Persistent PSA

[Nonno]

3/23 Prostatectomy PSA pre-op 4.8

Gleason 4+4, epe: present, lymphnodes removed and clear

4/23. PSA: 0.21

7/23 PSA: 0.22

8/23. PSA: 0.32

9/23 39 rounds of IMRT,

ending 11/23

1/24. PSA: 0.32

3/24 PSA: 0.39

PSMA PET scan shows no evidence of recurrence or metastatic disease.

Never had Adt

Exercise daily and feel great. Have been plant based for 13 years. Limit alcohol and sugar.

Meeting with MO tomorrow. What should I ask?

In New Orleans area, but will travel for second opinion or treatment. Any suggestions where to go?

Any help is greatly appreciated.

[Tall_Allen]

It's hard to understand why you didn't have at least short term ADT with your salvage radiation.

If your PSA rises rapidly, there are two clinical trials (EMBARK and PRESTO) that showed that ADT with Erlaeda and Xtandi, respectively, can delay progression:

prostatecancer.news/2023/05...

prostatecancer.news/2022/09...

[Nonno in reply to Tall_Allen]

Just met with MO. She wants me to take Casodex for 30 days, since she thinks this will reset my PSA and lower it. Thoughts?Thanking you in advance

[Tall_Allen in reply to Nonno]

It will lower your PSA, not "reset" it (whatever that means). IMO, it's a band-aid.

[Justfor_ in reply to Nonno]

Check my Bicalutamide (aka Casodex) manoeuvres thread. The head post has some useful quantitative info.

[cscmetsfacil]

Looks like you had a PSMA PET when you PSA was at 0.39. Generally, the lowest PSA value that can generate detection is 0.5 +. I have waited until my PSA was at 1.0 and the PET has rendered useful information about where I have mets. Dr. Kwon at Mayo seems to be more aggressive with chemo early. You might what to check with Dr. Mark Scholz with the Prostate Cancer Research Institute at Marina Del Rey in CA. Sorry to hear that the PSA is persistent, but you are early in the treatment path so this is the time to dig into your options. Going to your MO is a good step, as is getting the opinions at this point. Best of luck.