Hi Junior,
As has been previously said, you have done very well coming from when you were diagnosed and the actual diagnosis. However, there have been other men on this forum who had a gradual but increasing PSA rise following many years when their PSA was fairly stable. Your cancer cells were attacked by the course of radiotherapy aided by HT. Sometimes any cancer cells that may have survived can be virtually dormant, perhaps for a number of years but for reasons that are not clear, at some point in time, perhaps through mutation or consolidation begin to become active again. Also where there is still a Prostate, even a radiated one, it is also possible for a new tumour to grow.
In some cases, even with a fairly low PSA, a good quality MRI scan may be able to identify where the PSA is being produced and appropriate further treatment started. But in other cases, dispersed micro cancer cells may not show on an MRI scan. In the latter case, If PSA continues to increase beyond a level decided by your consultant, It may well be decided to treat you with HT and or another systemic treatment. If it can be determined that there is cancer in the Prostate, you might be offered further RT, or focal treatment and possibly additional systemic treatment.
My original Gleason was lower than yours and I had HT/RT in 2008. After a couple of years or so my PSA began to increase very slowly. Though slow, every PSA thereafter showed a rise at an increasing rate. By the time it reached 1.4 I was lucky to be given an MRI scan which showed cancer was in the Prostate. A 50 needle Transperineal Biopsy revealed only one core with cancer and this was treated with HIFU which had the effect of reducing PSA to 0.39 and twenty one months on from HIFU to 0.66. There is still a suspicious area in my Prostate and also in an Iliac node which may be responsible for the PSA or there could be micro cancer cells elsewhere. Also, as I still have a Prostate, non cancerous cells could be wholly or partially responsible. Further treatment may or may not be required at some stage and I am being monitored.
You can't assume that your cancer journey will be the same as anybody else here even if they had a similar diagnosis and treatment. It's best to discuss with your consultant when your MRI scan has been assessed.
Barry |
User
barry,
many many thanks for your prompt and enlightening reply -
let's hope for the best when the next results appear.
User
i had a full body scan on 23/05/2017 and have just be advised by the oncology nurse that the results have shown nothing to be concerned about.
i will now continue with the psa checks starting with the next one w/b 24/07/2017 and 6-monthly thereafter.
could have been a lot worse i think (i.e. cancer spreading to bone).
thanks to everyone for their moral support.
User
had a telephone discussion with the urology nurse on my latest psa blood sample(given in august 2017):-
my psa has risen from 3 to 3.9 -
the mdt team have suggested that the situation be monitored and if the psa doubles in 6 months, then they may consider restarting hormone treatment -
i will be giving another sample in the next few days.
once again many thanks for all your support/comments.
Edited by member 06 Sep 2017 at 15:30
| Reason: Not specified
User
Hi Junior, fingers crossed the PSA is fairly stable this time.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
my psa has now risen to 4.4(from 1.8 in october) –
a sample will be will reviewed in 3 months time with a view to starting hormone treatment if there is a significant rise in my psa.
sorry to be so brief, but i don't know what else to say - i would appreciate any guidance as to how is should be putting information on this forum.
as usual any comments/advice(especially from anyone who has been down a similar route) would be most welcome.
thanks in advance
Edited by member 26 Sep 2017 at 12:06
| Reason: Not specified
User
Hi Junior,
I am of the thought that with a Gleason score of 4+5 I would be looking to go
back on Hormones before the next PSA test at six months ,
I would ask for a monthly test
(CHECK MY PROFILE}
Good luck
Barry
Edited by member 25 Sep 2017 at 18:38
| Reason: Not specified
User
hi Junior, the rate of rise is fairly stable but 6 months does seem a long time to wait so I am surprised that the MDT suggested it. You might be under one of the hospitals that waits until the PSA rises to 20 before re-starting hormone treatment. Do you have a nurse specialist allocated to you? If so, could you phone him/her to ask whether 3 months might be better for the next test just to keep an eye on it.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
apologies that should have read 3(three) months(i have corrected the post) - i plan to give the sample on 27/12/2017(hope the christmas celebrations do not affect my psa)http://community.prostatecanceruk.org/editors/tiny_mce/plugins/emoticons/img/smiley-smile.gif
User
That makes more sense, Junior. A lot of turkey and wine has never been raised as having an impact on PSA - happy Christmas!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Hi Junior
Tony was diagnosed in 2006 gleason 9 t3B very similar to you, tony has been on and off hormones quite a few times usually when his psa had gone above 5, as soon as his psa has gone to almost zero he has been taken off them again.( he has usually has a mri scan before re-restarting them) the last rise he had at the end of last year went up rapidly , had a scan and it was in 1 lymph node, he is now on hormones permantly, will have another scan in November before seeing onco. the other times his psa had risen there had been no spread. he has no symptom at all (other than getting up 3 or 4 times in the night) try not to worry as hopefully it is just a blip and a short time on HT will sort it out.
regards Barbara.
User
i submitted a blood sample for a psa test on 27/12/2017 andi was give the result in february/march of 6.9(up from 4.4 in october2017).i submitted another sample on 20/03/2018 and have been told that my psa is now at 8.7 and that i will be given appointment with the urologist in about 2 weeks time.
sorry to be so vague/brief but as usual i would be extremely grateful for any comments(especially anyone who is on a similar route as myself(gleason----9)
Edited by member 27 Apr 2018 at 18:35
| Reason: Not specified
User
I think your urologist will probably pass you over to an oncologist for further treatment. You would be well advised to remove your real name and phone number from your profile as an anti-troll measure! You have been at this for as long as me and with the same Gleason 9 diagnosis. We are a rare breed - well done!
AC
User
Here is Junior's most recent thread for anyone trying to track progress
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
i had an appointment with the urologist on friday11may2018:-
i am now on hormone treatment as follows:-
bicalutamide(50MG) tablets daily from 15may with an intramuscular injection of decapeptyl(3MG) after 10 days on 24may(and every 4 weeks thereafter) - the tablets will continue and after 3 months another psa reading will be taken.
as usual comments/advice/moral support would be most welcome
User
That looks like the kind of treatment regime that many other members have had in similar situation to yours. Hopefully, your PSA will drop very quickly and if you are managing the side effects okay, you may eventually move to 3 or 6 monthly injections rather than every month.
Try to keep active - fatigue can play havoc so rest when you need to but try to do things like walking or swimming.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
many many thanks for your encouraging and optimistic post