Should I be seeking extra treatment?
Hey guys and wives, this is my first post here but have been lurking a couple months. I have a pretty good heath plan at Kaiser in Southern California. I got my first PSA test last June at 56 years old with a result of 138. Immediate bone and CT scans were negative. Subsequent PET scan indicated no spread. Biopsy in July resulted in Gleason 9 (4+5) and PNI. started casodex and PSA had declined to 80 before RARP in late September. Pathology indicated 1 of 10 lymph nodes positive, seminal vestical and bladder neck invasions. No mention of cribriform. PSA of 9.4 six weeks after surgery. Had another PET scan mid December and lit up a bit in soft tissue near sacrum and rectum. Started Lupron (24 months) and SBRT in January on a TrueBeam (35 sessions). PSA in April was .3 and latest June results are < .1. I have an appointment tomorrow with urologist and have some topics to discuss including sexual health since I have severe ED. Bone and heart health. Pelvic pain issues. Also interested in more treatments I’ve read about here like adding a second ADT drug like Erleada, Estradiol or Eligard? Anticipating some reluctance since PSA is “undetectable”. Any thoughts on questions or treatments I should ask about? I’m very active and in pretty good shape, doing some weight training and coming out of the initial Lupron aches and pains that wrecked me after second 3 month dose. I’ve switched to a one mont dose and getting another tomorrow as well. Still have a bit of pain near rectum and in genitals, mostly in testicles, is that normal? Thanks for reading this far, if you have any tips or suggestions for questions to ask it is appreciated.
Brett
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Dang! Hope your treatments are successful and smooth as possible. Regarding the pump, I too bought on Amazon but the one I recently got from my doctor is a bit different and uses a ring ejection mechanism that holds the blood in better. The ADT is obviously going to work against you but try and stay in the game. That’s what im doing, only 10 months post surgery but send a lot longer.
Thanks for the kind words if they directed at me, I’m very thankful for my progress thus far.
The Zytiga is in fact what the oncologist recommended today for two years. Reluctant to sign up for that wit an undetectable PSA right now. She also ordered a pet scan, anything that showed up on it would likely be reflected in PSA levels yes? Would a different type scan be better in your opinion? Thanks again!!
A PET scan is a good idea, But if your PSA is undetectable, it is unlikely to show anything. Is it a PSMA pet scan she set you up for. If you have a large metastasis that might show. Considering Your history I wonder what it is that Makes her think a scan is necessary now, You’ve gotten over both surgery and radiation, not that long ago.
You should ask your doctor her thoughts on why she thinks a PSMA PET scan would really show anything with your PSA so low. You could do this in an email.
If you have a previous CT scan to compare against, that might be an idea. Not great.
An Axumin or FDG scan may show something, The FDG would show cancer better I think.
Usually people just don’t get tested when they’re undetectable.