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PSE Test for Prostate Cancer Before an MRI and for Re-Occurrence
Prostate Cancer | Last Active: Nov 15 10:56am | Replies (42)Comment receiving replies
I completed salvage radiation last May. I have been on ADT for 11 months (6 months of Eligard followed by 5 months of Orgovyx + Abiraterone. My original episode was in September of 21 when my PSA was 23. I had RP - pathology was GS 4+4 stage Pt3b. I had persistent PSA, 60 days post RP PSA was 7. Did about 2 years of intermittent Bicalutamide. Went to Houston for RO consult. They put me on the Eligard and performed the SR. Last PSA was < 0.01. My MO thinks i have a good chance for cure but wants me on ADT another 7 months for micro metastases . I wonder if a test like this could tell if there are any micro metastases or if it’s safe to stop ADT?
Replies to "I completed salvage radiation last May. I have been on ADT for 11 months (6 months..."
What is SR?
Whether it is safe to stop. ADT depends on your Gleason score. If it is seven, you can stop after six months if it is eight or higher, you need to go 18 months or more in order to make sure it doesn’t come back. That doesn’t even guarantee it won’t come back, but it does allow some people to go into remission.
You need a PSMA pet test to see if you have metastasis that have gone beyond Micro, you would probably have to do that after you stop taking the drugs because your PSA has to be higher than < .01. . You do have to realize that prostate cancer is in your bloodstream and will stay there. The best chance of getting rid of it is stay on ADT for the recommended time.
Having a PSA of seven after an RP, and not treating it with SR is almost malpractice. Sure you can keep the PSA down by putting you on ADT drugs, but that seven means you had something active that should’ve been treated. Doing that so late may leave you with a much higher chance of recurrence than had you been treated properly.
Six weeks after my RP my PSA was < .1 and stayed that way for 3 1/2 years. Then it started to rise and when it hit .2 they did SR. That is the standard treatment that is supposed to be given, and you were not given that
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I'm not a medical professional, so someone who knows more please feel free to step in, but for detecting small metastases I think the best available test is still a PSMA PET scan.
I haven't see anything in my layperson reading on PSE so far to suggest that it is related to detecting specific metastases; instead, it combines epigenetic testing with PSA testing to get a better idea of the probability of cancer and cancer progression — in general terms — than either test can give alone. Think of it as adding some more certainty to deciding whether it's time to act on rising PSA yet.