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Opinion wanted on PSA result

Prostate Cancer | Last Active: Apr 28 3:40pm | Replies (20)

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Profile picture for rlpostrp @rlpostrp

Good question about the PET Scan. If the reason he had the orchiectomy was prostate cancer vs testicular cancer, I wonder why his urologist did not do the PET Scan pre-surgically? If it was prostate cancer, the urologist would want to know if the cancer was "prostate confined", or if in fact it was spreading to lymph nodes and/or bones. You unfortunately don't know, and for some reason radiation was done instead of prostatectomy...again, assuming he has prostate cancer (seems he does). If he did have prostate cancer, "why" did he go for radiation "first", when that is customarily done "after" radical prostatectomy if/when there are new, detectable and increasing PSA levels. Radiation "first" just made it much ore difficult to surgically remove the prostate if needed, now that it is scarred and is like a chunk of concrete. Please offer some answers and more clarity on what is going on with him. Good luck to you and him.

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Replies to "Good question about the PET Scan. If the reason he had the orchiectomy was prostate cancer..."

@rlpostrp
Actually there are solutions to reoccurrence after radiation is the first treatment.

Please check out this article
https://connect.mayoclinic.org/discussion/salvage-focal-therapy-and-surgery-equally-effective-after-radiation/

@rlpostrp
Hi, Orchiectomy is a form of ADT, probably offered to older patient, instead of ADT injections. PSMA PET scan was of course done, which showed it was also in Lymph Node and SV. Coming to your point on RP, due to his age of 78 years, the Urologist strongly suggested against surgery and recommended 28 rounds of Radiation. I believe RT + ADT is a standard of care in such cases as per NCCN guidelines, however, after a few follow-ups doctor also added Abiraterone+P. My question was only to check if it's normal that PSA drop slows down 3 months after RT?
I also saw the video of Dr. Schulz from 2022, that he rarely saw salvage prostatectomy, and there are alternatives as Jeff has also mentioned.
Btw the RO said, next PSA should be after three months, instead of one, however we plan to continue once a month.