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PSA Started Rising after HT and Cyberknife

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Posted 4/9/2018 12:22 PM (GMT 0)
I had Cyberknife and HT for local recurrence outside the prostate in January 2017. My original treatment was brachytherapy in June 2011 for Gleason 3 + 3 prostate cancer. The PSA went down to 0.1 after brachytherapy. But it started to rise gradually about three years ago reaching 1.5 in July 2016. Biopsy detected malignancy in a mass attached to the prostate. I had HT from October 2016 to April 2017 and Cyberknife in January 2017. Due to HT, my PSA just before Cyberknife was 0.2. A few months after Cyberknife PSA became undetectable (<0.1) and stayed there until January 2018. A recent PSA test on 4/4/18 found an increase to 0.2, an increase of 0.2 in three months).

How concerned should I be about the increase? I will have another PSA test in July.
Posted 4/9/2018 2:17 PM (GMT 0)
So are you currently on HT? If I'm reading correctly, you completed HT a year ago. HT would keep your PSA low, once that wears off, you PSA will rise so what you're seeing is normal and expected.

If the Cyberkinfe treatment did get the area of recurrence, then you can expect a slight rise before leveling out. At this point I wouldn't be to concerned and just wait for the next test to see where it's going.

Andrew
Posted 4/9/2018 5:41 PM (GMT 0)
Can I ask what the results were of the second biopsy? The first was 3+3, which does not extend beyond the capsule, correct? I thought that brachytherapy did a thorough job on cancer cells within the prostate. Can you give information about pathology and what doctors think happened?

Thank you— we are getting brachytherapy lined up, so I’m very interested!
Posted 4/9/2018 8:21 PM (GMT 0)
The second biopsy in July 2016, found no cancer inside the prostate. Brachytherapy took care of that. But there was a mass about 10 mm in diameter attached to the prostate capsule that was malignant. Since cells were radiation damaged, so no Gleason scale was assigned. The HT and Cyberknife targeted this mass.

Obviously, the first diagnosis missed something on the capsule, which brachytherapy could not kill completely. If your diagnosis is 3 + 3, you should not take it lightly. I have learned that the hard way. The radiation oncologist should have added HT with my initial brachytherapy treatment.
Posted 4/10/2018 7:00 AM (GMT 0)
You still have a prostate, so your PSA will probably never be undetectable after the HT wears off. If it stays under 0.5, that's really good. At some point you might ask for a biopsy of whatever is left of the mass to assure yourself that it is dead and staying dead.
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