Slight PSA rise 9 months after radiation.

I wish you luck, you are relatively young and not at the age that they recommend ignoring a high PSA.

Dying from prostate cancer is extremely painful, people need morphine and then fentanyl at the end and are unable to even talk to other people there so dosed in order to stop the pain.

A Biopsy is a pretty simple test. If you let it go until you start feeling something, it may be too late to really treat you and allow you to have a long life.

I was diagnosed at 62 with a PSA of 6. The biopsy did find cancer. I’m still alive 14 years later because I’ve been regularly getting treatments even though I’ve had four relapses. I’ve been undetectable for nine months, but it will come back, each drug you get only last so long.

@racslider wrote "I'm not going to worry about it unless I have problems...."

I was diagnosed with stage 4 prostate cancer at age 56. I wasn't getting routine PSA screening (most health authorities around the world had stopped recommending it for men 50+ with no other risk factors), but it might have saved me a lot of grief. My "problems" were initially nothing more than an occasional pain in my middle spine radiating to my shoulder, which rapidly accelerated to balance problems (staggering sideways), and fully paraplegic in less than two months of the first symptoms.

When they found the tumour on my spine, they did a PSA test then and found it was at 67. I would have LOVED to catch earlier this when my PSA was still at 5, or 10, or 20, and maybe my prostate cancer could have been cured instead of just "managed" for the rest of my life. Fortunately, I'm responding well to treatments, and 3 years in I can walk again (with a spine full of hardware and cement) while meds are keeping my cancer completely dormant.

Yes, rising PSA alone isn't a diagnosis, just like smoke doesn't always mean there's a fire. But both are strong warnings to do more investigation (a biopsy is a very easy one), and you're wasting a potentially life-saving opportunity if you ignore them.

p.s. I'm not alone. From 2010 to 2018, after routine PSA screening declined as Dr. Ablin recommended, the number of advanced prostate cancer cases has risen by 43% because we're not catching it early as often any more. The medical community *did* listen to him, and he was wrong. https://www.webmd.com/prostate-cancer/advanced-prostate-cancer-rise#6477bfe8-c64c-4989-9ba7-b0597bc9cb76-1-3

I forgot to mention that if you get it treated early, they may be able to completely cure you. If you wait until you feel it that won’t happen.

You are the veteran of PC knowledge to me. Don t ya think that at some point a drug will be found? ie… pluvicto, the latest one to find and eliminate the double helix of the cancer cells adm. via chemotherapy. Another person here pointed out a future vaccine to stop the cancer like we did with Covid.

@ecurb wrote "Don t ya think that at some point a drug will be found?"

I can't answer for @jeffmarc, but I for one very much hope we'll have a cure for advanced prostate cancer some day.

The thing is, even if it happens, that drug won't reverse any damage the cancer has already done. My spine, for example, won't rebuild itself; someone else's damaged kidney or pancreas won't regenerate; a honeycombed pelvic bone won't suddenly become strong and resistant to breaking again; etc. Once cancer spreads, it leaves an irreversible trail of destruction through your body.

That's why it's so valuable to catch cancer early, when it's still confined to the prostate.

You sound a lot like me! Just watched my PSA go from 5.75 in 2016 to 17.5 in late 2022. Didn't want to do a biopsy but did 4 MRIs over that time. Saw a tiny lesion of about 5mm (older Tesla machine) grow to about 11mm. At that point PSA was 12.3 and i still resisted a biopsy. My thoughts were that once you are on that track with an elevated PSA and visible lesion on MRI, you were destined for the knife or radiation. both of which terrified me.

I am very familiar with the short-comings of the PSA test and used that as an excuse. However, I did know that in the vast majority of cases, high levels of PSA equate to greater chance of mets. Sure someone may get to a PSA of 50 or so with none but they are the outlier. Dr. Shultz of PCRI.com fame mentioned a few of these cases in a symposium I listened to.

When my PSA got to 17.5 late 2022, I went ahead with a biopsy. I knew if would mean treatment but was also cognizant of the pain with a prostate cancer death as my father passed away from it.

I went with proton beam therapy and now know that my fears of treatment were way, way overblown. No ED, no meed for meds and came away wishing I had moved earlier.

Ultimately, you have to decide what works for you. Have you at least done an MRI?

Wishing you the best.

Pluvicto works great for 33% of the people. Works Midling for 33% and doesn’t work at all for 33%.

You also have to have your cancer expressing PSMA for it to work in about 10% of people don’t have that.

After Pluvicto there is Actinium. Pluvicto is a beta particle. Actinium is an alpha particle and has not been approved for you in the United States yet but is used in Europe. It is more effective and can be targeted more narrowly. The problem is it sometimes totally kills peoples salivary glands, and they can no longer produce saliva. I know someone who tried it went to Austria and was treated there, but he had some non-PSMA cancer and it didn’t work.

They are working on targeted therapies that work on the individual. Something like this may eventually cure prostate cancer completely but it’s very expensive since it’s only designed to work on one person.

Yes, there will be a cure one day, quick question as well we live long enough to see it

Men can have high (but not super high) PSA from benign prostatic hypertrophy and from stimulation of the prostate from direct pressure on the prostate (cycle riding or sex). But a continually rising PSA or a year over rise of >20% is concerning for prostate cancer. Yes, you are correct that most men will die of something else than their prostate cancer. About 80% of prostate cancers are of the more indolent variety that usually doesn't kill the patient. But 20% are aggressive and are linked to rising PSA. Those cancers will metastasize and kill you. There are very good treatments available today. I hope you don't have the disease but putting your head in the sand, misinterpreting what your urologist is saying is not the best thing for your health.

Good luck whatever you do.

You're probably correct.
I guess it's more attitude now for me. I live alone, I'm not that important to anyone... So, you gotta die of something I guess. :/
Thanks for giving me something to think about

No sir I have not.
I think now, my attitude is in the toilet. The bride left, I live alone, just retired and thought we'd have a life together....
But now? Well what's the point? Gotta die of something I guess.
Thank you for taking the time, sir