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Low, But Rising PSA--Wait for Imaging or Act Now?
Prostate Cancer | Last Active: May 11 3:56pm | Replies (72)Comment receiving replies
Bikeman, it looks like your PSA is indicating that your cancer is growing but you don’t know where. Sometimes it can come back in the Prostate bed area, or hips, or neck, ect. How would you propose they treat it now? Overall body radiation? Chemo? ADT will suppress your PSA number to a certain extent and weaken your cancer but how do you aggressively attack the cancer if you don’t know where to attack?
Dave 3+4
Replies to "Bikeman, it looks like your PSA is indicating that your cancer is growing but you don’t..."
@clevelandguy wrote: "it looks like your PSA is indicating that your cancer is growing but you don’t know where. Sometimes it can come back in the Prostate bed area, or hips, or neck, ect. How would you propose they treat it now? Overall body radiation? Chemo? "
Salvage radiotherapy in the absence of a PSMA avid target is incredibly common and will typically involve radiation to the prostate bed and the optional addition of the pelvic lymph nodes.
The majority of post-RALP BCR starts with regional spread in the prostate bed and PLNs, hence the validity of this approach. Of course there's no guarantee that there could also be distant spread that's missed, but that's always going to be the case since PSMA PET has a detection threshold, and some PCa is not PSMA avid.
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@clevelandguy
Excellent question