Post prostatectomy: What do rising PSA levels mean?

Posted by hoard @hoard, Sep 10, 2019

New to group! Wish I had checked this out 2 years ago while supporting my husband! Now over e years post prostatectomy, wondering what might make psa go from all 0 to 2.6...

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was diagnosed with prostate cancer in 2013--recommendation was radical removal of prostate as best treatment as it appeared cancer was localized in prostate -(horse was in the barn my Dr said) so get rid of barn and problem goes away. Prostate was removed and PSA was 0.0--all good until 2022 mid year discovered PSA had climbed to 2.6--talked to Dr who did my surgery and recommended biopsy of area where prostate was---results came back positive for cancer in prostate area. Radiation was recommended and 35 treatments were performed over app 2 month time frame---PSA now at 0.0 again. I just had some blood work done yesterday 9Feb23, (6 months after surgery) am awaiting results which should be available 13 Feb 23. Fingers crossed

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@gpaluvsaces

was diagnosed with prostate cancer in 2013--recommendation was radical removal of prostate as best treatment as it appeared cancer was localized in prostate -(horse was in the barn my Dr said) so get rid of barn and problem goes away. Prostate was removed and PSA was 0.0--all good until 2022 mid year discovered PSA had climbed to 2.6--talked to Dr who did my surgery and recommended biopsy of area where prostate was---results came back positive for cancer in prostate area. Radiation was recommended and 35 treatments were performed over app 2 month time frame---PSA now at 0.0 again. I just had some blood work done yesterday 9Feb23, (6 months after surgery) am awaiting results which should be available 13 Feb 23. Fingers crossed

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I had almost the exact same situation. I’m now on my second recurrence. I’m now at 0.73 on my PSA. Both of my doctors said to wait on the next treatment. They don’t want to rush me into Hormone Therapy.

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What do most Gleason 8 patients do for treatment

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@gpaluvsaces

was diagnosed with prostate cancer in 2013--recommendation was radical removal of prostate as best treatment as it appeared cancer was localized in prostate -(horse was in the barn my Dr said) so get rid of barn and problem goes away. Prostate was removed and PSA was 0.0--all good until 2022 mid year discovered PSA had climbed to 2.6--talked to Dr who did my surgery and recommended biopsy of area where prostate was---results came back positive for cancer in prostate area. Radiation was recommended and 35 treatments were performed over app 2 month time frame---PSA now at 0.0 again. I just had some blood work done yesterday 9Feb23, (6 months after surgery) am awaiting results which should be available 13 Feb 23. Fingers crossed

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Looks positive- if PSA dropped to 0 after the Radiation treatment- looks like you got it covered. Good luck with the blood tests

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@shelby29

What do most Gleason 8 patients do for treatment

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I was Gleason 8 & 9 in 2013, then had RP. Just had recurrence of .2, .3 late 2021. Then radiation early 22'. Had my 6 month PSA about a month ago and fortunate to have undetectable. Next 6mos is July. Hopefully your medical team is working with you. One thing I learned is to ask the doctors questions, and not afraid to ask "why and what are options."

All the best to you!

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Rp in 2018. 36 radiation and 3 mos orogovyx in 2021. Psa undetectable until 12/15/22 then .26. Psa on 2/15/23-.32. Urologist appt on 3/6. Thoughts , suggestions ,treatment recommendations , next step?

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I’m in the same situation. Had RP in 2006. 39 radiation treatments in 2013. Now my PSA is 0.73. My doctors are just waiting and watching me . They both said the next treatment would be LUPRON.

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@firespooks

I’m in the same situation. Had RP in 2006. 39 radiation treatments in 2013. Now my PSA is 0.73. My doctors are just waiting and watching me . They both said the next treatment would be LUPRON.

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What are they "waiting and watching" for?

Have they discussed with you the clinical data which will cause them to recommend you start treatment - at what PSA, will PSA doubling and velocity times be a factor, when and with what will they image...will they do any genomic testing...?

Having that type of clinical data combined with your personal health and preferences for quality of life, aggressive treatment or not...can inform any decision between you and your medical team.

The imaging could show recurrence in only the lymph nodes, if so, how many and where. Or, it could show bone and, or organ involvement. If so, where...depending upon the PSADT and PSAV, you and your medical team may decide to not doing anything and continue to actively monitor, if the PSADT

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@itterac

Rp in 2018. 36 radiation and 3 mos orogovyx in 2021. Psa undetectable until 12/15/22 then .26. Psa on 2/15/23-.32. Urologist appt on 3/6. Thoughts , suggestions ,treatment recommendations , next step?

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Next steps - gather clinical data, consider bringing a radiologist and oncologist on to your team, a multi-disciplinary approach.

Gather the clinical data to inform any decision between you and your medical team to start treatment - at what PSA, will PSA doubling and velocity times be a factor, when and with what will they image...will they do any genomic testing...?

Having that type of clinical data combined with your personal health and preferences for quality of life, aggressive treatment or not...can inform any decision between you and your medical team.

The imaging could show recurrence in only the lymph nodes, if so, how many and where. Or, it could show bone and, or organ involvement. If so, where...depending upon the PSADT and PSAV, you and your medical team may decide to not doing anything and continue to actively monitor, if the PSADT

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@kujhawk1978

What are they "waiting and watching" for?

Have they discussed with you the clinical data which will cause them to recommend you start treatment - at what PSA, will PSA doubling and velocity times be a factor, when and with what will they image...will they do any genomic testing...?

Having that type of clinical data combined with your personal health and preferences for quality of life, aggressive treatment or not...can inform any decision between you and your medical team.

The imaging could show recurrence in only the lymph nodes, if so, how many and where. Or, it could show bone and, or organ involvement. If so, where...depending upon the PSADT and PSAV, you and your medical team may decide to not doing anything and continue to actively monitor, if the PSADT

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Yes. They have discussed PSA doubling time and rise and scans and testing. I’m just not ready for further treatment.

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