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Cancer: Prostate Message Board
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Old 09-03-2010, 01:20 AM   #1
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gegullalong HB User
PSA on the rise 4yrs after treatment

4yrs ago I had hormone and then radiotherapy on my prostate to deal with a cancer - 4+4 Gleason score. The treatment was successful but the consultant gave me a 50/50 chance of it not returning within 5 years.
I have had regular PSA checks ever since. Mostly they have been less than 1. 2yrs ago PSA was 1.89.
I went recently (June 2010) and the score was 2.32. I have not been worried by this as the score is still in the normal range 0-4.
However, being a tad psychic I went again today, - same hospital, and the reading now only 2 months later is 3.25. Now I am worried as this seems like a big increase. I would appreciate any suggestions and advice. Local Dr. says the result is still OK, but I'm not convinced.
Thanks.

 
Old 09-03-2010, 04:57 AM   #2
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Re: PSA on the rise 4yrs after treatment

I read your post I assume that the doctor looking at your results is your GP. My understanding differs however I will state upfront I have no medical training and am working from what I have been told by my DR's and what I have read. Since you have a Gleason 4+4=8 you are in the highly aggressive range and would want to be aggressive in pursuing a treatment plan.

While there is some disagreement as to the exact level for post radiation PSA tests the Dr's i follow like to see it <.05 measured via an ultrsensitive PSA test. The normal range of 0-4 would be for men around 60 who do not have prostate cancer and have not been treated for PC by radiation or Prostatectomy etc.

With a rising PSA the doubling time becomes important ie a year to double is way better than 3 mos.

I would be seeking a second opinion from an oncologist specializing in prostate cancer. If one is available I would specifically look for one that had lots of experience with Gleason 8 and higher patients. I found with a Gleason 4+5 there is a difference between the advice I got from my uroligist, radiation oncologist, my first general oncologist and the oncologist I see now who deals with a lot of highly aggressive cases. BTW I see Dr Myers who wrote Beating Prostate Cancer (Hornonal Therapy and Diet) and am currently on intermittent triple blockade.

If you go for another opinion get a copy of all your past tests etc. I took the advice of someone on this site and now keep a copy of my entire records. Of course I travel from Guam to Virginia for my annual appt with him so I make sure I travel with my record summary.

I am sure a number of more informed individuals will chime in but when all is said and done you should be asking questions and taking charge of your path aggressively given your Gleason.

All the best

John






Quote:
Originally Posted by gegullalong View Post
4yrs ago I had hormone and then radiotherapy on my prostate to deal with a cancer - 4+4 Gleason score. The treatment was successful but the consultant gave me a 50/50 chance of it not returning within 5 years.
I have had regular PSA checks ever since. Mostly they have been less than 1. 2yrs ago PSA was 1.89.
I went recently (June 2010) and the score was 2.32. I have not been worried by this as the score is still in the normal range 0-4.
However, being a tad psychic I went again today, - same hospital, and the reading now only 2 months later is 3.25. Now I am worried as this seems like a big increase. I would appreciate any suggestions and advice. Local Dr. says the result is still OK, but I'm not convinced.
Thanks.

 
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Old 09-04-2010, 12:28 AM   #3
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Tall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB UserTall Allen HB User
Re: PSA on the rise 4yrs after treatment

PSA can rise from several things, including BPH and prostatitis. You can usually (but not always)rule out prostatitis if antibiotics don't work. Finasteride or Dutasteride is pretty good at resolving BPH and may even help with some incipient PC. However, if you take antibiotics and finasteride and your PSA does not go down, or if it goes down at first and then increases, it is most likely a recurrence. I would call my Urologist or Oncologist and get this checked out right away.

 
Old 09-05-2010, 01:25 AM   #4
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gegullalong HB User
Re: PSA on the rise 4yrs after treatment

Quote:
Originally Posted by Tall Allen View Post
PSA can rise from several things, including BPH and prostatitis. You can usually (but not always)rule out prostatitis if antibiotics don't work. Finasteride or Dutasteride is pretty good at resolving BPH and may even help with some incipient PC. However, if you take antibiotics and finasteride and your PSA does not go down, or if it goes down at first and then increases, it is most likely a recurrence. I would call my Urologist or Oncologist and get this checked out right away.
Thanks for both replies. Update. Yesterday I went to see an oncologist I've seen before who is regarded as an expert in this area. He took another test and it was 2.7. He hasn't put me on any new therapy yet and says that there are many reasons for the fluctuation. I will continue to see him directly now every 6 months. I am much relieved, Although I know that the long term odds are not so good. Thanks again to you both for your useful input. Tim

 
Old 09-05-2010, 12:57 PM   #5
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Re: PSA on the rise 4yrs after treatment

Get psa tests monthly. An up and down or incostantant readings indiate psa bounce wheras a consistant rise indicate a reoccurrance.
JT

 
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