Connect
← Return to Puzzling about PSA rise 7 years after prostatectomy
Discussion
Puzzling about PSA rise 7 years after prostatectomy
Prostate Cancer | Last Active: Feb 10 7:35pm | Replies (30)Comment receiving replies
Thank you for sharing your story of BCR. I am 69 and 14
months post RALP for G7. So far undetectable, but I asked my surgeon what happens if if returns, He said nothing if PSAdt (doubling time) stays above 12 months. I get the impression that meant even if it PSA rises above .2 over the years, long PSAdts are indicative of an indolent tumor mass (G3 versus G4)so do nothing.
Hmmmm.. not sure, I would not want to seek salvage radiation like you did. Anyway I did not know they could do prostate bed biopsies. Obviously they were concerned there was mire than one metastasis, but it might have been interesting to know what Gleason score cells had escaped the prostate.
Replies to "@melvinw Thank you for sharing your story of BCR. I am 69 and 14 months post..."
@beachflyer That’s so true! I asked AI and got a similar answer. I’ll find out with my new oncologist too!
Thanks
Connect
@beachflyer
You should be aware that doubling time is not that critical when it comes to having your PSA rise after your prostatectomy. If your PSA hits .2 you want to have salvage radiation, You don’t want to wait for it to rise much higher or there are risks involved. 3 1/2 years after my prostatectomy my PSA Rose to .2, I know dozens of other people that have the same thing with different time between surgery and PSA rise. I had 8+ weeks of salvage radiation and had no side effects at all the time, Six years later, I started having some incontinence, but I’ve had radiation and surgery so who knows what caused it. That does not happen to everyone.
Below are the standard set by the American Society of clinical oncology (ASCO) For what to do if you have a PSA rise after a prostatectomy. If your doctor is not aware of this, you might get a second opinion.
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/