Rising PSA years after radical prostatectomy

Thank you web265 for your response. I appreciate you sharing your salvage radiation experience. I suspect I will follow a similar path and hope the side effects are not too bad. What is your PSA now? As for my undetectable PSA, all I can say is that it was <0.01.

I would think scans, SRT radiation and they will likely suggest ADT therapy as well. My jump in PSA percentage wise was very similar to yours.

I wish I could find the chart but I'm not having any luck. Someone posted a chart in here that showed a correlation between PSA level and positive results from a PSMA scan (meaning finding cancer). I had the scan but none was found. (my PSA level was only .091 at the time, but rising quickly) Maybe this will trigger a repost 🙂

I'll tell you that I was dreading getting this treatment, but, it really went by rather quickly and I was lucky to not have side effects that were too bad. If this is the route you take, hopefully you'll have a similar experience.

If I may, how do you define undetectable when taking the ultra-sensitive PSA Test?

I am six months post RP and my PSA jumped from "undetectable" 3 months ago to 0.51 today. Waiting to speak with my urologist. I assume scans and radiation are in my future but I'm seeking advice and suggestions from others who have been here before me.

It's obviously an annoyance with regard to the way it's done, every weekday at the same time for 40 days (weekends and holidays off at my treatment center). Once you get fitted (tattooed, markers inserted if necessary) it only takes about 5-7 minutes to get the treatment. The issue here is they wan't your bladder "as full as you can stand it while still being able to stay still on the treatment table." It can take a little trial and error to figure out how much water to drink and how long before treatment. Mine was 24-28 ounces one hour before.

Side effects... different for everyone, mine were VERY minor I'm told...
At first it was actually hard to notice anything different, then by about #13/15 I started to get digestive changes/symptoms. I'm a "one a day guy" normally. Then the treatments seemed to aggravate my bowels somewhat to a point where it often took a couple bowel movements before I felt emptied. My anus seemed to be sore as well. There were maybe 3 or 4 bouts of diarrhea that I couldn't otherwise explain too. By about treatment 3O I experienced some fatigue issues, particularly a few hours after treatment (mine was at 9:20 AM). I found it took a herculean effort to get through workouts too. My normal 2 mile run was really tough to get through.

Now at one and a half weeks after ending, I can already feel the difference in energy levels, soar through the runs again and don't have to struggle to end the workout. Getting through the days with no naps again as well.

Really, the only reminder at this point, is the occasional hot flash from the orgovyx. It feels like those are becoming less frequent as well. It seemed daunting when getting ready to start of course, but, now it feels like it all went pretty quickly.

Good Luck to You!

Your PSA scores since the surgery have remained very low.
After 4 years its worth getting a Pet PSMA scan which picks up any possible cells that may have cancer.
This is via absorption of isotopes which show up in a different color.
I had the prostate removed in Sept 2018 but the PSA rose rapidly and reached 5.17 recently.
I had a few sessions of radio therapy to treat lymph nodes that showed up on the scans.
Your situation looks excellent but take the Psma pet scan to be at ease

Thank you for your quick response. Still trying to decide on radiation treatment. Don't know if I should have PSMA now or wait until after next result psa in October. What a mess, huh?

The short answer is yes, but....
right after surgery I didn't take anything. It was nine mos before my PSA went from .039 to .091, at that point I went on orgovyx and started radiation (SRT) for 40 treatments.

There are some who suggested to me that at those low numbers I may have jumped the gun on treatment and may have been better off waiting another couple months to see what the PSA did during that time period, my urologists are pretty aggressive I guess.

The radiation is over now and I'm down to .014 as of a couple weeks ago, and, still taking the drug. I'm not really certain how long my urologist is going to want me to take it, I tolerate it fairly well. I'll ask on my next follow up.

You may be thinking like I did, why don't they use the ADT as soon as you get diagnosed as an additional therapy and maybe to slow the spread while you make a treatment decision, then after surgery to help starve any cancer cells floating about in the nerves or capillaries? I'm planning on asking that at my next visit just to see what they say, someone here may have already asked that one. Haven't seen if that's the case.

Hi, did you take orgyvx after prostatectomy? Thanks

Not sure if the Orgovyx brings it to undetectable or just helps it. It all seems to be a bit of a crap shoot to me. It may be that the radiation knocks it down and the ADT helps keep it there, and/or (hopefully) starves off the last few stray cells.

My radiation oncologist told me that outcomes are only 3%-5% better with ADT than without. I took it under the "give me all ya got doc" principal. I'm in your shoes as well, but don't really know the docs plan for how long on the orgovyx yet. My guess is that may change depending on how well I'm tolerating it, which is pretty well.

Best of luck to you, hopefully it stays nice and low!