After several years of biopsies and repeated PSA tests, my PSA finally peaked around 5.0 and the most recent biopsy (June 2017) indicated cancerous cells, all contained within the prostate itself. I elected for total prostatectomy via robotic surgery to protect nerves and allow for continued erection and orgasm post-surgery. PSA levels were basically undetectable until January 2024; at that time, 0.25. My urologist was not concerned at that time with slight rise. I had been quite active, cycling, playing sports, traveling, farm work, etc. up to that date. In January 2025, my PSA rose to 0.56 and a PET scan was done. Results of PET scan were negative with no indication of cancer anywhere in the body. However, my urologist referred me to a urological oncologist who recommended immediate radiation treatment with testosterone depression medication. My testosterone levels, even after bio-identical hormone replacement (SottoPelle pellets), remained fairly low, from 250-450.
I'm scheduled for another PSA test within the next week just to see if there has been any increase even since January.
Given the possible side effects of 5 days a week/8 weeks radiation along with hormone depletion treatment, I'm questioning whether to pursue this course of action. Again, negative PET scan, so assumption would be to treat the prostate fossa since that's the best 'guess', so to speak.
I'm 75 and in relatively decent health; however, I was diagnosed in 1999 with fairly severe post-polio syndrome which has resulted in continuing muscle atrophy and weakness.
Just wondering whether or not to pursue the recommended course of therapy or wait and see if another PET scan may reveal something more specific.
In the summer of 2017, a rather major paper was released that basically stated that a man of my age (67 at the time) with the type of cancer I had along with my Glisan score would most likely survive 10-15 more years without surgery or radiation at the time.
Any thoughts from other folks with similar findings and near the same age as me?
Thank you