Should I wait - my PSA has never gone down

Re-posted - sorry i forgot the subject - id10t

Greetings for this new year to all my brothers;

hmmmm

I guess i am wondering at this point if i should wait for my Salvage Radiation psa results in march or should start consulting and planning further treatment as at this point as my psa has never gone down.


My quick synopsis
PSA before surgery was 12
da Vinci surgery 4/4/2013
First PSA 5/14/2013 0.34
Second PSA 7/5/2013 0.52
Salvage Radiation (IMRT/IGRT) – ended September 29th 2013
First PSA After 12/9/2013 0.60


Prostate Pathology:
Radical prostatectomy 4/4/2013:
Specimen Source:
A. Prostate
B. Right Pelvic lymph node
C. Left Pelvic Lymph Node
Diagnosis:
A. Radical prostatectomy specimen (46 g)
- Extensively involved bilaterally with prostatic adenocarcinoma (Gleason pattern 4+3, total score 7)
- Approximately 45% of prostate slides contain tumor
- The greatest diameter of tumor is 1.8cm in the left posterior inferior aspect of the gland
- The tumor extends into, but not beyond the prostatic pseudocapsule but is focally present at a right posterior mid pseudocapsular recestion margin
- Intraprostatic perineural infiltration with tumor and high grade PIN are identified
- The apical, base, pseudocapsular and soft resection margins and seminal are negative for tumor
B. One Lymph node negative for tumor
C. One Lymph node negative for tumor
AJCC stage: PT2NOMAX

Prostate Gland:
Histologic Type: Adenocarcinoma (conventional, not otherwise specified)
Histologic Grade Primary {Pattern Grade: 4
Secondary Pattern Grade; 3
Total Gleason score: 7
Primary Tumor(pt): PT2: Organ confined
Portion of lobe involved PT2c: Bilateral disease
Regional Lymph Nodes: pNO: No regional lymph node metastasis
Number of nodes examined. 2
Number of nodes involved: 0
Distant Metastasis(pM): pMX: Distant metastasis cannot be assessed
Seminal Vesicle invasion: Seminal Vesicle Invasion absent

Like Ed said, probably a sensible time to talk to your oncologist. Most likely (s)he will tell you to wait to see what your PSA does before you talk about next steps but this would be a good time to have a chat.

I would mention that it can take many months for PSA to go down after radiation, if it does.So you could be in limbo. Good luck.

burgess,

What was your salvage radiation dose, and I'm guessing that you did not have hormone therapy before or after the SRT?

It may be possible to use a PET scan to detect whether there is are treatable foci outside of the radiation field, especially if they did not treat your pelvic lymph nodes (only 2 nodes were sampled on your RP).

- Allen