4 Years Since Prostatectomy and Sudden Rise in PSA

It's nearly 4 years since my robotic surgery. Negative margins and no lymph node invasion. Undetectable PSA until today's 0.09. I would like comment on what the chances are of this apparent recurrence - could it be benign cancerous tissue, is it likely the cancer is in the prostate bed?

My uro is referring me to a radiatipn oncologist for a chat.

It is a 1.5 hour drive to the oncology unit, what's the chances of driving this daily? I am self employed.

I have the added complication of urethral stricture, they say will need to be cleared before radiation team will consider the treatment.

I believe bleeding bowel is a side effect, I already suffer slow bowel condition.

Hoping for your good news guys, this is tough.

Kick,

Sorry to hear your news. I think a retest in a couple of weeks would be advisable. We have seen cases here of errant test results.

I have been tracking mine for 3 years, and unlike yours, has been slowly creeping back and forth for the last 6 months. Mine was .04 the last test. Will be taking another one in April.

My oncologist from Cleveland Clinic believes that .05 is an important number. so we will see what he does when I hit it. I am assuming radiation with full pelvic.

Meanwhile, I am just enjoying the good life. Am doing my best to not let this sucker get me down.

Good luck ! Keep us posted.

OK, here's the PSAs.
June 08 Prostatectomy
Sept 08 0.01
March 09 0.01
March 10 0.02
March 11 0.02
March 12 0.09

The same testing lab was used throughout.

Urologist is saying salvage radiation, earlier the better. I also am thinking retest in a month. Meanwhile may undergo some natural remedies. open to suggestions guys. Though vegan sounds extreme, death is more extreme and if I don't make another 20 years I will set a record for our family over 3 generations, a record I prefer not to accept without a big fight.

Sorry about this sudden change to your stats and thus to how you are feeling.

My uro and RT doc do not test to anything more than one decimal, so I am still simply "less than 0.1" since my SRT, and thus if I had actually had your stats neither they nor I would know. They don't think it helps guys if they are able to get anxious about small changes as they only plan additional treatment on the basis of bigger changes. (Hence they sent me for SRT when I jumped from 0.1 to 0.4)

So I think you can definitely wait for another PSA test in about a month.
If the PSA is the same then still do nothing other than re test more frequently than annually
Even if it is up you need to see what the rate of change is, and that too may just mean waiting for another test in a month or two. But clearly if it rises a lot and quickly then you are probably heading for SRT. But wait till you reach that bridge before thinking about how to cross it.
And if the PSA is down then rejoice!

Alf

  KickintheButt said... ... open to suggestions guys. Though vegan sounds extreme, death is more extreme and if I don't make another 20 years I will set a record for our family over 3 generations, a record I prefer not to accept without a big fight.   kickinthebutt, Prostate cancer serves as a “wake-up call” for many men—not everyone, but many—to make lifestyle choice changes.   Doctors who are expert in PC are very consistent that these choices do make a difference in outcomes.   For emphasis, let me stress that it may not “cure” your cancer, but you WILL increase your probability for a better outcome  than if you ignored the advice of the world’s leading PC experts. Further to that point, here’s a LINK to an article worth reading titled, “ Lifestyle and Diet May Stop or Reverse Prostate Cancer Progression ,” which includes this line:   " There was a direct correlation between the degree of lifestyle change and the changes in PSA. " You mentioned changing to a vegan diet.   Many men here at HW have gone that, or similar , route to maximize the efficiency in which their bodies help fight cancer progression.   For example, in another link two days ago on Monday of this week, a HW member (ralfinaz) discussed his adoption of a near-vegetarian diet (plus fish) as a tactic for battling his serious PC case since 1992. Others have already commented to you regarding your latest PSA test result; I agree that it is too early for triggering a conventional secondary treatment.   I would, however, offer two comments for your consideration at this point.   I’ve made these comments elsewhere in other HW replies, and if it’s ok I’ll just copy/paste them again here: 1.     In my humble opinion, anyone who uses only alternative medicine techniques (and completely foregoes traditional medical approaches such as surgery, radiation, HT, etc) to combat prostate cancer is foolish.  At the same time, anyone who uses only traditional aggressive medical techniques (previously listed) without supplementing with integrative medicine techniques such as lifestyle changes (diet, exercise, stress reduction, etc) is also foolish.   2.     [My second comment is actually a copy/paste from Dr Mark Moyad from a PAACT Newsletter which basically says to ignore the individual anecdotes of others who say “ it didn’t work for me! ”; and instead, focus on improving your own probabilities]:   “People … love to tell the story of some unhealthy person that lived to be 100 years old. Sure, this can happen, but for every unhealthy person that lives to be 100 there are hundreds of other unhealthy people that never lived to be 40 years old because they were not taking care of themselves. And, for all those people that love to tell the story of one young healthy person that died young, there are hundreds of other stories of people that lived to be very old because they were taking care of themselves. All of this stuff basically comes down to probability, and of course no one is given a guarantee that they will live longer if they exercise and maintain a healthy weight, but who gives a darn - I am going to side with the higher probability here and I refuse to side with the improbable here because most of us live by trying to increase our odds or improving our probabilities.”   best wishes…

Hi KickintheButt,
Labs change PSA assays all the time. Are you sure that the same assay was used throughout the years? Verify that with the testing laboratory. Even the time of the day when the blood was drawn could affect results. PSA follows an offset circadian rhythm with the testosterone circadian rhythm that could affect PSA results.

Be sure to verify if the assay used this time is the same as it was used before. I would not act until you know for a fact that recurrence is the cause. Wish you the very best!

RalphV

Ozbob - it was capsule confined. My uro told me that the length of time to recurrence with my pathology is good news, inasmuch as the location is likely to be within the prostate bed.

With the 0.01 rising to 0.02 and staying there for another 12 month test I was not at all alarmed, but 0.02 to 0.09 is a sharp rise, seems unusual when I know so many of the stories here which led to SRT.