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← Return to PSA detectable 18 mos after prostatectomy
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PSA detectable 18 mos after prostatectomy
Prostate Cancer | Last Active: Aug 10 4:52pm | Replies (85)Comment receiving replies
Well, I think I'll be looking at next steps soon. I had non-nerve sparing RARP on 6/24/24 with pathology of stage pT3a, Gleason 9, 60% Intraductal Carcinoma, and Cribriform Patterned 4. Today, my first 3 month PSA was 0.26 mg/ml. My Mayo team says it isn't BCR until I have two results over 0.2; however, I was also told that a test false reading was highly unlikely and it is very unusual to have a reading this high this quickly - they expressed concern. My incontinence is improved since surgery,
but the team said that salvage radiation will stop any improvement and may worsen it. I'm scheduled for a follow-up PSA in 6 weeks. I know what the treatment protocol is but I also know that my situation isn't optimal. I read all the studies saying that even with high risk PC, 10-15 years was highly likely but I am also reading that early BCR with doubling rates < 6 months puts 5 year survival at < 20%. I have my fingers crossed that my next reading does not reflect accelerated PSADT. I'm a bit anxious now!
Replies to "Well, I think I'll be looking at next steps soon. I had non-nerve sparing RARP on..."
I just want to make sure that this comment is clarified, because it is not at all true:
" ...but I am also reading that early BCR with doubling rates < 6 months puts 5 year survival at < 20%. "
This would be more accurate:
Research has shown that while a short PSADT is a negative prognostic factor, the 5-year survival rate is not as low as the statement suggests. Several studies have shown that for patients with BCR and a short PSADT, the risk is more focused on the development of distant metastases and a shorter time to death from prostate cancer, rather than a low 5-year overall survival. A large-scale analysis of men with BCR after prostatectomy found that those with a short PSADT had a significantly increased risk of developing distant metastases, but the 5-year metastasis-free survival was still well over 50%.
Additionally, the overall cancer-specific survival for men with biochemical recurrence is generally quite high, with some studies reporting 10-year cancer-specific survival rates of over 90% after salvage therapies like radiation. This shows that even with a high-risk feature like a short PSADT, many patients can still have a good prognosis due to effective follow-up treatments.
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So sorry to hear this news and your anxiety is totally understandable - it’s OK to be fearful in light of your numbers.
BUT, so many advances have been made in even just the last few years! You will probably be put on some form of ADT right now to stop the cancer in its tracks and then you can exhale while your team works on the next steps.
As has been posted on other threads, radiation initiated immediately or down the line has the same outcomes so don’t sweat it out waiting for it to begin. You may be on ADT for many months - perhaps even different forms - before your team is ready to do radiation.
So many others on this board have faced similar scary situations and have come out on the other side with fantastic results and a hopeful future. YOU WILL TOO!