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prostate removed 15 years ago, PSA rising 2 years ago, radiation
My husband had his prostate was removed 15 years ago due to cancer. 2 years ago his PSA started increasing, He went through 8 weeks of radiation, Erleada and Orgovyx. He finished his oral medications in February of 2025. In October of 2025 his PSA started increasing again. All of the PET scans and MRIs do not show anything.
PSA:
10/28 .1
12/03 .21
01/20 .48
04/07 1.1
His urologist wants to put him back on the oral medications. I think we should get a second opinion from Mayo Clinic or MD Anderson.
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I had the same thing happened to me, but my timing wasn’t identical to yours. I had a prostatectomy and 3 1/2 years later My PSA started rising. I had about eight weeks of radiation two months after having a six month Lupron shot.
2 1/2 years later it came back and I had to go back on ADT full-time. While you can get a PSMA pet scan It may not show Anything. In that case, there is nothing to zap so you either wait around until your PSA rises more and you wait for a metastasis to show up (While Micro metastasis that can’t be seen accelerate) or you can go on ADT Along with an ARPI To prevent you from becoming castrate resistant.
After I was on ADT 2 1/2 years, it came back, I became castrate resistant and went on abiraterone. I was on that for 2 1/2 years and now I’m on Orgovyx and Nubeqa. After 16 years of prostate cancer, I Have been undetectable for the last 29 months.. I do have BRCA2, which makes my cancer more aggressive. I’ve now been on ADT for eight years.
What I’m getting at is with the proper drugs you can live a long time.
Carefully consider your options, The drugs work well for almost everyone, but the side effects can be problematic.
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4 ReactionsHave you just had a PET PSMA? Detection with PSA >1 and < 2 is about 85% so now would be a good time to get a scan if you have not gotten one since PSA has been high (it is 95% at >2). You might find a metastasis that can be zapped with SBRT. Detection is about 30% at 0.2 and 40% at 0.5 PSA so no detection at these levels does not preclude detection now. If the PET finds too many hot spots or none the first choice will be to go back on the drugs.
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5 ReactionsSo sorry to hear this. You would think that 15 years puts you out of danger of relapse; But the cancer comes back (?!) and you figure that ADT and SRT would finish it off for sure, right?
Just another WTF moment in the lives of those living and sharing this thing…
I agree with others that a PET scan might be very useful at this point; hopefully, it’s a cluster of cells that were outside the SRT field of battle and they can be zapped with SBRT.
Phil