Puzzling PSA increase

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

Hi L, they won't target the whole pelvic area until they know what they are dealing with and it's very important that best use is made of what is usually a once only treatment. Chocoholic 28s MRI will show the cause of the PSA rise as it seldom shows on a CT. 

Eddie 

Hi Chocoholic28.

Good afternoon, yes I have been on Hormone Therapy since last June 2023 after a PSA off 1000+.

My PSA instantly dropped to single figures but my past three numbers have started to rise again and I have started the experience tremendous bone pain down my right side.

I have recently had CT scans and Bone Scans which have shown cancer spread all around my pelvis "unfortunately"

I had RT around the pelvis (right side) last week and my pain seems to have settled down "long may it stay"

Yes we have been very "proactive" in my treatment plan to date and have found this a very good way to deal with things and to keep them all on their toes with no excuses to date.

This worked very well after my Stroke in 1998 and is something that continues to "bear fruit" to date!!!!!

I do hope that this is helpful please come back to me if required!!!!

Prostate Worrier.

Thanks Barry.  His consultant has so far been reluctant to fall back on either RT or chemo, although his registrar recently suggested trying a course of chemo.  I wonder if it's age related - he's 75.

Hi Chocaholic28, the main criteria for treatments are general health and fitness and of course whether treatment is worth the physical impact cancer treatments can cause, I think it would be naive to think age doesn't matter.

Eddie xx

 Chocaholic28 Yes it's strange how different consultants can be. I wonder why they are so reluctant? does your husband have other issues? Maybe they are thinking with the right HT it's possible to tick over. but there are plenty of people here that have had Chemo in there 70';s and it's been very successful.

 I would want a second opinion, it's easy enough and you can go private for that and at least then you will know more about your options. You should question your treatment choices and options if you are concerned, because consultants are human and could make subjective decisions about things like anyone else. 

Lx

Hello L (BarryW) 

That's a good idea in this case - here's a link to "Getting a Second Opinion"

https://www.macmillan.org.uk/cancer-information-and-support/treatment/your-treatment-options/getting-a-second-opinion#:~:text=A%20second%20opinion%20means%20asking%20a%20different%20GP%20or%20cancer,to%20provide%20a%20second%20opinion.

Best wishes - Brian.

Millibob Perfect link!

Hi Eddie, 

Unfortunately he isn’t that fit.  His consultant knows about his upper lobectomy in 2023 and also his sleep apnoea.  They've probably noticed that he's overweight but  don’t know that he’s not hot on exercising, and would rather drive or catch a bus than walk as he gets breathless on even a slight hill.  He also has a back injury from a fall a few years ago and currently has a broken wrist!  They told him that any chemo would have to wait until his wrist had healed, which could be months yet. 

I’m not sure with all that how his body would cope with any treatments.

Haze x

Hi Barry,

I’ve just explained to Eddie how unfit he is, but I suppose the main considerations for his consultant, apart from being 75, would be that he’s missing part of a lung and has sleep apnoea (under control with a CPAP machine).

He isn’t currently interested in seeking a second opinion, saying he’s just grateful he’s ‘in the system’ and prepared to accept whatever his consultant comes up with. We’re fortunate in that our local hospital has a very good record for cancer care which makes him feel confident about his consultant's decisions.

Haze x