Post prostatectomy: What do rising PSA levels mean?

I don’t believe cryo is an option for salvage treatment and he has no prostate so seeds are out too. Only option left is some form of EBRT

Hi Phil,
It’s been a while but have read of cyrogenic options and obviously the seeding with radioactive seeds. The cryogenic seemed to be very new back in 2014 when I had my radical prostatectomy. Al

Hey conchman, We are in similar situations in regards to RP/ salvage tx.
What alternative other than ADT - which has it’s own set of side effects - are there? And I don’t mean diets, supplements or any of the non medically approved regimens out there. Thanks!
Phil

Wojo ,
Follow the Drs that you’re working with. I had RP removal and margins were clear……… for 6 years. The numbers started rising. 39 treatments of radiation treatments. That was in 2020. Sorry to say , buts lots of issues followed 2 years later. I would ask about ANY type of alternate therapy to radiation IF it comes to this later. Sorry this is so negative , but just want to stress to look at options versus automatically going with routine radiation. Best of luck to you.

Hi,
I'm 3 months from robot surgery extracting my prostate. I feel good. Leaking is improving. Hower, I had my 3 month checkup today and my PSA was 0.1. That sucks. Unfortunately he's confident that he could not get all of it. Pathology said that some cells perhaps broke free of the encapsulation. Another PSA test in 3 months. We talked about all that could or could not lie ahead. May have to get radiation therapy. What a day!

@samadhi, you've received a lot of helpful replies from members. Is your oncologist concerned about the rise in PSA levels? Are you currently taking any treatment or is treatment being discussed at this level?

I won’t call it luck but I will agree that I’ve been fortunate, even blessed. I’m fortunate that I found great care at Northwestern Medical in Chicago. I’m fortunate that my care team includes some of the most competent and compassionate people I ever hoped to meet. I’m fortunate that they’ve figured out improved ways to detect PCa beyond the 2019 study you cited. I’m fortunate that my known metastasis on recurrence was limited to two pelvic lymph nodes and that I was a candidate for salvage RP after failed focal brachytherapy 2020. I’m fortunate that the cancer that they were unable to reach and remove during salvage RP this January still showed up on the subsequent PET-PSMA scan with only a 0.44 PSA reading and is being used to guide my upcoming salvage RT.

I wish you success on your journey with PCa and hope you wish me the same success.

38% chance of detection at .4 PSA per the internet. 87% chance of detection when > 4.0 PSA. Look this up . You got lucky.

Thanks for sharing the charts. As I have been on this journey with recurrent PCa and as a retired engineer/scientist, I try and read as many relevant publish medical papers as possible. I fully understand and appreciate that a when a scan is done on a patient having lower PSA, the scan may not be sensitive enough to reveal all the lesions present within a patient’s body, especially if the prostate is still present within the body. At any level of PSA, it’s one of the best tools that’s ever been available in helping to diagnose PCa and guide treatment protocol.

Best wishes for success on your personal journey.

Correction: Post RP PSA target < .1
(not < .01)
Following Salvage Treatment Rad Onc ordered Ultrasensative PSA testing and 6 and 9 mos uPSA has been < .02 (Quest Labs limit of detection therefore deemed "undetectable").
Coincidentally, had uPSA blood draw this morning for 3rd post treatment uPSA, now 12 months since Salvage Tx completed May/June 2023.
Best to all.