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0,7 after srt

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Posted 2/27/2018 4:52 PM (GMT 0)
Hello

I am very worried for my father because we just had the last results, and I do not find them good at all. he just called his cancerologist who told him not to worry that if there had been something he would have called it.

but me, after reading several sites and look at several forums, I wonder.
after, I do not know the complete file of my father.

I do not dare tell him to take another opinion because I feel he trusts his cancerologist.
Passer à la langue suivante : français

and you ? What do you think ?
I'm sorry but I'm french and I'm squeezing google for translation.

thank you for your understanding and your answers

68 years
Psa 6
Rp 08/2016
10/2016 0,20 12/2016 0,54
Srt 02/2017 - 04/2017
07/2017 0,49 10/2017 0,43
02/2018 0,70
Posted 2/27/2018 5:01 PM (GMT 0)
Welcome to the forum.

From the information you have given, it appears your father's PSA is still in the positive range after his surgery in 2016. That could indicate some cancer cells remain, and further treatment might be indicated.

Please note that I'm not a doctor but based on what I've been though, and what I read on this forum, your father should at least talk to his doctor again, or seek out another opinion from a radiation oncologist.

It would be helpful if you furnished a bit more information about your father's pathology report after surgery.
Posted 2/27/2018 5:05 PM (GMT 0)
My father : t3b gleason 8
Posted 2/27/2018 5:11 PM (GMT 0)
Welcome to HW.

sorry you need to be here.

The PSA is still low so that is good. It should be lower. After SRT the next treatment (ADT or HT) won't start until the PSA is much higher - 3 or 4.

So for now there is nothing to do but watch and wait. That is not easy to do. There is a possibility that his PSA may fall on the next reading.

Andrew
Posted 2/27/2018 5:22 PM (GMT 0)
The Gleason 8 indicates a higher risk disease, and T3 can mean some spread of the cells.

But InTheShop is correct that you may have to just watch the PSA for a while. Make sure you have a doctor you trust.

Check in with us when you need to.
Posted 2/27/2018 6:12 PM (GMT 0)
Unfortunately, I think it is clear now that the SRT did not work. His PSA seems to be rising very quickly now, which would indicate metastases. I do not agree with Andrew that PSA should reach 3 or 4 before starting on ADT. The presence of metastases or rapidly rising PSADT are almost always used as indicators. And one study suggests that it should begin as soon as recurrence becomes apparent.

If he wants to know if there are any detectable metastases yet, there is a clinical trial of a new PET scan in France.

/clinicaltrials.gov/ct2/show/NCT03443609

You can contact them to see if your father qualifies:
ROUSSEAU Caroline, MD +33 2 40 67 99 00 [email protected]
Posted 2/27/2018 7:19 PM (GMT 0)
Thank you for your comments, which confirms what I thought. I was afraid of the arrival of metastases! And I think we have it.
So what does it mean? Big pains, how long is life ???
It's up to me to gently convince him to see another oncologist and start what? ADT? Chemotherapy?

Or wait for an appointment with the urologist in May
I'm afraid of the time we have left ....
Posted 2/27/2018 9:14 PM (GMT 0)
Katia,

I apologize for missing the information that your father already had salvage radiation.

A medical oncologist would be your best recourse now.

Tall Allen is a most informed member of this forum. His advice is very worthwhile. In the meantime, good luck.
Posted 2/27/2018 9:57 PM (GMT 0)
Katia-

In the US 20 years ago, the median time from failure of prostatectomy to the appearance of metastases detectable by a bone scan (which means they are relatively large) was 8 years, and the median time until death after that was 5 years. And that was before we had drugs like docetaxel, abiraterone, enzalutamide, Xofigo and Provenge. In the next few years there will be many more life-extending medicines and better ways to use them.

Metastases don't often get painful until they are large and rapidly growing. Very brief courses of radiation can relieve the pain and prevent fractures.

Most of the clinical trials of medicines have been done in patients who are already metastatic (or at least castration resistant). The only drugs approved for recurrent PC before metastases and while it's still hormone sensitive would be a drug that prevents testosterone from forming, like leuprolide or goserelin, or a drug that blocks testosterone like bicalutamide. Whether he should start any of them, which he should start, at what dose, and whether they should be taken intermittently or continuously are all questions he should discuss with a medical oncologist (not a urologist).
Posted 2/28/2018 12:46 PM (GMT 0)
Thank you for your comment a little reassuring.
What I do not understand is that by looking at stories similar to those of my father, I often see the metastases that happened about two years after the operation !! You, you tell me a median of 8 years ?? Or I do not have everything.
Not easy to navigate by reading the net. Maybe I should never have done it, and stay in the shadows.
I feel like I know more than my father who made it to his oncologist who finally told him what he wants to hear.
For me, convincing him to go see someone else is to make him understand that it is more serious than he thinks.
Waiting for another treatment (adt, ht, chemo) 6 months more will change a lot of things or not ???
Thank you for reading me.
Katia
Posted 2/28/2018 6:02 PM (GMT 0)
Median means half of all patients will be less than that and half will be more than that. Statistics never predict for an individual, only for the group as a whole.
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