Worried and confused about my father's condition

Any thoughts, suggestion, advice welcome about the below.

My father (66 years old) was diagnosed with prostate cancer back in June 2011 (about 10 months ago) PSA29 and Gleason 6. He immediately underwent Orchiectomy in June itself; Bone scan, CT scan and PET scan were clear. There was some confusion about a small spot at the top of the spine (found in the bone scan), but an MRI indicated that the spot had nothing to do with cancer. We also decided it was best for him to undergo radiation therapy (To the prostate, I think about 30 odd sessions) which concluded in September.

We did a follow on psa test in end October which came in at 1 (I know it was early post radiotherapy but we were curious), and we were very happy about it. The doctor asked us to do another psa test in March and we did that yesterday. However yesterday, to our bewilderment, it came in at 67.

We are meeting the doctor tomorrow but simply cant understand how for a Gleason 6, the cancer could have become hormone refractive in less than 5 months and that too increase from 1 to 67 in less than 5 months. Does somebody understand how could this be happening?

Thank you very much.

Worried, I have no concrete answer for you, but I was also faced with an odd situation regarding my father´s PC, as you can see from my signature. I think Dr. Leibowitz said once "there are very few if any absolutes in treating PC" because of the varied nature of PC. While I am aware that anything is possible, I must say that I highly doubt that your father´s PC has become hormone refractory. Having read as much as I have in the last year, I believe this is some sort of an odd post-radiation PSA reading. Have faith, and I am sure in a few months you will be able to get another reading that will put your worries to rest. Greetings!

I'm not sure if it matters to wait or not but I would be getting it checked again soon.

Worried,
This sounds a lot like a varient and most doctors are very inexperienced in Dxing and treating PC varients. Dr Brankhoph, a pathologist in Germany and Dr Snuffy Myers in Earlysville Va are two doctors that come to mind that have a lot of experience in detecting and treating varients. At this point in time you need an experienced expert.
JT

(Just to confirm that I do know that removal of the testes is a form of HT in that it permanently removes the source of Home made testosterone.)
My query was more about the idea of an orchidectomy being chosen as the first treatment for a Gleason 6 with a PSA of 29 and clear scans, as that all sounded like organ contained PCa and I'd have thought removal of the prostate rather than the testes would have been more likely.
Alf

Terribly sorry about all the confusion on hormone therapy, I guess I was not thinking straight. He underwent Orchiectomy and then had radiation therapy.

We did another psa test today at a different lab, with the psa virtually at the same level, came in at 66. His Alkaline Phosphatase was at 98, which according to the doctor was within the normal range and would have been much higher if bone mets were present. My father will anyway have a bone scan in the coming day's.

The radiation oncologist believes this could be a case of post radiation "bump" in psa. I am guessing a bone scan in the coming day's will give us a clearer picture.

Thank you.

I'm wondering why the treatment for a Gleason 6 would include an immediate orchiectomy. That sounds like a very drastic approach to what would appear to be a non-aggressive cancer. My impression has been that orchiectomies are usually only performed in advanced or seriously recurrent cases.

I also wonder if Riviere may not have hit on a very important point. If your father had a normal 12-core biopsy, it's possible that the samples taken may have missed a tumor area where cancer was present and of a higher Gleason level. Unlike a surgery patient, your father's complete prostate was never biopsied, so it's impossible to say if the biopsy missed a serious tumor.

I don't speak with any medical authority, but those are some of the issues I would be thinking about.