Puzzling PSA increase

Hi Chocaholic28 , a worrying time waiting for results, hope all goes well.  Best wishes, David

Hello Chocaholic28 

I am so sorry to read of your husband's rising PSA. I would have said the cancer is resistant to the original hormone therapy but the PSA is still rising after a change - so like your Consultant I am at a loss to know what is going on.

I wish you both well with the MRI and bone scan - can you please let us know how he gets on and what the answer is.

Best wishes - Brian.

Hi Chocaholic28 - I’m sorry to hear this news, and I re-read your bio. Your husband’s battle is ongoing since 2008 and I note that, even when he was Gleason 6, his PSA was high at 12.  This makes these latest PSA readings less frightening, as he is obviously a high PSA patient whose cancer doesn’t easily show up on scans. Hopefully, they will find where the PSA is being generated and deal with it, and then PSA should reduce sharply again.  I wish you both the very best of luck with the ongoing prognosis.   AW

Thank you, David.

Thanks Brian.  It’s good to be able to come on here where people know what you’re talking about and share the same anxieties. 

He has another oncology review next month so we’ll find out the result of the MRI scan then, and the next step.  Will post an update as and when.

Thanks Alpine Wanderer.  His last PSMA PET scan in Dec 22 showed a slight spread through the prostate and into a lymph node (as well as an unrelated lung cancer).  We understand that PET scans are more thorough than CT scans so have been feeling a bit less confident about the results of the latter, which didn’t show any further spread.  Apparently PET scans are very expensive so I suppose they have to keep them to a minimum.  Still, presumably the MRI should show up anything it missed. 

Will post an update in due course.

I don’t understand why they haven’t gone for full pelvic radiotherapy. I had brachytherapy boost (Brachy plus radiotherapy to the whole pelvis), so surely they can now add the radiotherapy to his treatment pathway? When deciding whether to go for boost, I was told that the radiotherapy to the pelvis could be added at a later date - they just needed extra work to calculate the dose in the margins, so they didn’t exceed permitted exposure to too much radiation.   Maybe one question for your oncologist?    AW

There hasn’t been any mention of radiotherapy so far and my hubby assumed that he couldn’t have it, having already had the brachytherapy.  Must admit we’re rather in the dark with a lot of this so he just tends to go along with whatever the consultant says.  I suppose he’s waiting to see what the MRI shows to decide the next step.

wishing all the best.

Hi Alpine Wanderer 

I agree with you, why haven’t they done full pelvic RT? Or Chemo

Hi Chocaholic28 my partner originally had Zoladex and it wasn’t enough to bring the PSA down so he had Abiraterone with Prednisone, but the most important treatment he’s had along side HT is full pelvic RT. His original PSA 115. Apart from the obvious Cancer in the prostate and seminal vesicles the metastatic spread had not been picked up by any scan, even Pet scan, partly because he was on hormone treatment and it was working so well that it had shrunk the cancer back. The RT covered the full pelvic area, nodes and lower torso bones because even though the spread was not visible they knew it was there because of the high PSA. Clearly your husbands PSA is climbing so micro metastatic spread is there, it probably needs a strong intervention now, full pelvic RT or probably Chemo? To hit it hard and focus on killing off or disabling any undetected spread. Definitely push for something strong and proactive. 
Best wishes to you both. 
L