How do you fight anxiety from rising psa

The next step is to get salvage radiation. That is what is recommended by almost all the doctors when your PSA hits .2. I had it when mine hit .2 3 1/2 years after my prostatectomy.

As for the anxiety, Exercise Can make a big difference for some people, Getting out there running or walking going to the gym.

Common drugs for depression and anxiety are
Wellbutrin, Zoloft, Effexor, Buspirone, Cymbalta, Lexipro, Prozac, Celexa, Paxil, Escitalopram
You want to speak to a doctor about getting something to relieve the anxiety.

I’ve had prostate cancer for 16 years, have had four reoccurrences and at this point I’ve been getting PSA tests every month for eight years. The anxiety just goes away after a while. I don’t worry about my test results. I get them the next day. I don’t have anxiety, but it takes a long time for that to go away. Don’t feel like something is going wrong when you feel that way, It happens to almost all of us.

Here’s a recommendation from the American Society of clinical oncology for what to do after your PSA rises following a prostatectomy.

From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.

0.2–0.5 ng/mL:
Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.

0.5–1.0 ng/mL:
Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.

This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/

"How do you deal with the anxiety?"
"Single malt"
"But it's 7 o'clock in the morning"
"Well then, float a Cheerio in it"

Kidding aside...best wishes.

Hi,

My humble non medical opinion would be to get a PMSA PET scan to see if you can find the cancer. But at lower levels sometimes nothing will show on the PET scan. Your doctor might want to put you on some type of ADT drug to slow down the growth of the cancer. Your doctor team should help with your treatment forward. Sorry but dealing with Prostate cancer is never easy mentally.

Dave 3+4

@marlite1

On this web site somewhere, one of the patients mentioned that they give themselves a treat before the blood test so that it becomes part of the "worry" process. For me, every three months, before my blood test, I treat myself a nicer golf course and try to avoid thinking about my golf score...unless I played well.

You don’t mention Salvage Radiation therapy, which is usually standard procedure. The Lupron will suppress growth /spread but will not destroy the cancer on its own.
Phil

You say:

Had prostate removed 2021 - do you have the pathology report?

Radiation soon after PSA rose - was this SRT to the prostate bed?

After - 3 years put on Lupron - does this mean that for three years after the radiation you mention, your PSA was "undetectable or went down, if the latter, what was the Nadir? Were you on Lupron for a defined period or continuous?

Now PSA rising was .1 now .2 what could be the next step. That depends on the answer to the question, are you on Lupron and your PSA is rising or did you come off and after a time, PSA returned. The former may indicate castrate resistance, the latter has a different answer from the forum.

How do you deal with the anxiety? In part, may depend on the answers to the questions.

Kevin

How to deal with the anxiety of rising PSA? A few things that have worked for me:

- accept that the anxiety is normal, and that it’s not just you. Try not to make it worse than it is (i.e, don’t worry about worry)

- if you wake up in the middle of the night with anxious thoughts, don’t lie in bed and try to fight them. Get up and do something to refocus your mind—read, do some relaxing stretches, scratch the dog, wash the dishes, fold laundry, whatever works. Go back to bed when your mind has cleared.

- don’t be a “suck it up” stoic about the anxiety. Share your feelings with those who are close to you, or in a forum like this.

- as Jeff said, exercise can be a big help. Can be as simple as going for a walk or doing some gentle stretching exercises

- try to place yourself in the present rather than the “what if” future. Not easy, but your ability to do this gets better with practice.

- just like PCa itself, accept that you don’t defeat it as much as you learn to live with it and keep it in check.

- if all else fails, seek professional help from your medical team.

Next step? Sounds like a PSMA PET scan is in your immediate future to look for possible recurrences(s).

Best to you,
Mel

From my experience it was a shock to find out I had a tumor with PSA at 3. Biopsy confirmed Gleason 9 Grade 5. Yeah, I was shocked. I was anxious and the testing process always seemed too slow. So once I had the information and the RP I focused on the things I could do. The big one was acceptance that my life had changed, from then on I used the term "the new me" at each stage. I started hiking and spent a lot of time with my guys. I got fully engaged in life and got in really good shape to mountain bike and officiate my sport of choice. 3.5 years later, post radiation due to BCR I once again have a new me that has been ongoing for 13 months. Frankly I am so over this one but keep moving, pushing, cutting out time to rest and spend with my wife, exercise and mountain bike. Radiation took officiating away from me. No more running. I find it extremely helpful to change what is in front of my mind, as I believe it will focus on what is in front of it. Probably the most important thing I can do for my mental health.

THC (syrup) was a game changer for me in the leadup to treatment. Tiny amount from zero to 4 times per day as needed, usually only once before bedtime. Also focused on one step at a time in diagnosis and treatment. This helped with my anxiety.

@chippydoo

That's it Chippy! Stay active, keep the brain engaged and happy. I'm also a G9 and yeah, it can come back. I'm almost expecting it to so if/when it does, I'm ready! I walk everyday and run 3 days a week. I feel great right now. Keep active and try to eat the right things.

Guys, WE GOT THIS!