No Longer Undetectable

[DesertDaisy]

Hello Everyone,

I just posted this on APC, but want to post it on FPC also as I know some of you are not on APC any longer and I am looking for advice.

My husband had his prostate removed in April 2021. The cancer had spread out of the capsule and one lymph node was positive. His cancer is both acinar and ductal. After surgery he was given a 6 month Lupron shot and that is the only treatment he has had since. Details are in my profile.

He is being treated at Mayo in Phoenix and we typically see an MO, but have also seen an RO. We were advised that radiation wasn't necessary after the surgery and, in fact, the RO said what would we radiate at this point. The MO has assured us that he was doing really good and no other treatment was needed.

His PSA has been undetectable up until now. He was undetectable on 11-29-22. On 3-31-23 his PSA jumped to 6.3. We requested another test be done today, 4-3-23 and the PSA was 7.1.

We are meeting with the MO's PA on 4-5-23. I plan on telling them that we need imaging done. I am wondering if there is anything else at this point for us to request. What should the next steps be?

We have both been taken off guard by the PSA not only becoming detectable, but the fact that it seems quite high and I just don't want to forget anything. Any advice would be appreciated.

[Don_1213]

Daisy - I think this is a textbook case calling for the use of a PSMA-PET scan.. That should bring some answers to the question of what's going on. If the MO or RO doesn't suggest it - you suggest it. If they resist it - start looking for new doctors.

[DesertDaisy in reply to Don_1213]

Thank you. He is having the PMSA-PET tomorrow morning. Hopefully, we will know more very soon.

[Spyder54 in reply to DesertDaisy]

DD, just so you know, do NOT fear the worst. This is not what you wanted but happens more often than you think. Something is obviously going on to cause PSA to rise (injury, bike riding, and sex can also cause false rises). Also 2nd gen ADT drugs work better than Lupron alone one step at a time . No worries.

There are now, just in the past few years with the approval of PSMA-PET, countless cases of Men that get their scan results, hit the higher SUV-Max uptake areas shown, with 3 or 5 days of Stereotactic Ablative Radiation (SABR/SBRT), or Pelvic Floor Beam Radiation, and boom, their PSA continues back down to undetectable levels (wait 3 months for first PSA as dead and dying PCa cells give off lots of PSA). Not to worry. There are answers.

All our best to you and yours, Mike

[DesertDaisy in reply to Spyder54]

Thank you Spyder. My hope is that if it shows cancer, it will be just in the lymph nodes and that radiation will be an option. We should know what is going on next week. I'm glad they were able to get him in for the scan so quickly.

[Ahk1 in reply to DesertDaisy]

please let us know the results. I am waiting to do my psma on 5/8.