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PSA 12 years later

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Posted 5/24/2024 9:00 PM (GMT 0)
I really don't have all my history available at hand but thought I would ask.
In December 2012 I had a Rp, Followed by 36 visits of RT I do remember mention of seminal tubes being affected, anyway my question is that for 10 years my PSA was always .01, then 2 years ago it started to change to .05 then .07. It stayed at .07 then almost 1 year to a day it is now .14 My Urologist quit last year so I asked my GP she said that my numbers are normal, what say (anybody) Thanks.
Posted 5/24/2024 9:34 PM (GMT 0)
Well, to this non-physician, after the treatment you had an increase in PSA would signify a little bit of PCa somewhere. You have met the medical definition of a cancer recurrence and shouldn’t ignore it. Such an increase, for someone with your history, shouldn’t be termed “normal” in my opinion. However, if you are 93 with a bad heart I wouldn’t worry about it.

So your urologist quit……just find another one. Better yet, consult a medical oncologist that does a lot of work with men that experience delayed PCa recurrence. When one has used both a radiation oncologist and urologist/surgeon and still has prostate cancer, then it is time for the medical oncologist……not the GP.
Posted 5/24/2024 9:36 PM (GMT 0)
Hello - There have been a few threads about this PSA situation (RP followed by RT) this year. Seems that there is no universal answer but “keeping an eye on it” tends to be common and waiting for PSA to get high enough (>0.20) so that a PSMA scan might have a chance of finding something are typical.

Are the numbers normal?, probably not but it happens. Is it a big deal?, to be determined… You might consider going to 6 month testing but nothing more than that. You might consider finding an oncologist that is knowledgeable in prostate cancer at some point. The urologist does not have much to add at this point and this gets beyond regular docs pretty quickly.

JNF - sorry, we posted similar answers at the same time
Posted 5/24/2024 9:41 PM (GMT 0)
Mumbo…no problem and we both had the same advice. Well played.
Posted 5/25/2024 12:04 AM (GMT 0)
Agent, I assume your GP was thoroughly knowledgeable about your PCa history including the surgery and radiation before declaring your PSA increase was normal. Was she your GP at the time you were referred to the urologist that led to your diagnosis and treatment?
Posted 5/25/2024 11:41 AM (GMT 0)
I appreciate the quick responses..
Posted 5/25/2024 1:12 PM (GMT 0)
I had my pet scan when my PSA was .05 and that is when they found nodules in my lungs.... That was 2020. Now after 4 years on ADT no cancer in my body......
Posted 5/25/2024 2:56 PM (GMT 0)
Agent,
You have had a pretty good run with the RP/RT. At this point, no one knows what's going on with your PSA trend, but it sure looks like it could be a recurrence. That's pretty significant considering you appear to only be 66. I don't think you necessarily have to be in a hurry with this, but as others have said, I think it would be a good idea for a Medical Oncologist's opinion. The good news is that your PSA doubling time appears to be about a year with the limited data you have. If that holds true you won't need treatment for a long time. I wouldn't put too much faith in your GP's opinion. GPs are not experts for PCa. At this time in your PCa travels take your guidance from an MO who knows PCa.
Posted 5/25/2024 6:04 PM (GMT 0)
Hello Agent. I'll just echo the responses you have received and suggest you ignore your GP and find a medical oncologist with experience treating prostate cancer. And...good luck to you!

Jim
Posted 5/26/2024 6:39 AM (GMT 0)
Are the PSA Tests being done at the same lab every time?
Posted 5/26/2024 8:44 PM (GMT 0)
Yes the PSA tests have been at the same lab for the last 10 or more years. I even sent a second message , via the portal to my GP adding some history so as to remind her, just crickets.
Health care in Florida seems to have really gone downhill since Covid. We have less doctors and they pay less attention.
Posted 5/27/2024 1:06 PM (GMT 0)
Agent, just to put an exclamation point on the other solid comments above….

When my PSA went from <.02 to .03, 2 years after RP, my Primary Care Dr, who is board certified in both internal medicine and cardiology and is also my cardiologist, commented “so why are you concerned? That’s extremely low.” He was very well aware of my history.

Most doctors in this world of specialization, live in silos, within their own area of expertise, and many are clueless when they get out of their lane.
Posted 5/28/2024 4:56 PM (GMT 0)
Agent, you and I have a very similar history. 12 years without much of a problem. However, My post RP PSA persisted. Then HT and radiation. Fast forward, I aited a few years ago for my psa to rise before seeking help since my Uro retired. It went over 1.0 quickly and I got concerned. PSMA scan f-18 showed three pelvic lymph nodes shining brightly. Went to both a Urologist and a Medical Oncologist (Med. Onco is with Northwestern Cancer Center Chicago). The Urologist said Hormone treatment for life. (Uro is the head of Urology at Lutheran General park ridge Illinois.) He also opined that seeking out radiation for lymph node involvement was a waste of time.

My Medical Oncologist recommended radiation with hormone therapy, combined 1st and 2nd Gen for, 18 months. Luckily, next door to the Oncologist is the Northwest Proton Center. I inquired there first because I had prior radiation. My Radiation doctor said proton therapy is perfect for what needs to be done. I've been on Firmegon and Abiraterone for a few months now and scheduled to begin 28 proton sessions on June 10.
Posted 6/3/2024 2:38 PM (GMT 0)
Wow sounds like a lot of options. Best of luck to you.
Posted 6/4/2024 6:13 AM (GMT 0)

Steve n Dallas said...
Are the PSA Tests being done at the same lab every time?

I see this question often. As a patient you should get the same comparable results not matter what lab you use. If you believe this is not true, how do you know your tried and true lab isn’t consistently providing false negatives?
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