Stagnant Condition.

[SoonerMark]

I've had a prostatectomy followef by salvage radiation due to a rising PSA. Initially, the salvage radiation worked and PSA was undetectable. However, a few months passed and my PSA steadily rose at a quite rapid rate doubling about every three months to .8 before stabilizing. For the last 6 months it been about the same, no increas and no decrease. My understanding is that any PSA reading is reflecting cancer cells remaining in my body. So does this stagnant condition mean the cancer is there and not growing but could do so at anytime ? Is there any need for continued treatment at this time ? I've not been on androgen deprivation and my testosterone level is low but within the normal range. Would it be safe to add testosterone ? Just not sure what to do going forward, do nothing, be proactive with treatment, or go opposite with testosterone treatment. Any opinions or suggestions appreciated.

[Magnus1964]

Having a PSA that stays the same is a great thing. I would not move to any new treatment and enjoy the ride. Don't do anything until your PSA changes.

[SoonerMark in reply to Magnus1964]

Thanks for the suggestion. I must admit, it makes me a little nervous not doing something. But whether it works is the unknown for me.

[NPfisherman]

Mark,

At this point, like most anyone, you have a serious concern that your PCa has returned. I would get a referral for a Pylarify scan to see if they can ID any tumors and where that might be, for possible SBRT treatment. Also, consider getting a germline and somatic DNA test to determine if there are any mutations.

In the event that you are oligometastatic ( less than 5 tumors) AND... have no major DNA mutations, then SBRT may give you some time off before having to consider doing ADT.

Refer to the ORIOLE trial or some of my posts on the ORIOLE trial on this forum for information on SBRT for oligometastatic patients. Lastly, perhaps, there is some residual prostate tissue left after surgery which is not PCa resulting in a PSA increase..

Knowledge is power, so get a scan in order to make an educated decision.

Best of luck,

Don Pescado

[SoonerMark in reply to NPfisherman]

Thanks NPfisherman,

I found an easy to understand article on the difference between Germaine and somatic cancers at: voice.ons.org/news-and-view...

I've had a PSMA scan within the previous year with no findings. But I never considered the possibility of residual prostate tissue remaining. I'll ask my doctor about this.