rising psa after surgery

Here is a follow-up to my rising psa.

  After my psa rose to 01.3 the surgeon suggested I meet with a radiologist who specializes in prostate cancer.  I met with the radiologist in June.  He suggested I wait until I have another psa test before making a decision.  I agreed and decided to wait.  Last weeks result was a jump from 0.13 to 0.2.  Based on previous tests this quite a large jump.  Back in May, Sterd82 suggested that 0.2 was a good line to draw in the sand.  This is the number I had in my mind when it was time to take further action.  Now I am here.

  I meet with the oncology surgeon tomorrow.  I will discuss with him radiation and HT.  Then I will talk with the radiologist. Does anyone have more ideas?  Our GP has suggested to my wife that maybe I should wait.  He suggested there might be disadvantages to radiation over waiting.

  I was eating healthier after surgery.  Started drinking pomengranite juice, hardly any cheese and other fats.  I went from eating cheeseburgers three times a week to maybe once every other month.  In the last three months I kind of went back to my old eating habits.  Cheeseburgers once a week not three though. I also quit the pomegranite juice.  I couldn't find the juice I was drinking.  Anyway, would this be reason for such a large jump in my psa from 0.13 to 0.20?  It was only rising 0.01 every three months prior to this.

Thank you

 

Hi, I've just joined although I've benefited from the conversations over the last couple months after finding this site. I don't have a lot to contribute except to say that I'm also in the same boat. My 6 week, 3 month and six month post LRP psa tests were .1 and my 9 month taken this month 8/09 was .2 . My urologist/surgeon said he was "worried" and in two months wanted another psa and a bone scan (I've never had one). And if the psa does not return to .1 then he will have me consult with a radiation guy. He did reiterate, as he had with my previous psa results, that there is a possibility that benign prostate tissue at the bladder neck when he peeled the prostate off ant that could be causing the psa. My GP (I had my annual physical a few days ago) said not to worry because "it is just 1 observation" and I should just cool my jets for a couple months. I've also joined the Yana website. Terry Herbert wondered if the psa rise could be linked to the fact that I broke all my ankle bones two months ago. I believe Terry's point was that psa results at this level can be influenced by other factors. We are all different I guess but I'm thinking I'll wait the two months and try not to think about it (easy to say).

Purg,

We do seem to be travelling down a very similar path. I will keep you informed. I am pretty sure I will opt for treatment asap instead of more waiting. I will see what options for further treatment are available. It is great to read here what others are doing.
With the diet thing. I was just thinking that the diet could have an influence on psa results and the growth of cancer. Not sure just speculation. I know there are others out here who are convinced that diet can influence the growth of pca. The junk bond guy, Mike Milken,
has pca and he supposedly is controlling its spread by eating fruits and vegetables. I am going to go back to my healthier eating ways no matter what influence if any it has on pca. After all of this pca stuff, I would feel rather foolish having a heart attack because of a poor diet.

Jon

Hi Cave,

Here is a cookbook approved by Mike Milken...I believe you were looking into his diet...

http://www.amazon.com/Taste-Living-Cookbook-Favorite-Fighting/dp/0966080564

Tony

You don't want to wait too long if you're going to have salvage radiation.
Stephenson, Kattan, et al, have shown that the pre-salvage PSA reading is a very important variable. You're best off starting before 0.5 if possible (very good results for men who were able to do that) and the next cut point is 1.0 ng/ml.

Original article from Journal of Clinical Oncology ("Predicting the Outcome of Salvage Radiation Therapy for Recurrent Prostate Cancer After Radical Prostatectomy") is here, in full text for free: http://jco.ascopubs.org/cgi/content/full/25/15/2035

Updated nomogram from the article is here: http://jco.ascopubs.org/content/vol25/issue26/images/large/zlj0150759390003.jpeg

This article and nomogram are the basis for the salvage radiation nomogram on the Memorial Sloan Kettering website, http://nomograms.org

G.

The conclusion I came to is "The trend is not your friend"  so why wait when there is mounting evidence that the lower the psa when you start the better your chances.  Just my opinion.

Cave

As you will see from my stats below I have went down pretty much the same path as you after surgery. All looked well until 9 months after when it jumped to .2 then to .3 a couple months later. At this point we were in discussions with the Radiation group and getting all the planning in place to start radation. It was felt because I had a margin that was real close but nothing else involved that it probably was a local reaccurance or a stray cell or two that was missed that this would knock it out. My first rise in PSA was in November of 2007 to .2 by the end of January of 08 it was .3 and when I went in March it was at .42. We started radiation in April finishing in June of 08 and 6 weeks later it not only had went done but fell all the way to .09 which was under the guidelines of detectable at .1. A few weeks later in had fell to <.06 which is a low as they can read and it was that was this past March as well. I have not been checked since but will have a PSA again in November and hopefully all is still down. They felt the way it dropped so fast it was a local reaccurancae and they must have hit it.

I know there is no way to know for sure but I am hopeful this is the case and it's stays <.06 from now on. Good luck to you with this potential next phase and you can have as good of results as I have had at least up to now.

Norskie

Wow!!!
Everyone thank you. My decison is to go forward with the radiation treatment. It seems as though there are many who have and will travel down this same path. I will try to stay more in touch with HW. I'm not much of an advice giver but if anyone one can learn from what I am going thru or doing I hope it helps.

Jon

Cave,
I always say that why we get cancer is not as important as what we do about it. Looking back with regret is not a good way to keep a positive mindset. Instead moving forward with today works best for me.

And moving forward, may peace be with you, And hopefully some good recipes too...

Tony

Good luck. I am four sessions in. So far so good. It is quick, painless and so far no side effects.

The surgeon met with my husband and I after our 3rd consecutive rise in PSA post op in less than a year. we went from .50 to .102 in a little over 6 months and she said that the less than 6 months doubling time was concerning and that it usually indicates that it is not localized but would rather start with radiation first anyway as hormone therapy only suppresses. this is a bit confusing to me. any thoughts out there

I don't have much to add except to say that I am sorry to hear that you are in that gray area of rising PSA.

Don't hit yourself over the head about your diet. At best, diet is a minor issue in the return of PCa and it is hard to believe that you have been harmed by your eating. You are not in control of what is happening in your body but you are in control of how your mind reacts. Even with rising PSA you have time to think and judge -- and you have time to remember that life is moire than a PSA number

I hope for the best for you whatever that may be.