PSA rising 2 years after RP, adjuvant radiation and ADT - Now what?

Hi gang,

This is my first post in about two years. At that time I had just made the decision to embark on a course of adjuvant radiation therapy in conjunction with ADT three months after RP. I did as much research as I could and talked to numerous doctors along the way. In the end, based on my Gleason 9 PCa and positive margins, I concluded that taking these proactive steps was the way to go. My signature line(s) summarize the timeline and current situation.

The RP and radiation treatments were well tolerated with minimal side effects. The worst part was the year on ADT. During that time period I had daily hot flashes, experienced difficulty sleeping, gained 30 lbs and saw my cholesterol levels triple. All this while continuing to exercise and eat well. Once the ADT ended it took about 3 months for my T levels to rebound and since they have I feel great - so a small price to pay IF it helped keep the PCa at bay. This week’s PSA test results however show that there may be trouble on the horizon.

The first thing I’m doing is retesting the PSA next week. I read that lab error is not out of the question so I might as well check that first before going down the next medical rabbit hole. I’ve also set up appointments next week with my RO and urologist. In addition I have an appointment at the Moffitt Cancer Center in Tampa FL in a few weeks.

Is there anything else I should be doing? I’m guessing that they will want to do another scan and get me started again on ADT - does that seem likely? I really dread the prospects of enduring more ADT...but I suppose you do what you have to do.

Gene

Very similar to what my PSA did after going off ADT.

Our solution was to go back on ADT. It went back down, now we get to wait for ADT to fail and then try something else.

I had nine months of ADT and it took already about nine months for T to fully recover. Therefore I do not think your T did fully recover after three months. I did quite some reading on this and three months is an unusual short time.

So if you stopped ADT end of 2017 and then add nine months to that, your T level has recovered just now. Don't be surprised the PSA value goes up.

George

George_ said...
I had nine months of ADT and it took already about nine months for T to fully recover. Therefore I do not think your T did fully recover after three months. I did quite some reading on this and three months is an unusual short time.

So if you stopped ADT end of 2017 and then add nine months to that, your T level has recovered just now. Don't be surprised the PSA value goes up.

George

George - No, my T level took about 6 months to recover. ADT started fall of '16 and lasted until June of '17. When it did come back, it actually rebounded to higher than pre ADT levels and has stayed there for 8 months now. There were a few quarterly blood tests during that rebound period where it continued to be undetectable...but no doubt it eventually played a role in the recent rise.

Shueswim - I may have missed, but have you had your retest yet?

InTheShop - The retest is scheduled for next week. They wanted to have two weeks between tests.

Quick update - Met with local FL doctor today. He nixed the idea of going up to the Moffitt Cancer Center. Sending me to Johns Hopkins to meet with one of their doctors.