What's going on ????

I just had another PSA test and this time it's 2.6 up from 0.54 almost four month ago which means an increase of almost 400%.

I had it double checked and it's not a mistake :-(

I understand that PSA can go up and down but 400% in such a short time???????

 

By the way, had a colonoscopy which showed "Radiation proctitis". My thyroid reading is up from 1.09 to 7.01 as well. Don't think there is a connection but thought I would mention it anyway.

 

I have an appointment with the radiation oncologist in a couple of weeks, is there anything I should be asking him?

 

Cheers, and thanks for any help/explanation you can give.

 

Hello friend,

Sorry to hear about your rising PSA.  It is, I believe, time for you to gather some more info on the next steps.  It’s my hope that with Gleason 9 and seminal vesicle invasion (SVI), your doctors have previously indicated that you are at higher risk of progressing and needing additional treatment.  This is what it looks like to me, from my non-MD degreed perspective.

I have a free online link to a document which will help you get “grounded” in what most doctors will be thinking your “next steps” should be.  The National Comprehensive Cancer Network (NCCN) publishes GUIDELINES for treatment of most cancer types and THIS link takes you to the Patient Guide for Prostate Cancer. 

Lots of words in the front of the document, most of which you will already be familiar with, but then jump to the flowchart/”Treatment Pathways” starting on page 44.  From what you described in this thread, your pathway starts on pg44, then jumps to pg47, then to pg49, then to pg51.  You should map out your own pathway, and see if it follows the same steps that I just traced for you (you might have other information not included here that might lead elsewhere).

From pg51 (and pg52), we are talking about systemic treatment and controlling your testosterone in order to further control advancement of your cancer.  Please do read the descriptions on pages 58-59.

 

Depending on how much you’ve already learned over the last several years of your PC journey, this could be repetitive, but I find that it is sometimes helpful to go back to “square one” when embarking down a new pathway.  This GUIDELINE is the “patient version” of the same document that your doctors should also be following.  You will need to find a medical oncologist next, so I would advise searching for one who specialized in the complexities of prostate cancer and don’t settle for a generalist.

 

I hope this helps you, and best wishes…

PK
John Hopkins and Partin's findings are that patients with a G8 or greater, detectable psa after surgery, negative margins and positive SVI are much less likely to be cured by salvage radiation because these are indicative of distant mets.
Your best next step is to see an oncologist that specializes in PC, as there is nothing else a radiologist or surgeon can do for you.
Good luck.
JT

PK5, just want you to know that we are all in your corner for you buddy. Do keep us posted.

Cajun Jeff