18 Months Post Brachy: PSA rising help....

[blkman60]

Dear Brothers, friends and caretakers!

I had low dose brachytherapy radiation (permanent seed) implants over 18 months ago and the lowest my PSA was post brachy was .6 and it was .7 for about 6 months now it went up to 1.1.

I stop eating meat and my alcohol consumption is a beer or two over the weekend at MOST.

However lately I've been smoking majurana over the weekend. Not much, for example one joint will last two and sometime 3 weeks (it doesn't take much). My sugar consumption might have increased a little but it's not been much. I'm concerned and made an appointment with my doctor and I'd like to query this all knowing forum to find out if someone had the same experience and what they've done to get their PSA back under 1 (I hope that's possible). I'm also concerned because my PSA is on an upward climb and I am under the impression (as my understanding is) that if your PSA keeps rising that this potentially signals biochemical failure/relapse.

It now has been 18 months and I'm wondering how concerned I should be given this upward trend. It doesn't look like a PSA bounce as insofar the PSA has been steadily rising upward. Though it is now 1.1. How concerned should I be?

I'm meeting with my Dr. this Monday and would like to get your recommendations as to what I should I ask in terms of treatments and how concerned should I be because honestly I am scared. I am very anguished by this result. Prior to my surgery, I was diagnosed with an intermediate Gleason of 3+4 and PSA was hovering around 7 and the cancer was localized and had not broken out of the capsule.

I still go the bathroom frequently (average 3 times at night) and I've never gotten back to a consistent continuous stream of urine. I feel like I'm "pissing like a sea serpent!!" Joking aside, I re-started taking Flomax again for the past 6 days and I noticed lately that when I don't take it, it's bad.

Looking forward to your feedback and sending you much love and good vibes!

[NPfisherman]

Based on your case, the classic definition of a recurrence would be a PSA of 2.6 or higher... Nadir of .6 +2=2.6.

You still have a prostate... I doubt that any insurance companies will pay for a Ga68 PSMA PET/CT if you are looking for reassurance... Talk to your MD about your concerns and the urination issue... I wish I could give you some guarantees but there are none... Here is some info on brachytherapy recurrence..:

redjournal.org/article/S036...

Some other information from Harvard Health on post treatment recurrence...

health.harvard.edu/blog/how...

Perhaps, if you had a third consecutive PSA rise then you could get that scan... Just the word Cancer brings fear to people our age but you are doing what you can....Exercise, eat right, get your rest, and try to relax... If you had a recurrence, then it would likely be local and they could give you adjuvant radiation and ADT....

Best of luck....

Don Pescado

[blkman60 in reply to NPfisherman]

I appreciate the comforting words, Don. I'm doing all I can. Thanks for sharing these journal articles. I will bring that Scan to my doctor. I'm insured with Kaiser Permanente and it's worth an ask. As for adjuvant radiation with ADT. What are the drawbacks?

Thanks again,

Tony

[NPfisherman in reply to blkman60]

Well Tony,

I think they will say it is too early for the scan yet.... Androgen deprivation therapy (ADT) has been associated with numerous side effects, including sexual dysfunction, gynecomastia, bone mineral loss, anemia, fatigue, muscular pain, hot flashes, metabolic complications, and potentially increased cardiovascular events. The radiation therapy has caused issues with bowel irritation--diarrhea, urinary tract irritation and these may be temporary... Here is some information from PCF on ADT:

pcf.org/news/18-month-adt-o...

Talk it over with your MD and good luck...some men get a PSA bounce effect post brachytherapy... I can tell you're worried and it took me a while to realize that I had time...Many on these forums have had much worse PSA and multiple metastatic lesions at the start and they are still here... The science is coming on fast and when you consider that abiraterone was approved in 2011 and there have been multiple new drugs and treatments approved since with over 300 clinical trials in the US currently... Take a breath and see your MD...

Take care,

Don Pescado

[Magnus1964]

If your next PSA test shows further increase it might be time to consider moving on to another ADT drug.

[blkman60 in reply to Magnus1964]

Thanks. I hope I don't have to, but I'm going to explore that option as well.

[blkman60]

Never heard of that test, NPfisherman. Thank you for that. I will bring it to my doctor's attention.

[blkman60]

I will be sure to do so. Thanks, Nalakrats! God bless!

[Nsaalu]

Good afternoon Bikeman,

Is it possible that you might be Diabetic? Also, have another look at your diet - alcohol and red meat and coffee/tea should be avoided. Try concentrating on Fish, Chicken, and Turkey with pleanty of greens - and if you are Diabetic be careful with those Carbs such as potatoes, carrots, parsnips, bread, cake & buscuits.

Milk, butter, and cream ARE good for you - processed foods are BAD. It might also be a good idea to check your blood sugar when you have to get up in the night.

Have a nice day.

Nsaalu.

[ron_bucher]

Sleep apnea often causes more bathroom trips at night. It can also cause a host of other health problems. 90+% of people who have it don't know they have it until getting tested.