POST RP PSA HAS INCREASED--RADIOLOGY?

Sorry to hear that, it happens which brings many to this site. Would help to know more about your diagnosis leading up to surgery.

Your next step is probably to visit with the radiation oncologist or a medical oncologist since the surgeon did his work already. There may be some scans required to look at the local area and for any obvious spread. Most have salvage radiation treatments to cover the immediate area around where the prostate was. However, there are some new PET scans that can be done that might find things at low PSA numbers like 0.30 so ask about that.

You should make appointments with best providers you can find at this point. Tahoe may or may not have what you need. You might consider heading to UCSF, UC Davis, or Stanford for an evaluation. Recurrence after primary treatment requires the best shot at treatment so you need to talk to the best in my opinion and more than one if you have the time. You can get the actual RT locally but it helps to consult with well known cancer centers to develop the “plan”. Radiation after surgery is not a real big deal (it will seem to be at first) but eats up a lot of time with daily treatments. Ask questions as they come up.

I think you need to move a little faster. If you are going to do SRT, the optimal time to do it is before your PSA hits .2. Seems you are past that and rising quickly. We went through similar with my boyfriend. We started salvage radiation at .13.

And then there are those who have managed to hang on a lil bit and had there psa settle down and then go about their business never looking back...its a fine line tween over treatment and nipping it in the bud...the bold go where no one has gone before (and btw taken a lot flack for doing so)...what ever road you take...take it with gusto and courage...the universe abhors "Mr. Inbetween"

Which gives me an idea...a new thread...the small edges of the bell curve...and what are they doing different...alas it will not be me...I would need a pseudonym for it to be paid attention to...I am well versed in this kine stuff and would pay dearly for it...Not I Gunga Din...not on healing well...I'm borging it...if you will

Taho - The plot thickens with Kaiser. As one of the largest HMO operations, it has its good and bad parts, the most notable being the difficulties in getting care outside of the organization. This puts a lot of responsibility on you to work their system unless you have lots of cash to do things yourself.

All I can suggest is learning about the PCa standards of care and push Kaiser to get you what you want and need. They will have systems to challenge decisions, get second opinions, and so on. It would be helpful to know how old you are and what your post-op pathology was regarding Gleason score and other not-so-good observations to see where this may have came from.

With your PSA now rising rapidly after surgery, hormone therapy and salvage radiation would be indicated but getting one of the new PSMA PET scans (FDA approved 12/20) might help direct the radiation to the source of the PSA increase otherwise it is just a standard protocol that may or may not include lymph nodes. Once you start hormone treatment, your PSA should start going down quickly and scans will have trouble finding anything as it shrinks.

Like I said, you have to all the work to do now. See the RO, determine if he is any good somehow, and have a list of things to ask him about. Their knowledge and confidence usually has them quickly telling the patient what they want to do and you will be on your way in 20 minutes. It is a lot better if you listen carefully and ask the appropriate questions and go over your list when the time is right. Every doctor I have visited in recent years asks me what I have in my hand and I tell them it is my list. They immediately want to see the list so they can see what I am thinking and get to those items right away and not waste time with the standard speech.

Hopefully your RO is excellent and this goes well for you.

Have you ever wondered why...in various venues of the pca world...you are advised to take your time in deciding treatment...and when finally...after all the banter back and forth and you do decide...there is a rush to judgement to pull the trigger on that treatment without checking the chamber...the rush is sometimes as low as .03...that one based on one study with a small cohort...fostered by internet forums such as this... by not a few...with a monkee see monkee do motif coloring their decisions...and ya know what it is getting worse as we edge faster and faster to where truth is but an instrument with no particular reason but to count how many angels and angles there are to a bridge to nowhere...yeh...I get it tho...it's my "curse"... tea and empathy