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PSA rising 22 Years After RP. Ideas?

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Posted 9/13/2014 2:44 AM (GMT 0)
after having my prostate remove because of cancer , for 22 years my Psa reading was 0.000 . had a PSA ON 3/24/14 reading was 0.080 repeated it on 9/02/14 reading was 3.900 does this mean after 22 years my cancer
have return . I will call my urologist tomorrow and make an appointment . Any one on the forum have any idea
about this.
Thanks
JIMMIE WEBB
SFC RETIRED U.S. ARMY

Post Edited By Moderator (PeterDisAbelard.) : 9/12/2014 9:20:55 PM (GMT-6)

Posted 9/13/2014 3:24 AM (GMT 0)
Jimmy,

Welcome to the forum. Sorry you find yourself here but glad you found us.

I gave your thread a title so people just skimming will know what you are asking for. Hopefully we can get you some advice.
Posted 9/13/2014 3:39 AM (GMT 0)
Well, this is pretty hard to imagine and hard to hear. 22 years? Good grief! I await some wise comments.
Posted 9/13/2014 4:39 AM (GMT 0)
I think you should see a Medical Oncologist, not a Urologist..Your case is an EXTREME rarity..I don't think medical science yet understands how and why cancers can go dormant for decades and then reappear...Do you remember the Gleason score given to the tumor(s) when they removed your prostate? There must be an explanation but I don't have it...
Posted 9/13/2014 4:58 AM (GMT 0)
Welcome and sorry you need to be here.

I vote for a retest - that sounds wrong. Best to get it confirmed, false positives are a possibility. If it is true then you've got something that we don't see around here.

Then you need a good MO to check it out. I've not heard of a case like it.
Andrew
Posted 9/13/2014 5:15 AM (GMT 0)
Hammer,
Really sorry to hear about your recent lab reports. I agree with Fairwind that you should find a medical oncologist. Both my uro and my RO have told me that PCa can lie chemically undetectable for some years until it finds a way to mutate into something that can get past your immune system and become detectable again. At 22 years, you must be on the outer edge of what can happen. Maybe it's some kind of lab test fluke, but you need to get yourself into the hands of a medical oncologist who specializes in prostate cancer to find out what is going on. Best of luck.

Jim (former radioman, USN)
Posted 9/13/2014 1:34 PM (GMT 0)
I read of prostate cancer recurring after 28 years undetectable. You will probably need some imaging done and consult with good oncologist.The PSA doubling time is concerning. Good luck.
Posted 9/13/2014 1:55 PM (GMT 0)
Thanks for all the advice I will make an appointment with a Ongologist as soon as possible .
Posted 9/13/2014 2:35 PM (GMT 0)
Jimmy,

Labs are pretty good. They don't make a lot of mistakes. But then again there aren't a lot of guys who go from undetectable to 3.9 in five months 22 years after treatment either. When you call to make that appointment tell them that the first thing you want is a PSA retest to confirm the reading. If they set up the lab work first then you can have some solid numbers to talk to the doctor about at that first appointment.

In the meanwhile you can talk to us.
Posted 9/13/2014 5:15 PM (GMT 0)
It would almost seem that after 22 years, you don't have a reoccurrence , but a new case of prostate cancer, if indeed it proves out to be PC.

Hard to imagine it laying dormant for that long.

Wish you the best on figuring this out, and arriving at a good solution. You may be a good candidate for a Choline scan.

Goodlife
Posted 9/14/2014 2:03 AM (GMT 0)

goodlife said...
It would almost seem that after 22 years, you don't have a reoccurrence , but a new case of prostate cancer, if indeed it proves out to be PC..........................



Goodlife

Now there is an interesting theory. And why not? If there was some tiny bit of prostate left behind, I guess if it could go bad in 1992 then a brand new one could develop 22 years later.

And do I see that you were a Gleason 5 back 22 years ago? I think some folks do not even consider that PC anymore. There are a lot of folks these days who would not even recommend any kind of severe treatment for that. Hard to imagine a G5 coming back so many years later with such a rapid PSA rise.

I sure am interested to see what the answer is to this mystery!
Posted 9/14/2014 1:32 PM (GMT 0)
It sure does happen, just not very often. One of my clients went 16 years undetectable after surgery and then at age 71 his PSA started rising. It isn't a new cancer according to his docs. PCa is known to go dormant for a long time often then crop back up. My client went on a very brief course on HT and the PSA was knocked back down with minimal side effects. He is in excellent shape with familial longevity so he will definitely continue to treat the disease.
Posted 9/14/2014 1:48 PM (GMT 0)
By my calc you are now about 76 years old, where the treatment options are different from when you were diagnosed at age 54.

In my case as a hedge against eventual rationaing of care that may take place, I chose to get my treatments now at age 66 rather than milk Lupron as long as I can, but i am also Gleason 9(4+5) and we are yet to see what your new Gleason score is.

If the PSA test proves valid and not due to an infection of some other stimulas like sex within prior 72 hours (you devil you), bike riding, etc. Unfortunatley next step would be to get a biopsy, which has come a long way since 22 years ago. So with various image guidance no longer just a random shot in the dark.

You need a new Gleason score other than old Gleason 5 so your medical onco can develop a set of realistic treatment options for you to decide on. Two PSA scores do not a trent make, so another one will help decide it the last one was an anomaly.

Good luck and do keep us posted.

LupronJim
Posted 9/14/2014 2:20 PM (GMT 0)
LupronJim,

Since he hasn't had a prostate for 22 years I don't think sex before the PSA test would make much difference in the readings, and as for a biopsy to establish the new Gleason score, I'm not sure what they would biopsy at this point. If the PSA rise is confirmed and continues then maybe some imaging might be a sensible next step.
Posted 9/15/2014 6:58 PM (GMT 0)
That is scary. I've had undetectable PSA for 5.5 years and thought that I was out of the woods. I guess that is why when I asked my doctor if I was cured he didn't give an "yes: answer instead, he said that I have less than 1% of of recurrence.
Posted 9/15/2014 8:01 PM (GMT 0)
Actually it's not that rare. 10% of all surgical reoccurrances are detected after 10 years and some after 20. I would try to get a C11 PET scan to identify where the reoccurrance is taking place as there is a very good chance it could be radiated.
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