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Post surgery PSA after 3 months was 1.77
Prostate Cancer | Last Active: 2 days ago | Replies (15)Comment receiving replies
The doctor told me that the next treatment is radiation and it can be done
only after six months of surgery.
With Regards,
Joseph T J.
Replies to "The doctor told me that the next treatment is radiation and it can be done only..."
@josephtj
Again, I really suspect this doctor is not giving you the best treatment possible. One other person mentioned they had salvage radiation at three months. I know other people had the same thing..
Have you had a PSMA pet scan? That is essential to be done before radiation before ADT and immediately actually. The doctor should not be waiting. They should be doing this right now. It is very likely you have a metastasis that can be visibly seen since your PSA is so high. That might enable you to not have salvage radiation since it’s already pretty late. If you were to go to a center of excellence, they would immediately have you do this scan. It’s essential to be done before radiation because the metastasis may not be where they radiate.
Another thing you should be aware of is that the medical group that sets the standards for treatment says that if your PSA is above .5 you should be on ADT. Has your doctor told you about that?
Here is some information from that group about when you should Have salvage radiation after surgery. As you can see, you are way beyond the high level PSA that it is recommended to be done. This is another thing you should bring up with your doctor along with the need for the PET scan.
From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.
0.2–0.5 ng/mL: Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.
0.5–1.0 ng/mL: Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.
This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/
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@josephtj the more you can heal from surgery the better, but you don’t want any cancer left behind to get a foothold either. I had a 9.4 PSA after surgery and started radiation 3 months later. I’d get that PSA test now and hope your number has come down or get some treatment soon. Probably some Lupron to go with it unfortunately. Good luck,