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Biochemical reoccurrence
I have Stage 4 mcrpc . I have been on ADH and Zytiga for 4 years with PSA of .06 for all 4 years. In Sept my PSA rose to .17 and 1 month later to .24 My oncologist said that I had biochemical reoccurrence. I had a PSMA pet scan but now realized that my PSA was probably to low to get a good scan is it was negative. Has anyone been here and if so what was your next treatment. My Dr has sent a blood sample to Guardant LAB. For a biopsy of the cancer cells and genetic testing. He said that Lu-177-PSMA-617. Any advice is so welcome.
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At PSA 0.5 get the most sensitive PSMA PET scan you can. I got the Gallium 68 scan. If that’s not possible, wait for the PSA to get high enough for an effective scan you can get. Your PSA is still relatively low. Has anyone mentioned PROVENGE immunotherapy?
What does a blood sample tell you?
It wii give my Dr A biopsy of the cancer cells in my blood as well as genomics information.
After RP in 2019, Gleason 9
my PSA initially was 0.02
After 1 year 0.03 then steady rising to 0.22 ,I had pet/Psma in August 22, two weeks later Psma dropped to 0.13 now back up to 0.23
They saw something in one lymph node very small.
The radio oncologist in the public health hospital recommended 25-30 radiotherapy treatments together with ADT.
The private clinic that performed the scan said it doesn't necessarily mean it will evolve into a life threatening Situation and doesn't recommend treating with radio therapy and ADT with their possible toside effects which may effect quality of life.
He suggests monitoring PSA regularly and if it stays in similar figures to do nothing, if it rises to 0.4 - 0.5 then treat with proton therapy, but this I would have to pay for at a cost of 53,000 euros.
I'm in a tricky situation and not sure what to do.
I also had Gleason 9 and biochemical reoccurrence within a year.My PSA was over 3 before I started salvage radiation.
Did you also have hormone therapy?
Yes. They tried that first. Didn’t have the PSMA scans in 2016 and CT’s never picked up on the cancer. It would drop the PSA but as soon as I stopped treatment it would come back up. Finally went to Mayo for the choline scan which found the cancer. My PSA at that time was 3.5 so had salvage radiation with more Leuprolide.
Hello, after my surgery a small area of cancer was detected in one lymph node. The Mayo Clinic discussed with me the option of a recommended 39 radiation treatments plus hormone therapy for two years. From my research, I decided it was better, if at all possible, to avoid this course of action. (Too many side effects!) Instead, I’m doing active surveillance with PSA tests every three months. I’ve had three PSA tests; they all came back with undetectable results. My life style includes lots of exercises and avoiding red meat and pork. I’m basically following a Mediterranean Diet. Good luck with your decision.