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5 years since RALP, PSA slowly rising

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Posted 11/2/2018 1:46 AM (GMT 0)
You can see my PSA results in my signature. It's been five years since surgery and I feel fine and my overall health is good. ED is not an issue.
My PSA has slowly risen to 0.7 over a five year period. I have blood test every six months but have never seen an Oncologist and have never had any type of cancer treatments. Because of health insurance, I no longer see my original surgeon, I just visit my family doctor. He recommends that I visit a new Urologist and I agree.
My concern is, what do you guys thinks about this increase is PSA over five years?
Posted 11/2/2018 1:54 AM (GMT 0)
Something going on. Likely you need SRT. You should also be talking to an RO. That a pattern looks like a reoccurrence.

you should have been referred for follow up when you hit .2 Hopefully it's still contained in the prostate bed and RT will clear it.

Andrew
Posted 11/2/2018 2:18 AM (GMT 0)
Yes, nothing much to say other than it’s time to see an RO, now.
Posted 11/2/2018 3:06 AM (GMT 0)
The good news is your doubling time looks to be around 22 months which says you have a slow growing tumor.
I would definitely look into getting a PSMA-PET scan to locate potential cancer and than have it zapped if appropriate.

Thanks
Paul
Posted 11/2/2018 12:52 PM (GMT 0)
I think you are way overdue to see an RO and would do so immediately. This is now beyond the scope of your PCP or urologist.

Jim
Posted 11/2/2018 2:14 PM (GMT 0)
I entered your info on mkcc nomograms

https://www.mskcc.org/nomograms/prostate/salvage_radiation_therapy

PROGRESSION-FREE PROBABILITY AFTER SALVAGE RADIATION THERAPY : for 5 years it’s 55% (no HT and 70GY SRT )

If you add HT the result becomes

6 years it’s 74%

So if I were you I would go all out.

You can do this yourself. I used 24 months doubling time.
Posted 11/2/2018 2:39 PM (GMT 0)
Thanks for everyone's help. I've made an appointment and will report back with results.
Posted 11/15/2018 11:03 PM (GMT 0)
I visited the Medical Oncologist today. He did a rectal exam & said he felt a lump where the prostate used to be.
I'm scheduled to see the Radiologist in two two weeks. So it looks like I'll be having Radiation Treatments soon.
What side effects and other problems to I have to look forward to?
Posted 11/16/2018 12:20 AM (GMT 0)
RT would be the next step.

generally the SEs are tolerable. Some get fatigue, bowel issues, urgency, and other complaints. Everyone is very different on this so it's difficult to predict what you'll get.

Mostly RT is a marathon - an endurance test.

Andrew
Posted 11/16/2018 1:12 AM (GMT 0)
Everyone is different. As Andrew stated, some experience bowel, urinary issues, fatigue. Fatigue is the most common. Usually the last few weeks.
Others sail through it with their only problem being boredom as it’s monotonous.
Hopefully you’ll be one of the latter
Posted 11/16/2018 2:43 AM (GMT 0)
Stay+,

I have also experienced a RALP. For me, the RT was breeze compared to the surgery. As already mentioned, the hanging around was the hardest part.
Posted 11/16/2018 3:20 AM (GMT 0)
The lump may be an encouraging sign in that it suggests there is something going on
in the prostate bed that may account for the PSA and that radiation should neutralize. My side effects with SRT were minor. Some urinary urgency starting about halfway through the two months, which lessened and returned to normal within a couplenof months. No fatigue at all. about 10 months after treatments ended I began having some intermittent radiation proctitus - minor bleeding a few times per week. It lessened over time and returned to fully normal by about a year later.
Jim
Posted 11/16/2018 6:08 AM (GMT 0)
I see you're 61 so you're probably still working? The biggest annoyance can be having to fit in daily radiation treatments while continuing to work. Especially if the location is not convenient. I wound up going at lunchtime in order to avoid morning and evening rush hour traffic.
Posted 11/16/2018 4:14 PM (GMT 0)
Thanks for everyone's replies, they are encouraging.
I'm 63, (signature changed). 64 in February.
I plan to semi-retire in January, Social Security starts Jan. 1. By that I mean I will no longer be working in the field as an electrician. I own the business so I'll remain as designer and office work. It's time for my son, age 31, to take over.
I've always had the attitude that surgery and now treatment is a good thing and I'm thankful for it.
Without the advancements in health care, We'd all be in serious trouble.
Posted 11/16/2018 5:10 PM (GMT 0)
With your history, and the lump found, Stay, a PSMA PET scan, or an Axumin PET scan, is IMHO a good idea, and a logical next step. It may pinpoint the source of that PSA, and will evaluate the lump, which hopefully is the only source. With that data, you can find the most appropriate treatment.

Good luck!
Posted 1/6/2019 4:35 PM (GMT 0)
I've taken this groups advice and started Radiation. I had a Pet Scan, the cancer is contained within the prostrate cavity, which is good news. The Doctor feels that it is very treatable. I've had three treatments, 39 are planned. It's Proton therapy using a TrueBeam machine by Varian.

As always, I have a Positive attitude like my user name suggests "Stay +". Stay Positive.
Cancer Treatment Centers tend to be serious and gloomy places. I talk to the people in the waiting room. It starts out serious but I usually have them laughing.
I've already become close with several Technicians and the Doctor. I thank them everyday and make sure they know I appreciate their work.

I tell everyone that this therapy is the best thing that can possibly happen to me. We are truly lucky to live an age of advancements in detection, treatment and technology. Our Parents age group, wouldn't have known they were sick, until it was too late.
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