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  • Recurrent Prostate Cancer

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    Old 11-23-2012, 11:50 AM   #1
    Seasharp
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    Recurrent Prostate Cancer

    I had Robotic surgery in 2006 to remove my Prostate. My PSA was as low as 0.01 two and a half years after surgery. However eventually it rose to 0.3 after 5.5 years. I had salvage radiation (37) treatments this past spring. PSA was 0.17 after 90 days but now at 6 months it's 0.24. Is this a bounce or a sign that the radiation treatment failed? If so what do I do next?

    Joe

    Last edited by Seasharp; 11-23-2012 at 11:51 AM.

     
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    Old 11-23-2012, 02:44 PM   #2
    Tall Allen
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    Re: Recurrent Prostate Cancer

    Did you have any hormone therapy along with your SRT? If so, when was your last dose, and how long-lasting was it? I was wondering if your 90-day PSA was artificially depressed by the hormones, and your 6-month PSA is the true value, which is lower than where you started.

    - Allen

     
    Old 11-24-2012, 12:18 PM   #3
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    Re: Recurrent Prostate Cancer

    Allen:

    No Hormone Therapy was given.

    Joe

     
    Old 11-24-2012, 04:30 PM   #4
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    Re: Recurrent Prostate Cancer

    Joe:

    What does your oncologist say? He's probably seen a lot of PSA patterns after SRT. I think it's a good sign that the cancer was still localized that you had a drop in PSA soon after the radiation treatment. So the increase might be a bounce. If it were me, I'd want to monitor that closely before taking a next step.

    In case it turns out not to be a bounce... Before you start on lifelong hormone therapy, you might ask your doctor to take a shot at trying to find it. Traditional bone scans are useless when your PSA is so low. If you are willing to take a one-day trip to Rochester, MN, the Mayo Clinic offers an FDA-approved C-11 Choline PET/CT scan. I don't know what the cost is or if your insurance would cover it. They have been able to find sites of metastases that other kinds of imaging can't find. If they find just a few, you can have your radiologist zap them with some SBRT. That might cure you or at least slow things down.

    If they can't find any sites, it could mean that there are micrometastases that are too small to be seen. In that case, hormone therapy is the standard of care. There are clinical trials you might want to look into that involve new kinds of hormone therapy, immune therapy, and chemotherapies earlier in the disease progression process.

    But first things first -- you and your oncologist need to figure out if it's just a bounce.

    - Allen

     
    Old 11-25-2012, 02:10 PM   #5
    Seasharp
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    Re: Recurrent Prostate Cancer

    Allen:

    I have an appointment with my Radiology Oncologist on Tuesday. So I will see what he says. In any case I think I should wait longer before starting any HT. I think I read that a PSA >1.0 might be the place to consider it.

    Thanks,
    Joe

     
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