Rising PSA after 17 years

I have seen quite a few people in your situation when I attend the weekly advanced prostate cancer meetings with Ancan.org people come to the meetings asking what their next steps should be.

When your PSA hits .2 it is recommended that salvage radiation is done. In my case, it was 3 1/2 years after surgery before my PSA started rising, had salvage radiation and it gave me another 2 1/2 years before it came back again.

In your case, salvage radiation may give you many more years. They’ll probably want to put you on ADT as well, Six months of ADT could make the difference between reoccurrence and many more years of undetectable PSA.

One of the Participants that came into the meeting a A few weeks ago had it reoccur after over 30 years. His PSA was also around 175 but a PSMA PET scan showed nothing. His PSA has been high for a few years, but his cancer had not progressed.

PSA of 175??!!…and nothing showed. Will he do an Axumin scan or let it ride? PSE??Pretty scary when you hear things like this, Jeff.

He was recommended to do an FDG scan. That supposedly shows more than an axumin. His PSA Had been above 100 for a few months and then hit 175.

Is he someone that produces PSA but doesn’t produce PSMA So that scan shows nothing.

Jeff,

Thank you for your input. Much appreciated. I'm kind of starting to wrap my head around what radiation and ADT might mean for me. Sounds like everyone is unique...??? Sounds like some people have minimal side effects some significant. Time will tell. Thanks Again!

I had my prostate removed 14 tears ago at the Mayo Clinic. I’m now 77 yrs old. A few years ago my PSA started to show up from less than zero. It has been steadily rising and I am about 2.7. I just had my 3rd scan and no cancer was found. About 3 yrs ago it was zero.

I am now also on dialysis due to uncontrolled high blood pressure. Not sure if I should be worried.

Don’t….focus on you kidneys!

stratjag, thank you for your input. I wish you all the best on every aspect of your health!

10% of people with prostate cancer show no rise in PSA, even though the cancer has spread. In some cases, they do not produce PSMA as well, so the scan doesn’t show anything.

In that case an FDG scan is recommended by many knowledgeable doctors, To see if You have Metastasis that it cannot be seen by a PSMA Pet.

I had my prostate removed 15 years ago And 3 1/2 years later had radiation because my PSA rose to .2. That gave me 2 1/2 years more with undetectable PSA Before I had two more reoccurrences. They didn’t have the PSMA pet back then so they could not see any spread, But the radiation did work. I’m now 77 and my PSA Has been undetectable for the last 16 months. Darolutamide alone works well for me, after 8 years on ADT.

I got high blood pressure from ADT and Zytiga. I’m on three different blood pressure medicines to keep it under control, Which it does very well. Did they try multiple different types of BP meds Before putting you on dialysis?

On my morning walk, I walked with a recently retired, cardiac surgeon. I asked him about somebody being on dialysis to resolve blood pressure problems. He could not understand how dialysis could have anything to do with your actual blood pressure. Dialysis has a lot of risks and you have to have ports for it in your body.

He thought you had some other problem that required dialysis and that ended up stabilizing your blood pressure.

Jeff, uncontrolled HBP causes severe kidney damage leading to kidney failure.
Perhaps he thought that the dialysis was being used to actually TREAT the HBP, which makes no sense.
Unfortunately, many HBP meds actually cause kidney damage. I watched my own kidney function steadily decline on 3 different meds - all which used the kidneys to regulate BP. My physician wasn’t concerned….
I demanded one which did not target the kidneys, but the smooth muscle of the arteries. Kidney function (GFR) zoomed back up to normal.
A dear friend is facing dialysis right now because of being on the same drug I was on for 10 yrs.