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Prostate Cancer And Gay Men
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PSA

6 months after surgery and PSA test was 0.05. The same result as 3 months ago.

I take this as good news, righ!!!

No protect,no erection,is normal ?

Thank

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While I’m only at six months as well with a PSA of 0.05 mine has gone up from 0.035 at three months. It would appear to be the fact that mine has increased that they are concerned about together with the fact that it is considered aggressive. The fact that yours hasn’t changed I think is good but there appear to be different standards depending on which lab the test is done. Some believe that anything lower than 0.1 is okay. I’m having a retest in a month and if it’s the same or higher a PSMA-PET scan followed by radiation treatment. Best to talk to an expert.

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PSMA scans are poor at detecting anything with a PSA that low.

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Yes I know it may not show below 0.2 and it’s a risk but my PSA never went higher than 4.04 despite the fact that cancer was aggressive , outside the cap & in two lymph nodes. PSA May be not be properly indicative now either. I got negative margins from surgery so there’s nothing obvious to target other than the prostate bed and it may have jumped to a lymph node elsewhere. If nothing shows it would seem they will just have to target the prostate bed and hope it helps however I’m not one for guesswork. Meanwhile I’m hoping I respond to radiation cause my it was no help to my father. It was 30 years ago and I know things have advanced. I’m still injecting the caverject and using the pump but yet to get a proper erection.

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Unless it reveals distant metastases, with known cancer in two lymph nodes, whole pelvic salvage radiation is needed no matter what a PET scan shows or doesn't show.

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Really, I didn’t realise that. Why would it be necessary if the cancer was elsewhere? I have diverticular disease since my 30’s and was hoping to avoid it. Very concerned about bowel damage and I’m having a lot of bowel problems since going on the anticoagulant injections following VTB a month after surgery.

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I meant that (1) where the are 2 positive LNs, there are probably more, and whole pelvic radiation may be curative, and (2) if cancer is outside the pelvis, there's no evidence of oncological benefit to radiation. You should be talking to a radiation oncologist. I know that diverticulosis is NOT a contraindication. Your bowel dose is highly dependent upon individual anatomy and how much visceral fat you have,

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I appreciate your advice, 20 lymph nodes were removed from the pelvic area during surgery, only two had cancer. It may have jumped to a lymph node outside the area. He couldn’t find any more at the time. Just so I understand you clearly. Are you saying that radiation outside of the pelvic area will do no good? I will of course be talking to a radiation oncologist. I like to be fully prepared and advice from you and others on the site in the past has been very helpful.

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There are several dozen more lymph nodes in the area that he did not remove - it's very hard to get them all. Lymph vessels are invisible and often hidden in fat pads. They are networked, unlike blood vessels that are serially connected. That means cancer cells can be hiding anywhere in the network. The prostate drains slowly into lymph vessels in the pelvic area . Once the cancer is found outside that area (no higher than the para-aortic LNs and not lower than the iliac LNs), it means that the cancer is systemic and, therefore, incurable.

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Thanks for such a clear reply I understand. I didn’t realise there were so many. More than likely that may be where it is hiding. Hopefully the radiation will get it and give me a decent period of remission. Thanks.

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It depends - what did your pathology report say?

I hope you are keeping up with your penile rehab program.

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