Prostate cancer after rectal cancer

[Jbell211]

Hello,

I need some help/advice /or encouragement!

My father is 70 years old and has an elevated PSA!

I will first start off by saying he had rectal cancer 7 years ago n is cancer free from and is in good health, but does have a colostomy bag. Within the last 2 years his PSA level has been on the rise. Nov 2015 his Psa was 3.9, nov 2016 was 6.9, July 2017 was 7.5 and Oct 2017 is at 9.5.

We are worried! His case is complicated due to previous cancer he can't get a regular biopsy.

Any idea what his outlook might be?

[Hidden]

There are several reasons why PSA rises, cancer is only one of them. Also I believe the speed at which PSA rises can be an indicator that it's cancer and particularly if it doubles in less than 10 months. Your dad's hasn't. I also don't think having had bowel cancer increases the risk of prostate cancer. Unfortunately the chances of men getting prostate cancer with age is quite high anyway.

It's terrible not knowing for sure one way or the other. It's a complication that a biopsy can't be taken the normal way, but I imagine if necessary a biopsy could be taken another way. Also the necessity for a biopsy can be determined by a blood test which differentiates between "bound" and "unbound" PSA.

Ultimately, if he does have Prostate cancer, the probability of surviving it is much better than surviving bowel cancer. It is possible to live with prostate cancer.

[mike72]

Doctors will probably do an MRI scan to see if there is anything in the prostate gland. This doesn't neccessarily mean they can tell whether or not it is cancer, but it will reveal if there is anything there. There are ,of course, other signs that will help the diagnosis, like peeing more, loss of libido. Tell the Doc everything. If an op is deemed neccessary, I had keyhole surgery. Less invasive, quick recovery. Take heart, and good luck.

[Chubby42 in reply to mike72]

Im no expert by a long shot but to me if his PSA was going up only a couple of points every 12 months then he should have a minimum of 10+ year prob 20 with treatment it looks slow to me as mine & a few others our PSA doubles in 4 weeks.

Good luck live long and prosper.

[MelbourneDavid]

A transperineal biopsy, which puts the needles in through the skin between the scrotum and anus (or where the anus was) should still be possible. It is done as a hospital day procedure usually under a general anesthetic. As a bonus is is sterile, eliminating the risk of infection, and more accurate than a trans-rectal biopsy. Transperineal biopsy is common in Australia and the UK but unusual in the US.

I would be concerned if his health state suggests he will live more than 5 more years. You want to treat prostate cancer while it is still curable, and a PSA over 10 is associated with a higher risk of having already spread and become incurable.

Low dose rate brachytherapy (radioactive seeds implanted in the prostate) is a good low impact treatment if he has cancer and brachytherapy is feasible

[floridagirl2018]

Did your father get a treatment plan yet? Just curious because my husband is in the same situation. Rectal cancer nine years ago and now has localized prostate cancer, gleason 8 and another lesion gleason 9.