Rising PSA after surgery and after radiation

OCEANWAVE,

Wished we had the answer too. We are in your situation and decieded to start HT this past Feb. Will finish 1 more injection in Dec. and then stay off unless or until it starts rising again then deceide what method to take then.

I wished it was easier but hope for the best in whatever decision you make.

By the way it is working as far but not without SE.

Good Luck!

BOOGEE

Hi Oceanwave,

Yes it would be very helpful to post up you profile here.

See mine below...as I too have been experiencing rising psa post surgery and post radiation. Now do understand everyone's situation is different - and you should do your own due diligence and learn as much as possible and ask the docs lots of questions.

Presently I am being treated with casodex and pomegranate extract with good results (so far) and very few side effects. In my case there is also a potential for some new treatment with the cyber knife (see the other thread on that subject and again read below).

Bridge
_

Age 63, dx age 60, PSA 2.9 ; detected by dre
Stage t3b Gleason 7 (4 +3) tertiary pattern 5
11/09 Post-prostatectomy path: extensive extra-prostatic growth 60% tumor both lobes; perinural + l seminal vesicle and lympho-vascular tumor invasion; Lymph nodes:14 right obturator; 9 left pelvic (no regional lymph node metastasis)
10/11 adjuvant IGRT radiation 8 weeks
4/10/12 psa rise from 0.3;0.5;0.9 indicated ineffectiveness of SRT – on to medical oncology
5/30/12 negative bone scan; ct scan showing enlarged adrenal gland and 1 pelvic lymph node "involvement"...
6/5/12 initial meet with med oncologist began daily use of pomegranate extract; need baseline psa w/same protocols
6/5/12 psa rising to 1.5…then again on 7/10/12 psa 2.0
7/17/12 doc confirmed diagnoses of “aggressive metastatic” pc;
Prescribed 50mg Casodex (Bicalutamide) for 6-7 weeks + pomegranate extract before new psa blood test + ctscan
9/4/12 ctscan and psa blood tests first since casodex treatment began
9/11/12 results indicate psa drop from 2.0 to 0.2; ctscan shows significant improvement in lymph gland...to continue same regimen for next 90 days.
9/27/12 radiation team at hospital indicates they can treat my lymph gland with the cyberknife

Hi Boogee,

I have been on 50 mg of generic casodex daily (Bicalutamide) since about the end of July (I was delayed in getting the med started because of a stupid and incompetent mail order script house) + I have been taking 500MG of pomegranate extract daily (from the Vitamin Shoppe - their brand since 6/6/12).

As I indicate below in my profile my psa was rising from low counts but then started rising quickly - it went up to 2.0 (7/10/12) But then after adding the Bicalutamide to the pomegranate extract it went way down to 0.2 (9/4/12) and the one 'involved' lymph gland shrunk significantly...

I will remain on that prescription until my next meeting in December but in the meantime now they have called me back in and are now talking about possibly treating my lymph gland with the cyberknife (see other thread).

There has been no discussion of lupron at this point - my medical oncologist was pleased and kept me on the same treatment regimen.

Bridge
_

Age 63, dx age 60, PSA 2.9 ; detected by dre
Stage t3b Gleason 7 (4 +3) tertiary pattern 5
11/09 Post-prostatectomy path: extensive extra-prostatic growth 60% tumor both lobes; perinural + l seminal vesicle and lympho-vascular tumor invasion; Lymph nodes:14 right obturator; 9 left pelvic (no regional lymph node metastasis)
10/11 adjuvant IGRT radiation 8 weeks
4/10/12 psa rise from 0.3;0.5;0.9 indicated ineffectiveness of SRT – on to medical oncology
5/30/12 negative bone scan; ct scan showing enlarged adrenal gland and 1 pelvic lymph node "involvement"...
6/5/12 initial meet with med oncologist began daily use of pomegranate extract; need baseline psa w/same protocols
6/5/12 psa rising to 1.5…then again on 7/10/12 psa 2.0
7/17/12 doc confirmed diagnoses of “aggressive metastatic” pc;
Prescribed 50mg Casodex (Bicalutamide) for 6-7 weeks + pomegranate extract before new psa blood test + ctscan
9/4/12 ctscan and psa blood tests first since casodex treatment began
9/11/12 results indicate psa drop from 2.0 to 0.2; ctscan shows significant improvement in lymph gland...to continue same regimen for next 90 days.
9/27/12 radiation team at hospital indicates they can treat my lymph gland with the cyberknife

Oceanwave, welcome to HW, really sorry you have to join us. I can't add anything to the discussion except my welcome, Hope you find a place for yourself here and get a variety of answers.

ocean,

I'm just 9 days out from my first Lupron injection, so can't comment much. I finally pulled the trigger when my PSA got to 5.2 last month, with a doubling time just at 3 months. I did not want to start too early, but ask someone what "early" means and you'll get answers all over the place.

"Short term" is probably not a valid comment for HT. Many go for years, 10 and more, without going refractory. Looking at the stats, HW is not representative of the PCa world.

Welcome to HW. Hate it that you have to join us, but you are always welcome to ask questions and vent if need be.

Thank you all for your responses. I am still deciding whether to start the hormone therapy now or after another PSA test or 2.

My stats are as follows:
59 years old. Diagnosed at 54.
Gleason before surgery was 7 and a PSA of 7.4.
Surgery in 2008. PSA went back to negligable.
Pathology report: Gleason score 7, capsular involvlement, extracapsular extension, positive margin. No seminal invasion and lymph notes good.
PSA started going back up and received 40 days of radiation in 2009.
Post radiation, PSA back down to less than .1
PSA  has now risen in the last 3 tests and is now up to .5 (less than a year period).

I am torn between starting therapy now, before the mets go up (as Fairwind discussed), or waiting until a PSA of at least 1 (as HT doesn't work longterm and as it is at least theoretically possible my PSA will stay close to where it is for a while) and as the PSA is still lower than when many men are started on HT.

Again, thank you for the comments and thoughts. It is very helpful to get the opinions and insight of men going through the same situation.

Beanbagger,

Husband has been of HT since Dec. 2012 and is still undectable. Never had radiation treatmens as his PCa had already escaped. His T levels are rising and so his libido has come back. Read stats below. Husbands next PSA test will be Nov. 2013

Have you seen a PCa Oncologists? We are and it sounds like you as well past the point of seeing a Urologists!

 

Good luck

BOOGEE

Beanbagger -

Oceanwave's profile did not reveal much about how you would find him

www.healingwell.com/community/profile.aspx?f=35&m=2527938&p=79240

I did not look at his other posts, total of 3 hopefully not all in this thread, last one on 10-7-2012.

Hopefully the new thread moderator Jim started will give you a broader audience and others besides oceanwave whose metrics mirror yours.

mine do not.

Good luck at slowing the rising PSA.

LupronJim

Bean,

If you click on his name (hilighted in blue) it will take you to his personal EM if he has it listed.

BOOGEE

Jim,

Try and contact one of the mods. and perhaps he can direct you in the right direction.

As threads get too old people don't often look at them. You may have to look on the PCa page to see when Ocean posts again then jump in.

Good luck!

BOOGEE

Hi Oceanwave...thanks for your feedback. For last couple months, I have been on a very similar diet hoping to stabilize or even lower last 3 rising PSAs during a 12 mo. period from .2 to .4 & .6 in March with next one set for this Thursday. Like you I am reluctant to go to HT but have heard some good results with dramatic decreases in PSAs.
Also feel very good with good exercise throughout 5 1/2 years since the RP surgery & subsequent radiation therapy.
Will keep you informed...please do the same.

Best Regards,
Beanbagger

Hi Oceanwave,
My husband was dx in 2001 ...Gleason was 8....He had seeds, and external radiation, and lupron for 1 year. Then PSA rose in 2004...In 2006 had salvage surgery at MSK..then lots of problems, fistula, extreme incontinence, and then artificial sphincter, again more surgery for fixing the sphincter, and then hip replacement for bone loss from lupron..Now his PSA is up to 10.7 again. He has back pain and shoulder pain. He had a bone scan Friday and we are waiting to get results. The doctor said he should think about going on lupron and casodex..However, they didnt seem to be in a hurry.. We have not heard of Pom x pills, and will get some for Pete. The doctors, both at MSK and home don't seem to be worried about the rise in PSA...It was 7.5 in March, and 10.7 last month.. I guess everyone is different. I think patients have to figure out a lot for themselves. Good luck to you. Di