PSA still rising 5.5 years post radical prostatectomy What am I in for?

Welcome.
I wonder about your PSA results. They were pretty stable and then took a jump. Maybe a retest is in order.
You are 5.5 years out from surgery. Salvage radiation might be a gamble after so long a time.
You could also consider hormone therapy.
I would retest the PSA first. Good luck.

robertC said...

You are 5.5 years out from surgery. Salvage radiation might be a gamble after so long a time.
You could also consider hormone therapy.
I would retest the PSA first. Good luck.

You have no need to be hesitant to post here. We're all equal here, regardless of our individual alphabet soup of pathology reports or Gleason scores. I see that you are T3A with a 4+3 Gleason, which I grant is not as dire as some here, but it does mean you are at the lower end of the high risk group and do need to do something if your PSA persists at the level of your January test.

When you meet with the RO ask about whether he/she recommends hormone therapy along with radiation. My understanding is that these days most studies show a higher success rate if a short course of Casodex and or Lupron is done along with the radiation.

I had SRT 7 years after my open RP and have had excellent results. I'm now approaching 4 years since SRT and my PSA was 0.00 when tested two weeks ago. Like you, I had a long slow increase. I then stabilized at 0.1 for nearly three year. I agree that a retest might be in order, but be sure to have it sooner than later. When my PSA started moving again it moved quickly from 0.1 to 0.4 in only 10 months.

Jim

First, I vote for a retest. Could be a bad day at the lab.

Second, radiation isn't that bad - you'd do fine.

Third, before doing radiation you'll want to make sure the PC is still hanging around the prostate bed. Which is likely.

It's possible you could wait for a rise to .25 or .3 just to confirm a re-occurrence. But your RO is a better source for that kind of advice.
Andrew

Thanks for all the advice it is greatly appreciated. I will check around for a lab that reads PSA tests to the hundredths, to assure accuracy my Urologist believed my .2 was a round up of something greater than .15. I will have that result in hand when we have our consultation with the RO on the 20th.

I had a PSA done (at a different lab) it came back 0.240, so it appears I have a recurrence. Met with the Radiologist/Oncologist. He suggested Salvage Radiation treatment (The felt that I had a little better than 50/50 chance to be cured with SRT alone). He also explained to me the clinical trial #RTOG 0534 that I appear to be qualified for. If anyone has an opinion on the Pros and Cons of the SRT and the Clinical Trial please share it with me.
I have never had any bone or pet scans, the R/O said with such a microscopic PSA it was statistically unnecessary. Should I ask for one prior to treatment?