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High-risk recurrence at PSA 0.1 rather than wait for 0.2?

Posted by kivanc6081 @kivanc6081, Jan 24 12:37am

My pathological stage is pT3b, with unilateral seminal vesicle invasion and cribriform pattern positivity.

In such high-risk situations, are there any approaches in clinical practice that recommend earlier intervention at PSA levels such as 0.1 or 0.15, rather than waiting for 0.2?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

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mal1 | @mal1 | Jan 27 11:07am
In reply to @kujhawk1978 "Grab a cup of coffee or your favorite Old Fashioned, Manhattan, and read this. https://www.urotoday.com/conference-highlights/sociedad-colombiana-de-urologia-scu-colombia-2025/162647-scu-2025-evaluation-and-management-of-biochemical-recurrence-in-prostate-cancer.html?utm_source=newsletter_15016&utm_medium=email&utm_campaign=how-psa-kinetics-are-reshaping-care-after-biochemical-recurrence. What..." + (show)
Profile picture for kujhawk1978 @kujhawk1978

Grab a cup of coffee or your favorite Old Fashioned, Manhattan, and read this.
https://www.urotoday.com/conference-highlights/sociedad-colombiana-de-urologia-scu-colombia-2025/162647-scu-2025-evaluation-and-management-of-biochemical-recurrence-in-prostate-cancer.html.
What would I do with the clinical data you present.

I would discuss treatment with my medical team: Options may include:

Doublet Therapy - ADT + ARI
Triplet Therapy ADT+ARI+ Chemotherapy
PSMA PET Imaging
Radiation (hint, discuss inclusion of Whole Pelvic Lymph Nodes, not just the prostate bed).

Let the forum know how your discussions go and what your medical team says.

Kevin

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@kujhawk1978 Thanks this discussion is very helpful. I have seen my PSA rise over the last 2 1/2 years after my RP to .196

I am trying to decide how to go forward now and was wondering what side effects anyone had from the radiation treatment of the prostrate bed?

Thanks

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2 replies
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kujhawk1978 | @kujhawk1978 | Jan 27 12:29pm
In reply to @mal1 "@kujhawk1978 Thanks this discussion is very helpful. I have seen my PSA rise over the last..." + (show)
Profile picture for mal1 @mal1

@kujhawk1978 Thanks this discussion is very helpful. I have seen my PSA rise over the last 2 1/2 years after my RP to .196

I am trying to decide how to go forward now and was wondering what side effects anyone had from the radiation treatment of the prostrate bed?

Thanks

Jump to this post

@mal1

My SRT in March 2016 was 39 IMRT, 70.3 Gya to the prostate bed.

Side affects, none.

Why? Who knows.

Skill of my radiologist snd her team, and advances in the planning and delivery systems?

I've had radiation twice since then, whole pelvic lymph node, 25 IMRT, 45 Gya snd SBRT, 5x8 Gya.

Side effects, none.

Why, same as SRT...

Kevin

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heavyphil | @heavyphil | Jan 28 7:03am
In reply to @mal1 "@kujhawk1978 Thanks this discussion is very helpful. I have seen my PSA rise over the last..." + (show)
Profile picture for mal1 @mal1

@kujhawk1978 Thanks this discussion is very helpful. I have seen my PSA rise over the last 2 1/2 years after my RP to .196

I am trying to decide how to go forward now and was wondering what side effects anyone had from the radiation treatment of the prostrate bed?

Thanks

Jump to this post

@mal1 Have to begin with: everyone is different!
SE’s can vary from bowel/urinary issues either during or after treatment to absolutely none at all.
The single most important thing, however, is to strictly comply with your RO’s rules - NO short cuts!
Empty rectum , no gas (managed by diet), full bladder…that’s YOUR JOB. You are really a big part of the team effort and if you don’t hold up your end, SE’s will be more pronounced and possibly of longer duration.
BTW, just be sure your pelvic lymph nodes are being treated as well - treating the bed alone is insufficient. Best,
Phil

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