PSA six weeks after radical prostatectomy

Does the PSMA also check for bone lesions in spine and pelvis? I wish you well dealing with this very disconcerting news.

Was the MRI of the prostate only?

Those results would indicate your PCa was metastatic, not localized. While surgery is not ruled out in that situation, akin to taking out the "mother ship," it would generally include some type of ADT, perhaps with an ARI, radiation, chemotherapy, depending on how aggressive you and your medical team choose to be.

While historically, we tended to think PCa spreads first to the surrounding tissues, then the PLNs, then bones and organs, working it's way outward and upward, I think we (the medical community upon which we ask for their experience, training and education and ourselves as patients) now understand it can leapfrog wherever the heck it "decides" to.

Others may chime in, I don't recall a member posing about a situation such as this though I don't doubt there is.

Like in business, you may want to look at this as a "sunk cost," the decision facing you know is to determine where your PCa is, when you know that, which the PSMA scan may provide, then you can decide on treatment - doublet, triplet, will you use radiation or just systemic therapy.

Let the forum know what your PSMA scan shows and members can give you their thoughts.

Kevin

Yes the psma covers all areas. Thanks for your well wishes.

The MRI was of the entire pelvic area and only indicated the prostate lesion. With the surgeon and oncologist stating they have never witnessed these results in over 1000 prostatectomies personally performed or ever heard it reported it is quite puzzling and concerning. Pet scan is scheduled for March 13th, will keep you posted.

I am definitely grieving with you receiving this hard news. I know I got several screenings before my RALP looking for cancer elsewhere and you probably did too. At the time it felt like a hoop to jump through, not so much now that I'm hearing your story.
If you like gallows humor, the worse thing I've heard was a man in my same community that got RALP within a week of when I did and died within a week from sepsis. I don't think he's posting on this forum :-(.
But seriously, our hearts are part of your sunk costs too.

Same here. But PSA was 67 after surgery. PSMA Pet showed some bone Mets. Starting hormone and chemo. Sorry you didn’t have a better result. I was told the same thing. Said never saw it before. Hard to believe.

Sorry to hear that. Yes it's like a kick in the gut when you are told any level above .2 is a concern and you receive a number like that. What was your psa before surgery and was this your first test following? I pray your treatment will be successful.

Had my psma pet scan yesterday. It shows spread to two areas that seem atypical for prostate cancer.
1. Uptake in multiple retroperitoneal lymph nodes.
2. Nonspecific uptake in hilar mediastinal lymph nodes, metastatic disease cannot be entirely excluded.
I have my follow up with urologist next Wed. These results lead me to a couple questions.
1. Has anyone here received similar results?
2. I want a second opinion. Has anyone used a virtual service like offered by Cleveland Clinic or Cedar Sinai?

dwb1, not sure where you had your initial radical prostatectomy, but would highly recommend using the best possible center of excellence for your second opinion. I was treated at Mayo-Rochester -- Sorry, I don't have any experience with virtual services at this location.

Best of luck with your follow-up treatment!!

Jim

Did you have any symptoms prior to diagnosis such as urinary flow issues, pelvic pain, bloody urine, etc. or was it totally out of left field? It does seem to be a very, very unusual result.
Wishing you the best.