time and obscurity. After my unsuccessful RP I set 0.1 as value to take next actions. After my unsuccessful salvage RT I set 0.5 as value to take next actions. I do frequent PSA testing and graph results which clearly shows tread line.
At 0.5 you may as well get a Pylarify scan. That’s the lowest PSA value to give significant results.