Rising PSA after Salvage Radiation

Hi Munster - it’s been a while since I have commented on your case. Your rising PSA is what your consultants are watching closely - and, of course, there is something residual that is causing it.  However, the rises are small, which indicates a slow growing cancer that can be tracked and dealt with (hopefully, if accessible, by radiotherapy once they have identified the location via PSMA PET scan). Put your mind at rest - they have NOT chosen systemic therapy (like chemotherapy or lifelong hormone therapy) so that means that they are pursuing a curative pathway.  It’s just that the little buggers are being a bit mischievous and are hiding from the scans at the moment.  Medical intervention for prostate cancer has come on in leaps and bounds in recent years.  Let’s hope that the cause of the PSA is found eventually and terminated for good.  In the meantime, comfort yourself in the knowledge that it is a slow growing source and may take some time to reach 0.4.    AW

Hi Alpine Wanderer 

Thank you for your comments. Yes, my Oncologist still believes I can be cured and treating me accordingly. 

Whilst my PSA is still low, the doubling time is quick considering I had a Prostatectomy, HT and Radiation to my prostate bed and lymph nodes. In addition to this there are several clinical papers discussing that the PSA levels are low in Mixed DAC and does not always reflect what is happening. In addition to Mixed DAC, I have Intraductal and Lymphovascular invasion. I would be interested to understand what other patients with similar pathology have experienced. 

I remain positive and calm about my condition, knowing I am in good hands.

Kind Regards 

Munster

Hi Munster - I’ve just got round to reading the paper on hormone therapy that you kindly posted earlier in this thread. What a clear explanation of all aspects!  Thanks.

AW

Hi again Munster, yes, Mixed DAC, Intraductal and Lymphovascular invasion are aggressive traits (and uncommon types of prostate cancer).  As I mentioned before, the ductal word within refers to the gaps between cells, making it easier for the cancer to break away from the main lesion. However, your PSA levels are not increasing exponentially (hence the wait for PSMA PET to be effective), so it seems that your excellent medical team are waiting patiently “like a coiled spring “ to leap into action once they get sight of the rogue cells.  The good news is that you’re not lighting the scans that you have already had like a Christmas tree - so there’s not much out there.  Once they find it, I think they will zap it as soon as possible, then you’re back to PSA monitoring.  In addition, your body tolerated previous HT very well (and reduced PSA to very low levels) so you still have all those treatments in your armoury (to stop hormone production, block hormone production , or both).   AW