Cancer returned.

[Spursboy]

Back in 2006 I was diagnosed with Prostate cancer with a PSA of 17, treatment was 20 sessions of radiotherapy followed by Zoladex implant every 3 months for 3 years, my PSA then dropped to 0.10. There it remained until 2011 when it went up to 0.40.

From then until 2018 it varied between 0.40 and 0.71, but since then every test has shown a slight increase.

Latest Psa is 6, result of a recent PETscan shows a very small spot of cancer in my prostate, I am now waiting to hear what treatment is suggested.

Is this serious, does it mean I do not have much time left?

By the way I am 84 and reasonably fit for my age.

[Justfor_]

From the very sparce PSA information that you supplied I can gestimate a PSADT of about 2 years that translates to low aggressiveness. In my book this is anything but serious and would bet that you will NOT die of PCa. There is of course the possibility that some silly doc can put you in triple therapy, which is very fashionable nowadays, and your heart succumbs. Hypocrates said: "First, cause no harm" but it is Greek to silly docs.

[Spursboy in reply to Justfor_]

Extra Information:

1st March 2006 Routine blood test

22nd March 2006 Doctor – PSA @ 17 could be prostate cancer

23rd May 2006 Hospital – Confirms GP diagnosis.

25th May 2006 Hospital – Biopsy

8th June 2006 Hospital – Confirms cancer, Gleason Score 8

14th June 2006 Hospital – Bone scan.

20th June 2006 Hospital – MRI scan.

12th July 2006

Hospital – Bone scan clear, MRI shows locally advanced , no spread to lymph glands or seminal vessel, treatment will be 30 days Cyprostat, after 14 days Zoladex implant (3 months) for 3 years, Radiotherapy after 3 months of Zoladex.

13th July 2006 Started Cyprostat

26th July 2006 Nurse Zoladex implant.

18th October 2006 Nurse 2nd Zoladex implant, also had a blood test taken.

27th October 2006 Blood test result PSA now 1.6!!

2nd November 2006 Planning Scan before RT

1st December 2006 2nd Planning Scan

5th December 2006 1st Session Radiotherapy

20 sessions 55GY total

5th January 2007 Last Session Radiotherapy

5th January 2007 Urine infection found, antibiotics req'd

10th January 2007 Nurse - 3rd Zoladex implant

28th March 2007 Nurse - 4th Zoladex implant

17th April 2007 Hospital – Oncologist – PSA now 0.1

All looks fine return in 6 mths.

22nd June 2007 Nurse – 5th Zoladex implant

14th September Nurse - 6th Zoladex implant

30th October Hospital – Oncologist – PSA still 0.1

All looks fine return in 6 mths.

Change from Zoladex in tum to Prostap in arm to allow removal of Gall Bladder.

6th December 2007 Nurse – 7th Prostap

25th February 2008 PSA still 0.1

28th February 2008 Nurse – 8th Zoladex

29th April 2008 Hospital – Oncologist – PSA still 0.1

All looks fine return in 12 mths.

28th August 2008 PSA still 0.1

6th November 2008 Nurse – 11th Zoladex

29th January 2009 Nurse – 12th Zoladex – last one!!

8th February 2009 PSA still 0.1

30th April 2009 PSA still 0.1 12th May 2009

Hospital – Oncologist – PSA still 0.1. All looks fine return in 12 mths.

29th October 2009 PSA still 0.1

27th May 2010 Hospital – Oncologist – PSA still 0.1 All looks fine return in 12 mths.

11th November 2010 PSA @ 0.27

11th January 2011 PSA @ 0.39

26th January 2011 Hospital – Urologist – Increase being small, hard to tell, return in 3 mths.

5th May 2011 PSA@ 0.54

18th May 2011 Hospital – Urologist-looks as if cancer has returned, watchful waiting, return in 6months.

19th October 2011 PSA@ 0.59

2nd November 2011 Hospital – Urologist-slight increase is insignificant, could be due to healthy cells, watchful waiting, return in 6months.

1st May 2012 PSA@ 0.76

2nd May 2012 Hospital – Urologist- still says the slight increase is insignificant, could be due to healthy cells, so it is still watchful waiting, test in 6 months, consultation via post.

21st November 2012 PSA@ 0.62

6th June 2013 PSA@0.72

5th Dec 2013 PSA@0.71

2nd June 2014 PSA@0.66

2nd Dec 2014 PSA@0.60

20th May 2015 PSA@0.58

2nd Dec 2015 PSA@0.62

20th May 2016 PSA@0.75

6th Dec 2016 PSA@0.67

7th June 2017 PSA@0.68

29th Dec 2017PSA@0.59

15th June 2018 PSA@0.59

24th Dec 2018 PSA@0.81

11th July 2019 PSA@0.71

3rd Dec 2019 PSA@0.71

8th Sept 2020 PSA@0.75

12th March 2021 PSA@0.84

16th Sept 2021PSA@0.94 - needs to reach 2.1 for concern - Prostate Cancer UK Nurse.

15th March 2022 PSA@1.15

8th Sept 2022 PSA@1.47

26th Oct 2022 GP Dr Graham has contacted Hospital Oncology Dept.; Advises the back-pain has nothing to do with PSA increase due to clear CT scan in May, and there is no concern unless level reaches 6-7.

23rd March 2023 PSA@2.17

24th May 2023 PSA@2.57

15th June 2023 Telephone call from Oncology Nurse, checking how I am, not over concerned by the rise but will have a word with Doctor regarding a possible scan or bone marrow test. Not needed urgently so may be some time.

5th July 2023 Full body bone scan.

12th July 2023 Full body bone scan results, no evidence of bony metastases but significant degenerative lumber spondylosis.

7th August 2023 Follow up CT scan, all clear.

24 August 2023 PSA @ 3.22

30th August 2023 Call with Oncology Nurse regarding PSA increase and also now needing an appointment because of blood in my poo, fast track possible lower GI cancer.

She says they are watching until PSA double in 3 months then a possible Pet-scan and back on hormone treatment to keep PSA under control.

Hospital advise nothing found via colonoscopy.

24th November 2023 PSA @ 3.46 up 0.24

7th March 2024 PSA @5.61 up 2.15

15th March Spoke to my cancer nurse to day and she reassured me that the sudden jump she believes is due to the fact that I had recently spent a week in hospital with cholangitis (often referred to as primary biliary cirrhosis) a type of liver disease.

The hospital had taken the PSA test during the time I was in hospital and she is 90% sure that the next test I have in early April will show a lower figure.

3rd April 2024 PSA @ 5.36

[Justfor_ in reply to Spursboy]

Since December 2019 you have a monotonously rising PSA. In the above PSADT excel sheet the 7/3/24 PSA reading has been omitted as per your nurse's remark and also for being an outlier to the otherwise smooth exponential trajectory of your PSA (regression coefficient 0.9566 i.e. very good fit).

Your PSADT is calculated to 15,2 months which is considered as the lower limit of the very low aggressiveness stratification (15 months). The inclusion of the 7/3/24 reading lowers it a bit to 14,9 months.

The above doesn't change my previously expressed opinion.

Spurboy's PSA

[Tall_Allen]

It means that the radiation didn't get it all. If confirmed by a biopsy, they can simply add some brachytherapy to the single lesion. Hopefully, that will cure you.