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Rising PSA years after radical prostatectomy
I am 60 years and I had radical prostatectomy on 23rd Nov 2018. I was told out of the 15 lymph nodes taken only one was affected less than a millimetre. It was Gleason score 7B with PSA around 13 at time of surgery but 11 at time of diagnosis in June 2018.
The PSA been fluctuating between 0.09 and 0.18 since surgery on 23rd November 2018
I have no incontinence as well as Erectile dysfunction. I take hypertension medication – Norvask Amlodipine 5mg daily and Cetirizine 5mg for allergy. Below are some of the test results. I have many of these test results – a few below
Jan 2019: 0.11
April 2019: 0.11
June 2019: 0.09
August 2019: 0.12
December 2019: 0.12
April 2020: 0.12
August 2020: 0.11
October 2020: 0.17
December 2020: 0.15
February 2021: 0.18
I am worried the cancer may be returning or might have spread. I met my doctor today and expressed my concerns. He has agreed to refer me to the hospital where I had the surgery. Any suggestions based on this brief history?
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The future is always uncertain with PCa.
However, a friend is completing 7 wks of Salvage Radiation Treatment w/o ADT this week at a MD Anderson facility in NJ.
His PSA rose slowly over the last 5 yrs since his RP.
He is doing well, his radiation treatment has been uneventful and he is looking forward to ringing the bell next Friday.
I sincerely hope that is not your course; but know that Salvage Treatment generally is not horrible.
Especially if you can avoid ADT. See SPPORT trial results for breadth of radiation.
I had a short course of ADT as part of my Salvage Treatment and it seems that some men with recurrence are having radiation only.
Either way, I have hope and confidence that you will do well if additional treatment is needed.
Best wishes.
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2 ReactionsMine was all that too - not as many nodes, however.
Just find a few articles on salvage radiation and pelvic nodes - sorta new, maybe 2 yrs? Best,
Phil
My pathology was Clear Margins, No SV or LN involvement, had 1 bundle nerves removed, and 4 Lymph Nodes Removed, all clear/negative.
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1 ReactionYou’ve got a ways to go before you hit the magic 0.20. My PSA took exactly 5 yrs to go from .02 to .18.
If you do get salvage radiation down the road make absolutely SURE that they radiate the pelvic lymph nodes as well- not just the prostate bed.
Failure occurs when those nodes are not treated. Best,
Phil
I had my prostate removed in July 2019; 5.8 years ago. My PSA has been rising Slowly since at the lowest it was 0.008 in Dec of 2020. since then, it has been rising. I am currently @ 0.074 last PSA test on 14 Feb 25. I was told a slow PSA increase is consistent with a small cancer somewhere in the prostate bed, rather than distant spread. I do not know how true that is, still under 0.1 though, I am hoping the latter of that statement, the consistent part with only in the Prostate bed is correct. Dr says at this point will not show any thing on a PSMA scan. Maybe after it gets to >0.1. IDK
Thank you Colleen. I did a PSMA pet scan about 6 months ago that found nothing; disappointed in one regard but grateful in another...
They want me to do Lupron, I'm not willing.
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1 Reaction@jimlohman, I moved your question about elevated PSA years after radical prostatectomy to this existing discussion in the Prostate Cancer support group:
- Rising PSA years after radical prostatectomy https://connect.mayoclinic.org/discussion/rising-psa-2years-after-radical-prostatectomy/
I did this so you can read previous posts and connect with others in a similar situation.
Jim, what treatment did your team recommend? What did you decide?
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1 ReactionElevated PSA 17 years post radical prostatectomy surgeryPSA is >9 and PSMA scan found nothing.Any suggestions other than Lupron shots
Hey @urdblfs
A couple quick thoughts...
"I would like feedback also on diet and exercise...most part I am doing good on exercise but still from time to time eat junk/fast foods straying away from low fat diet."
If it's really just from "time to time", meaning not to often on occasion, well, you gotta live and enjoy life a little, otherwise what's the point. My weakness is at night I graze, crackers pretzels that kind of thing. All things in moderation right?
I always thought of it in terms of negating all that work in the gym if I ate junk food. Maybe that'll help a little, it does help me put the pretzel down.
"I have been working on pelvic, Kegels, core tightening, and going to restroom more"
All good things. Having said that though, have you tried to get the doc to prescribe some sort of specialized PT for this? If I was this far out, and otherwise healthy, I might get a little more aggressive on treatment. I'm no doc (and didn't sleep at a Holiday Inn last night....) but if you're down to two pads a day, you seem really close to fully continent. I might look for some help to get over that line.
That wasn't something I was aware existed prior to reading all the experiences of the kind folks on here. If I had known it was available, I'd have done it. Luckily now, there's no need, but it's in my back pocket should there be a slide in the wrong direction.
Best of luck to you!
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2 ReactionsThanks for the update, using this group support along with talking with others helps reduce my stress and anxiety.
I would like feedback also on diet and exercise...most part I am doing good on exercise but still from time to time eat junk/fast foods straying away from low fat diet.
In addition I still have incontinence (had surgery 2021), my understanding at this stage I will always have it but I have been working on pelvic, Kegels, core tightening, and going to restroom more and seeing much improvement to 2 pads per day along with going back to a therapist....any suggestions on this topic.