Reoccurrence with Prostate Cancer Tumor Attached to the Rectum Wall

Posted by retiredchief @retiredchief, 16 hours ago

Diagnosed with prostate cancer in spring 2018 at age 54. Underwent prostate removal surgery in June 2018, PSA undetectable until January 2021 when PSA levels returned to .42.
Underwent 35 sessions of radiation targeted at the lymph nodes near the prostate bed, along with 15 months of Lupron at age 56.
Again, things looked good for about 18 months when PSA levels began to once again increase. After a PSMA-PET scan showed a tumor near the rectum wall I underwent two biopsies which confirmed prostate cancer growth at the rectum wall. After further testing it appeared the growth had attached to the wall of the rectum, and I underwent Trans anal surgery in an attempt to remove the cancer. This surgery was in August 2025 at age 62.
My first PSA test following surgery was 0.10 and has risen to 0.62 in the last six months. In February 2026 had another PSMA-PET which showed that the surgery removed about 70% of the tumor but about 30% remains.
I’m currently in a holding pattern until the PSA goes over 0.80 when other testing will occur.
The fact that the tumor is located in connection with the rectum wall it rules out more radiation and other localized treatment to prevent damage to the rectum.
Looking to see if anyone else had this occurrence, and what the results and treatment plan were. I know one option would be to return to hormone therapy but the 15 months on Lupron were the worst of my life, side effects were unbearable.
Any recommendations?

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Jeff Marchi | @jeffmarc | 16 hours ago

You could go on Nubeqa As your only drug. It suppresses prostate cancer’s ability to use testosterone and works quite well for over a half dozen people I know using it alone. It does not reduce your testosterone. Most people have no side effects at all.

Drugs like Nubeq Can stop the metastasis from growing and spreading, but that’s for a limited amount of time. How long it will last is unknown.

Is there a chance they can use surgery to try to remove it again? Where are you being treated? Is it a center of excellence?

You definitely want the best doctors you can find treating this problem.

retiredchief | @retiredchief | 15 hours ago

In reply to @jeffmarc "You could go on Nubeqa As your only drug. It suppresses prostate cancer’s ability to use..." + (show)

@jeffmarc

Jeff thanks for your response, I'll look into Nubeq.

Surgery is a possibility if/when the tumor size reaches 1-1.5 cm. I'm being treated at Mayo Clinic Rochester, for the past year. I have a good team, and I know my situation is a tad different, so maybe someone else in the Mayo Connect world is in the same situation.

thanks again.