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I'm baaack! 5 years out - rising PSA

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Posted 2/18/2017 1:38 PM (GMT 0)
After 5 blissful years of 0.1, 6 months ago I went to 0.2, I freaked out but both docs said it could be an anomaly so let's do another in 6 months. That came back 0.3 so it's time for intervention. My appointment with my surgeon is in 2 weeks. My guess is radiation + hormone tx. Confused about 2 things. One, all the different radiation types IMRT, Proton, Cyberknife, etc. And the other, do they identify the area to radiate or do they just blast the whole prostate bed?

Nice to see some of the old gang still helping out, especially you, Purgatory.
Posted 2/18/2017 2:45 PM (GMT 0)
I think you were correct to be concerned at .2 PSA and wonder about your doctor.
I suggest modern state of the art equipment such as linac from a major center.
Good luck.
Posted 2/18/2017 3:28 PM (GMT 0)
Good to hear from you again, Robert. From your signature, it seems you're doing well. Glad to hear. I'll check out linac - thanks.

Tony
Posted 2/18/2017 4:00 PM (GMT 0)
at this point RT would be to the whole prostate bed. at your PSA levels it would nearly impossible to see where it is with a scan.

Andrew
Posted 2/18/2017 4:18 PM (GMT 0)
Godfather -

Sorry you need to be back here.

One decision you will need to make with RT is whether to include the Lymph Nodes.

Bobby Mac
Posted 2/18/2017 4:36 PM (GMT 0)
Godfather. Could you provide data from biopsy post op pathology etc?....sorry. about the turn of the screw. It may not be as amuch a time threat as you surmise. Steady as she goes godfather...imo
Posted 2/18/2017 5:15 PM (GMT 0)
Thanks, Bololidat. See my signature for post op pathology.
Posted 2/18/2017 7:59 PM (GMT 0)
Go to a radiation oncologist, not a urologist, and do it quickly! It's kind of crazy that your urologist did not refer you sooner, especially with a tertiary 5 and EPE. Yes, you're right that he will probably recommend ADT +SRT. There are experimental uses of shortened radiation schedules, proton, and SBRT, but those are limited to clinical trials. The standard of care is 7 weeks of IMRT to the prostate bed.

You should have a pelvic CT scan to see if any lymph nodes are enlarged.

In SW Florida, I'd recommend Constantine Mantz in Ft. Myers.
Posted 2/19/2017 1:32 PM (GMT 0)
Bobby Mac:

Appreciate the info. Yours tracks pretty close to mine. Question....how long was your hormone therapy? Any side effects?

Thanks, Tony
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