Biochemical recurrence

[cajun1949]

So the biochemical recurrence has me worried. I'm 14 years since my initial radical prostatectomy. PSA levels have been rising for 3 years. My question is at what point should my Urologist suggest for me to see oncologist? I'm not putting numbers, I've read so many conflicting suggestions online. I will say my initial diagnosis was made at age 53 ( now 67, going to be 68 next month) Gleason score of 7, and PSA 5.2, and  Cancer stage T2c. So being curious as I am would like some input on this. 

Also I've had leakage since after surgery. Started with one pad, sometimes two a day. I could live with that. Started leaking more 2 to 3 pads a day everyday. Had cysto on 4/7/15 and found scar tissue, had surgery to remove on 4/22/15. wore catheter for 2 weeks and leakage was worse, 6 to 7 pads a day. another cysto on 11/10/15  reviled more scar tissue. Back to surgery on 11/17/15, which they found a staple left from initial surgery, it was removed. I'm using 3 to 4 pads a day fully soaked, sometimes leaks through and I have wet jeans. I've learned years ago that if I wear really tight undies putting the extra pressure it lessons the leaking.  I walk a lot and watch what I drink and still it leaks. I went to a festival yesterday (live in Louisiana and we have festivals all the time)  and have to bring a back pack with extra pads. My Uro wants to implant the AMS 800 Urinary Control System. My worries are that I'll still have to wear pads and have this foreign object implanted and still have recurrent urine leakage. Anyone had this done? and how did it work for you?

And don't even get me started on my sexual problems!

Any advice would be appreciated!

[Darryl Partner]

Hi Cajun.  Since you are almost 68, probably American (Cajun), I am going to assume that you are on Medicare.   Seeing an oncologist now is appropriate.  You will get peace of mind and you might get actionable advise.  Medicare covers this, so your out of pocket cost, if anything, will be minimal.  

[Tall_Allen]

The kind of doctor you should be seeing depends on whether your recurrence is curable (in which case you should see a radiation oncologist) or if you will have to  manage the disease (in which case you should see a medical oncologist). What is your PSA now, and how quickly has it been rising? Have they done any imaging, like a bone scan and CT to see whether it's still localized?

Everyone I know who's gotten the AUS is thrilled with it. One guy had both the AUS and a penile prosthesis installed at the same time, and is very happy with both. If you're a candidate for salvage radiation, you'll have to wait until afterwards.

[JoelT]

The general rule is that it is never to early to get a second opinion or see a different type of doctor, but it can be too late.  So, now is the time to be seeking out a second and a third opinion. 

Joel