Depressing Update

Well, I got my retest - PSA went up from 0.11 on 20 May to 0.17 today. Freakin' rocket. Tomorrow I get a bone scan, and pelvis & abdomen CT scan. Hoping there's no detection of visceral disease - I have had some lingering tenderness (mild) in the abdomen. Also I'm being referred to a medical Onc. So I'm headed for ADT? My last therapy mode...at 54 yrs old. I'm in good physical shape (other than cancer) so I should tolerate treatment well hopefully. Unfortunately I know very little about.

Advise?

What I wrote on 20 May:
Three years of bliss comes to an end - I've been no higher than 0.05 psa since my RP in March 2011. So life has been pretty good. Unfortunately, things appear to have have changed.

My six month test just wighted in at 0.11 - six months ago I was 0.04. Almost triple in six months. Bad deal. My UR offered me a bone scan now (though he said he didn't expect it would show anything) or wait three months and re-test psa, then proceed to scan if still elevated.

I of course wanted a re-test to ensure the validity of the .11 value. If it's real it's highly unlikely to go down on its own. My UR then said I should wait 30 days and then re-test. Waiting seem pointless, the re-test is only (in my mind) to ensure the Lab didn't screw up which is at least possible. So why proceed to a scan prior to re-test anyway?

I think I should have insisted on a re-test straight away - Isn't that the obvious call? My psa doubling time is terrible. A delay doesn't seem like an advantage. Right? But what's 30 days? My UR pushes my off to a Med Onc at psa 0.2 (or evidence of mets) so my days with him are drawing nigh either way. T3 sucks.

Any thoughts/advise

pT3a - G7 (3+4) PSA 16
1 positive apex margin focally,-SVI,+EPE,+PNI,+LVI, N0, M0
open RP 3/17/2011 at 50 yrs old
ART 6/2011
PSA had been bumpy but no higher than 0.05 since RP - until today when my six month test came back at 0.11 on 20 May, then one month later (today) it was 0.17

K2, don't despair, I have seen many on this sight who have had similar situation who did HT and are controlling the beast. May be some of them will be able to chime in.

My husband is 10 years younger and in the same place. We had our first good news in a while when his PSA (after going from .11 in December to .18 in March), was stable at .17 in June. With one test, the psa doubling time improved quite a bit. He had surgery in 2011 and salvage radiation in 2012. He is also gleason 7 which the doctors said can be very unpredictable and psa can remain stable for years. So I'm assuming the best for the next 3 months and trying to live in the moment with him and our young children.

K2,
Our numbers are very similar but I had 2 positive margins. So far I am undetectable but...................

Good luck, I am pulling for you!

Bill from Florida

K2, I would like to give you another view of dealing with a rising PSA. This is certainly not a recommendation but rather the details of someone who chose to take a different view on a path that seems very similar to yours.

I see from your signature that you had surgery followed by radiation in a three month span.

I was diagnosed with GL7 cancer in June 2009. Circumstances dictated that I could not go to daVinci surgery until September 2009. My post surgery psa was 0.4 and in the two months following it had risen to 0.67.

I began 7 weeks of radiation therapy mid December 2009.

I never attained anything near undetectable for the next 4 and a half years.

I had used all of the curative options and HT was my future. I had many discussions with my Oncologist about HT. And I was of the mindset that doing HT based upon a number was like shooting at the walls of your house because you have seen signs of a mouse. I had no target to shoot at.

Over the next four years I was absolutely diligent in monitoring my psa and signs of advancement of my Pca.

I self enrolled in a diagnostic clinical trial at the National Cancer Institute. The trial was using the F18 Sodium Fluoride PET Scan and I had 4 scans in a twelve month period. I had other scans on a regular basis. No scan ever showed and sign of mets or cancer advancement. I knew it was there but there was no finite evidence that I was in harms way at the time.

After 4 years a CT scan finally showed involvement in two lymph nodes. I flew to Las Angeles to met with a Radiation Oncologist to radiate the two nodes. UCLA Medical was one of a few places in the country that was offering the new C11 Acetate scan and I went through this procedure. It was this scan that showed a couple more very small mets and this changed the mindset of radiation.

I returned to my home Oncologist and began a HT clinical trial in February of this year.

AT THIS TIME MY PSA WAS 92.5

I and my Oncologist have no reason to believe that my forestalling HT until this time has or will cause me any problems in the future that were not already there in my journey with Pca.

But during the 4 years of being HT free. I enjoyed a lifetime of living without degradation of my QoL.

I have been on HT for 4 months now and am tolerating the drugs with very minimal effect and receiving extremely good signs of the HT's effect I hope my good fortune continues.

I know that this approach goes against the grain of conventional wisdom, but it was a path that fit me, my personality and approach to dealing with cancer. Many are not wired this way. Many cannot bear the thought that cancer resides in their body.

I gave cancer the due diligence it required when it was required, but the rest of the time I laid it down and enjoyed life.

Many here know that my daily mantra is "Every Day is A Bonus, go choke the life out of it". I have been living this mantra for more than 30 years and have seen no reason to ever change it.

BTW, I was 60 at diagnosis and will be 66 in two months. In this time frame I have buried my wife of 30 years after her battle with cancer and have now been married almost a year.

All of this is just food for thought. As I said, this is not a recommendation of a path to choose. It is just one man's way of dealing with this crap.

Be well and I wish you the best for the future,

Sonny