1. < Prostate Cancer

Rising psa 15 years after radiation: Is cancer back?

Posted by sharlee @sharlee, Mar 28 2:25pm

I had radiation 15 years ago and I recently had my psa go to 2
Does that automatically mean the cancer is back.
I'm scheduling a PET Scan per my urologist.

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jeffMar | @jeffmarc | Apr 2 10:20am
In reply to @heavyphil "I understand that you are only the messenger, but what they’re saying is really SO different..." + (show)
@heavyphil

I understand that you are only the messenger, but what they’re saying is really SO different from what we’ve all been told. Basically, they’re saying that SBRT to a lesion is more effective than salvage radiation because you can see it - it’s targeted.
But if there is a mass (greater than 2.7mm since PSMA can detect it) that you CAN see, it has to mean that there are micrometasteses that you CAN’T.
Isn’t that the current thinking? Or not? Are they including ADT in the treatments? Salvage radiation, at the very least, will take care of residual cells in the prostate bed and pelvic nodes - a site which if left untargeted will be a cause for treatment failure.
I know these are two highly respected men and I’ve watched a few of their YouTube videos. Personally I’ve found Scholz very blase’ and somewhat wishy-washy in his approach - almost like, why treat at all? It’s weird…probably more my problem than his!
Phil

Jump to this post

You might go to the PCRI Video and watch the last hour and a half. That’s about how much time Moyad and Scholz Spent talking about this annd other issue.

Scholz Just seems to be convinced that most people with metastasis can have SBRT and not have it come back. As I mentioned, he really did emphasize how it can be curative. We know he sees a lot of people, I know that a few people in two of the Online groups, I am in, have used him as a second opinion.

This definitely does leave us with some anxiety about what’s going on with prostate cancer in the future.

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jeffMar | @jeffmarc | Apr 2 11:37am
In reply to @melcanada "Yes I did radiation 39 times in 2017 March Make sure last 5 are RAPID arch..." + (show)
@melcanada

Yes I did radiation 39 times in 2017 March Make sure last 5 are RAPID arch to get the margins

Then get on Cosedex and later Zolodex injections to stop testosterone the fertilizer of PC

In 202 it metastases to my bones Then its Stage 4 and not curable Only controllable

I have been on Xtandi, Radium 223 , 2 sets of Chemo and now Abiraterone with Prednisone as well as Xgeva injection every 3 moths

Google all these

Next year LU 177 Pluvicto

Pray It does not come back @northoftheborder @heavyphil ill

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It is surprising to see somebody switching from a Lutamide to Zytiga.

Did Xtandi stop working For you or did you switch to Zytiga before that happened.

Some study showed that switching from a lutamide to Zytiga after the lutamide failed is only effective in 5% of the cases. Is your PSA staying near undetectable with Zytiga?

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1 reply
melcanada | @melcanada | Apr 2 12:31pm
In reply to @jeffmarc "It is surprising to see somebody switching from a Lutamide to Zytiga. Did Xtandi stop working..." + (show)
@jeffmarc

It is surprising to see somebody switching from a Lutamide to Zytiga.

Did Xtandi stop working For you or did you switch to Zytiga before that happened.

Some study showed that switching from a lutamide to Zytiga after the lutamide failed is only effective in 5% of the cases. Is your PSA staying near undetectable with Zytiga?

Jump to this post

Xtandi failed after a year Then Radium 223 then 2 chos lungs got fluid Now Abiraterone with prednisone

REPLY
northoftheborder | @northoftheborder | Apr 2 1:38pm
In reply to @heavyphil "I understand that you are only the messenger, but what they’re saying is really SO different..." + (show)
@heavyphil

I understand that you are only the messenger, but what they’re saying is really SO different from what we’ve all been told. Basically, they’re saying that SBRT to a lesion is more effective than salvage radiation because you can see it - it’s targeted.
But if there is a mass (greater than 2.7mm since PSMA can detect it) that you CAN see, it has to mean that there are micrometasteses that you CAN’T.
Isn’t that the current thinking? Or not? Are they including ADT in the treatments? Salvage radiation, at the very least, will take care of residual cells in the prostate bed and pelvic nodes - a site which if left untargeted will be a cause for treatment failure.
I know these are two highly respected men and I’ve watched a few of their YouTube videos. Personally I’ve found Scholz very blase’ and somewhat wishy-washy in his approach - almost like, why treat at all? It’s weird…probably more my problem than his!
Phil

Jump to this post

"But if there is a mass (greater than 2.7mm since PSMA can detect it) that you CAN see, it has to mean that there are micrometasteses that you CAN’T."

Yes, there may be — that's why they don't talk much about a "cure" for stage 4 prostate cancer, oligo- or polymetastatic.

I think the idea is that we use ADT + ARSI (say, a -lutamide) to keep those individual cancer cells and "micrometastases" dormant, or at least, to slow their progression down to a crawl, then we zap any big ones that do manage to grow.

One line of thinking is that big tumours might provide critical support to help smaller ones to grow, so zapping the big ones may even help ADT and ARSI to keep the little stuff dormant.

It's definitely a bit like playing whack-a-mole right now, keeping stage 4 under control, but at least we some decent mallets now to whack with.

REPLY
1 reply
heavyphil | @heavyphil | Apr 2 3:07pm
In reply to @northoftheborder ""But if there is a mass (greater than 2.7mm since PSMA can detect it) that you..." + (show)
@northoftheborder

"But if there is a mass (greater than 2.7mm since PSMA can detect it) that you CAN see, it has to mean that there are micrometasteses that you CAN’T."

Yes, there may be — that's why they don't talk much about a "cure" for stage 4 prostate cancer, oligo- or polymetastatic.

I think the idea is that we use ADT + ARSI (say, a -lutamide) to keep those individual cancer cells and "micrometastases" dormant, or at least, to slow their progression down to a crawl, then we zap any big ones that do manage to grow.

One line of thinking is that big tumours might provide critical support to help smaller ones to grow, so zapping the big ones may even help ADT and ARSI to keep the little stuff dormant.

It's definitely a bit like playing whack-a-mole right now, keeping stage 4 under control, but at least we some decent mallets now to whack with.

Jump to this post

You hit thr nail on the head, North. Yes, SBRT for metastases but you MUST be on some form of hormonal therapy as well.
It DOES keep you alive, but all the SE’s still make me gravitate toward salvage radiation if I have a chance of stopping it there.
And I don’t doubt for a second that there may be some kind of communication or signaling between the larger tumors (or the gland itself aka”the mother ship”) and the microscopic ones always lurking.

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Moderator
Colleen Young, Connect Director | @colleenyoung | 4 days ago

@sharlee, have you met with your urologist or oncologist? Any update?

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