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Rising PSA's after treatment - an answer

Prostate Cancer | Last Active: Jan 11 8:59am | Replies (31)

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@kujhawk1978

My RP was nerve sparing. I was on Cialis and gained erectile function around the 12 month point.

When the nurse pulled the catheter out after my RP, I had zero incontinence.

The SRT has had no affects on either erectile or urinary functions almost eight years after SRT.

Question is, why? In part, the skill of my surgeon, the radiologist and her team, the advances in the technology and software for planning and delivering radiation treatment.

Kevin

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Replies to "My RP was nerve sparing. I was on Cialis and gained erectile function around the 12..."

Thanks for the quick reply. I am also lucky as my Urologist was at a center of excellence and world-renowned for his robotic surgery skills. 18 months later my erectile function is about 85-90% with no drugs and just about 100% with Cialis. I know I'm getting ahead of myself (which is easy to do with anyone experiencing a cancer diagnosis) but the reason for my curiosity is my uPSA was < 0.02 for 18 months and just today it came back =0.02 instead of < 0.02. I realize 0.03 is a more reliable early-sign of biochemical recurrence but I'm trying to mentally prepare. (History: pre-RP, 3+4 Gleason, 7 of 12 cores, tumor in the middle area instead of peripheral which typically has higher chance of cure but ironically higher PSA, mine was 29 (54 yo) so technically that alone classified me as "high risk." But post-RP Pathology was excellent. No extracapular extension, seminal vesicle invasion, no positive margins, and nothing in my extended lymph node removal. But there is such a thing as micrometastases.)

I moved out of state since the RP so I just was having my Primary Provider order the uPSA so the downside is I don't have a Urologist to give me a call to say, don't read too much into the test result change to try to calm my nerves.

I was just pondering long term if this wasn't just an anomaly in the test result what I'm in for down the road if it keeps going up. I'm also curious at what point does private insurance cover salvage RT? I hear Viewray went out of business so guided MRI is not an option right now, not that I'm anywhere close to needs that. But at least your story gives me comfort that sounds like worse-case in X years, I may need salvage RT and may just need to up my Cialis dose a bit.

Again, getting ahead of myself but needed to get this off my chest without any Urologist to talk to right now. I guess not at least starting a patient relationship when I moved wasn't wise but wishful thinking I'd never need one, at least for the PCA diagnosis, for the rest of my life.

Another issue is I'm on the most expensive private medical insurance plan you can buy in case I needed salvage RT. Was looking forward to downgrading from Platinum to Gold and save some money but now I'm thinking I should stay on Platinum even though on Gold out of pocket costs on PSA tests are $28 instead of $0. (My platinum plan covers all labs and imaging 100% regardless if deductible has been met.) But at my levels, I'm even wondering what is the chance I'd need salvage RT next year? Imaging is worthless at the lower PSA levels they generally recommend starting salvage RT at. I guess it's really a guess not knowing your velocity yet or if it was just an anomaly.