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My PSA climbed 02, .04, .07 .15 .21 had a RP 2 yrs ago PSMA negative ?

Posted by charlotte1216 @charlotte1216, Feb 18 8:04am

I am Lou, After 2 years after prostectomy PSA was undetectable
.02, .04, .07, ..15 to .21 oncology asked to do another PMSA
Results were good No Uptake No Cancer
Question, I go to RO tomorrow for consultation what happens if he wants to radiate prostate bed Is that common? Thanks for your reply!

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denkea | @denkea | Feb 19 11:41am
In reply to @jeffmarc "@denkea This sort of shows why urologist should not be involved when the cancer comes back...." + (show)
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@denkea
This sort of shows why urologist should not be involved when the cancer comes back. The American Society of clinical oncology says that you should have salvage radiation at .2 and at .5 you should also have ADT if you waited.

That urologist apparently never kept up with standards of care. You really got lucky having a radiation oncologist you could work with directly.

One of the doctors in the ancan.org weekly advanced prostate cancer meetings, was treated by a urologist who ignored his rising PSA. By the time he realized that he was being neglected, he had a Gleason nine and metastasis spread. Fortunately, he was able to get it treated and is still doing OK in his mid 80s. Even a doctor can be misled by urologists that don’t keep up.

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@jeffmarc
"You really got lucky having a radiation oncologist you could work with directly."
No question about it. I most assuredly did.
When all was said and done they told me I had a 5% chance of making it to 60yo. Way beyond that now and I believe he saved my life.

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heavyphil | @heavyphil | Feb 19 12:26pm
In reply to @jeffmarc "@heavyphil Dr. Kwon might’ve picked up that idea about waiting for metastasis to show up from..." + (show)
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@heavyphil
Dr. Kwon might’ve picked up that idea about waiting for metastasis to show up from Dr. Mark Scholz. He promoted the same thing in the PCRI conferences. Claims it works much better and he just keeps track of the people to see if they have Metastasis show up.

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@jeffmarc Yeah, he’s been advocating for that in his videos for a while. But he doesn’t come off as if he is monitoring them closely. Maybe it’s just his demeanor but he seems blase’ about just about everything. Not low key, simply ‘meh’…
I know he’s a guru of sorts but he doesn’t inspire me.

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jeff Marchi | @jeffmarc | Feb 19 1:06pm
In reply to @heavyphil "@jeffmarc Yeah, he’s been advocating for that in his videos for a while. But he doesn’t..." + (show)
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@jeffmarc Yeah, he’s been advocating for that in his videos for a while. But he doesn’t come off as if he is monitoring them closely. Maybe it’s just his demeanor but he seems blase’ about just about everything. Not low key, simply ‘meh’…
I know he’s a guru of sorts but he doesn’t inspire me.

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@heavyphil
if you were to come to one of the ancan.org Weekly advanced prostate cancer meetings, and noticed somebody come in who said they were going to doctor Kwon, Rick would immediately tell them that he does not really recommend going to him as a doctor. He is a urologist and should not be working with more advanced cases. There are a number of cases he’s run into where Dr. Kwon has not followed the standard of care.

I have noticed that people say that he does refer them to other doctors when he works with them, Something I think he didn’t do for a while. That should make his treatment decisions better, Since other doctors are also involved.

I don’t know what the real truth is here, Just reporting what I’ve heard.

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jeff Marchi | @jeffmarc | Feb 19 1:08pm
In reply to @wwsmith "@heavyphil Yes, when no radiation has yet been used, waiting to radiate recurrent cancer only when..." + (show)
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@heavyphil Yes, when no radiation has yet been used, waiting to radiate recurrent cancer only when first visible on PET scans will certainly allow cancer to spread more easily and greatly decrease the chance of a cure (NED after 5 years). I doubt that we will see other oncologists agreeing with Dr. Kwon's approach on this.

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@wwsmith
The other problem with this approach is that micro metastasis can start to proliferate and they can’t be seen by a PSMA PET scan. So the patient can be left with future serious issues.

We do have a couple of doctors say they like doing this and it works. I also am not convinced.

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surftohealth88 | @surftohealth88 | Feb 19 5:39pm
In reply to @jeffmarc "@surftohealth88 Not really heard much about salvage surgery. Looking into it, I see the numbers are..." + (show)
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@surftohealth88
Not really heard much about salvage surgery.

Looking into it, I see the numbers are not great, as you mention.

When I looked into it, I noticed a wide range percentages of problems with ED and incontinent. I wonder if finding a surgeon that is really experienced in doing it can make a difference.

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@jeffmarc
In this study 100% had ED and 55% incontinence , for example. https://www.sciencedirect.com/science/article/pii/009042959180282C
And I think that it is pretty logical since as you know yourself RT changes urethral elasticity - that is why Proact does not work well with RT patients. Urethra is stiff after radiation and there is scar tissue around it and when reduced further to one sphincter only- it just can not work properly. So you have 5% of incontinence for RP before RT and 55% incontinence in RP after RT.

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jc76 | @jc76 | Feb 20 6:10am

@charlotte1216
If your PSA numbers are correct I think some posters are not seeing what I see.

.02 and all your PSA tests would be considered non detectable with the traditional PSA test which is >1

If you are using the ultra sensitive psa test then each lab designates what is considered undetectable. You posted undetectable does that mean your labs are saying the numbers you posted are undetectable? Are you on any hormone treatments and did the end and you are seeing a extremely small increase each time? Is that correct.

I did not have RP nor hormone treatments but what I read is your PSA test are at the undetectable numbers but again not familiar with your lab and what they use as undetectable when using ultra sensitive test.

Not sure I help here but tried.

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chippydoo | @chippydoo | Feb 20 7:46am

Sounds like your cancer is "reoccurring" which is fairly common post RP. Cancer cells get out of the prostate either during surgery or before. Your numbers look like mine did. My surgeons comment was, "it looks like something got left behind." It was then onto radiation and 6 months of ADT. 2 month and 6 month post treatment my PSA was undetectable. I have 4 months until my next blood work, so 15 weeks until I get jiggy.

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chippydoo | @chippydoo | Feb 20 7:51am
In reply to @jc76 "@charlotte1216 If your PSA numbers are correct I think some posters are not seeing what I..." + (show)
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@charlotte1216
If your PSA numbers are correct I think some posters are not seeing what I see.

.02 and all your PSA tests would be considered non detectable with the traditional PSA test which is >1

If you are using the ultra sensitive psa test then each lab designates what is considered undetectable. You posted undetectable does that mean your labs are saying the numbers you posted are undetectable? Are you on any hormone treatments and did the end and you are seeing a extremely small increase each time? Is that correct.

I did not have RP nor hormone treatments but what I read is your PSA test are at the undetectable numbers but again not familiar with your lab and what they use as undetectable when using ultra sensitive test.

Not sure I help here but tried.

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@jc76 He posted .21 which is reoccurrence.

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heavyphil | @heavyphil | Feb 21 7:08am
In reply to @topf "@surftohealth88 I was under the impression that if you radiate the prostate bed and there is..." + (show)
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@surftohealth88 I was under the impression that if you radiate the prostate bed and there is cancer some place else that you would know from a psa test. He also says that salvage surgery after radiation is safe, which was also new to me.

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@topf 30% of SRT fails if ONLY the prostate bed is treated. You MUST treat the pelvic lymph nodes as well.
I received 6000gys to the bed and 4500gys to the nodes…and still🤞

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heavyphil | @heavyphil | Feb 21 7:14am
In reply to @jc76 "@charlotte1216 If your PSA numbers are correct I think some posters are not seeing what I..." + (show)
Profile picture for jc76 @jc76

@charlotte1216
If your PSA numbers are correct I think some posters are not seeing what I see.

.02 and all your PSA tests would be considered non detectable with the traditional PSA test which is >1

If you are using the ultra sensitive psa test then each lab designates what is considered undetectable. You posted undetectable does that mean your labs are saying the numbers you posted are undetectable? Are you on any hormone treatments and did the end and you are seeing a extremely small increase each time? Is that correct.

I did not have RP nor hormone treatments but what I read is your PSA test are at the undetectable numbers but again not familiar with your lab and what they use as undetectable when using ultra sensitive test.

Not sure I help here but tried.

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@jc76 JC, his last test was 0.21, which is salvage signal.
Phil

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