Rising PSA post RP

Hi David, whilst not minimising what you report, there are lots of treatment options available if, as seems likely, the PCa has escaped the prostate capsule. Even if the skeleton is affected, that remains true. I'm sure you'll get good advice from your consultant on next steps and find that you cope with the next ten years or so very well whilst undergoing that treatment. Be reassured - what you have is serious but not life threatening.

Good Luck.

AC

8 months post op my PSA had risen to 0.5 so I had salvage RT. The first PSA test post RT was 0.6 and six months later was 1.2 so I started on 12 week Prostap HT injections. Three months after the first injection PSA is undetectable.

I only tell you this because as the very wise Auld Codger has said there are many options available. I found that the onco was very helpful in that he explained what they thought was going on and how various treatments could work but we didn't do any scans because he believed that although the cells were out there somewhere it was most unlikely that they would show up at this stage.

As for the HT - well see the nurse every 12 weeks for an injection so no problem there. Very early days yet but only side effect I have had so far is the occasional hot flush which I reckon to be a fair exchange for an undetectable PSA.

Hope all goes well for you.

Kevan

Please keep us posted about how things go. Everyone on this site is so helpful and willing to offer support as well as their own experiences that might be relevant.

I just take it a step at a time and am still loving life.

Take care

Kevan

They will probably talk to you about salvage radiotherapy. Ask whether you would be suitable for 20 sessions (fractions) at a slightly higher dose rather than the usual 37 sessions of 2Gy. Trials have shown the shorter programme at more Gys to be very effective and it would be easier to manage 4 weeks of treatment rather than 7 weeks with your caring responsibilities at home.

Also ask about your original pathology - did you have any positive margins? Do they believe that these are just a few stray cells left behind in the prostate bed? Where would radiotherapy be targeted?

If they don't think you are suitable for RT (or if you don't fancy it) you may be offered long term hormone treatment instead. HT can't cure cancer but hopefully can control it for quite a long time.

Saw my Consultant yesterday and, for the first time since my operation in March 2015, I was face to face with my Surgeon who I had had many conversations with pre the operation.

A very personable and humorous man, he quickly put me at ease with the words 'Don't panic'. Yes, my rising PSA was a concern but in his opinion the increase to 0.3 had been slow and that perhaps the best course of action for the time being was to keep monitoring my PSA levels over the next months and years and to then respond accordingly. His words, not mine. My nuclear body scan had revealed nothing sinister to him and his team and whilst Salvage Radiation Therapy was an option for the future, it could not be used at this point in time because where would they target the machine? He thought it might be a good idea for me to see the Oncologist sometime soon to discuss future possible treatments and for me to voice my obvious concerns, too.

So that's where I stand. The meeting was extremely positive as far as he was concerned and I suppose to me, too. When I mentioned possible hormone treatment he said it was much too early to go down that route.

Very soon we were discussing Brexit and asking me what my opinion was. Surreal, but I suppose heartening for me all the same. I think ...

David

Salvage RT is a debatable thing. A slow rise in psa post op is assumed to be remnants of cancer left in the prostate bed. Many consultants offer RT with no real target. It can possibly cause many side effects but most people get through it ok. However 50% of men who have Salvage RT still get further recurrence. It may buy a bit of time so to speak. Although offered to myself , my psa levels show further spread so I don't want the bother and risk.
Good to see you so positive and best wishes

Saw the lady Oncologist earlier today and she is of the opinion that I should seriously consider having SRT which would be aimed specifically at the prostate bed. Apparently, when the PSA rises so slowly, as it has done in my case, then there is every chance that the rogue cells are hiding somewhere in the fatty tissue of the prostate bed. She went on to warn me of all the possible side effects, but she thought that any risk was outweighed by the advantage the radiation sessions would give me in hopefully preventing the possible spread of the illness. So, as things stand and after a night's kip, I think I will opt for the 33 radiation sessions.

Realise I'm just a hospital number, but did come away from today's visit with the thought that all concerned were dong their best to help me.

David

'Plodding On' was a great way of putting things and I intend to do just that ... only I won't have the problem of a 94 mile daily round trip as my SRT machine is situated more like an 8 mile round trip away. My only fear is incontinence both during and after the SRT sessions, because I consider myself extremely fortunate that I have not had an incontince problem since the RP op was performed some 30 months ago. In fact the waterworks have been in excellent working order both post and pre op.

Onwards and upwards and please stay in touch.

David

Thanks again, Kevan - the oncologist was making noises about the full bladder when she spoke with me earlier, but obviously I wasn't taking it all in. That's very reassuring ...

David