PSA back after removal

Radiation is the usual step for many who are in the situation like the one you are in. But there is also the option to do hormone treatment alone. For many people the side effects of the hormone therapy are more unpleasant than the side effects of the radiation. it is an individual decision whether to do either, both, or none.

It is important to get a good read on your PSA doubling time. That, along with your general physical health, will help guide you toward an understanding of how aggressive to be. If I were in your situation I would get PSA's not less than every other month, and maybe even monthly and then after another reading or two you can see more clearly how fast it is rising.

Based on the last two readings (which is *not* enough for a valid measurement) your psa is rising about 60% per year, so your doubling time is around 17-18 months, which is pretty close to indolent as these things go. If this rate holds, you could arguably go 8 years plus or minus without having any symptoms. At this rate your PSA would be around 24 in ten years.

But if you go the route of no treatment you should know two things:
1.) the chances of success for radiation therapy go down significantly as PSA rises.
2.) keep a close watch on things as sometimes the growth rate goes up without warning.

Post Edited (proscapt) : 8/6/2015 12:55:32 AM (GMT-6)

On your pathology report after your surgery, what was your Gleason score?

Todays LINAC's (the machines that administer the radiation) are MUCH improved over what was available 10 years ago. Your concerns about radiation damage and side-effects might be misplaced....I would at least talk to a Radiation Oncologist...

Jic811,

You may want to check with the lab that did the path report to see if they still have your prostate there. If so, you can ask for a new genomic test called Decipher. It can tell you your odds of progressing to metastases within the next 5 years.

Of course, it's a waste of a very expensive test if you have no intention of pursuing curative treatment.

For the same reason, further imaging (with an advanced PET scan) would not be useful. Even the best imaging can only identify the larger masses, and the spread in the prostate bed is most likely multi-focal, so you probably can't just treat one suspicious spot. However, if you are willing to get at least spot radiation, it may serve to slow the progression down. You'd have to find a radiation oncologist willing to do that, since there is no evidence to back it up.

Your other alternative is to do nothing - no hormone therapy either. There's no evidence that hormone therapy NOW is any better than waiting for further evidence of progression (i.e., rapidly rising PSA or evidence of metastases).

- Allen

What could happen if I did not do treatment. Just asking.