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Rising PSA years after radical prostatectomy

Posted by olanordman @olanordman, Feb 22, 2021

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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michaelcharles | @michaelcharles | Mar 22 9:18am
In reply to @fmcallister1954 "I had my prostate removed in July 2019; 5.8 years ago. My PSA has been rising..." + (show)
@fmcallister1954

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

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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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