Oncology

Hi Whittaker welcome to the forum . I don't know enough about the specific levels you are asking about . However, my fellow Champ Millibob will be along soon to offer information, advice and a warm welcome to this part of the Community. 

Thank you

Hello Whittaker and welcome to the family. Following a Prostatectomy it is hoped that the PSA drops to a negligible level and stays there. It is usually classed as a recurrence when the PSA rises above 0.2. The big question then is when to act. There is one school of thought which recommends hitting a recurrence hard and fast with the aim of keeping your husband on a curative pathway. The most sensitive scan available at the moment is a PSMA PET scan which can detect cancer at 0.2 but is more accurate at 0.4/5. The most frequent position for the recurrence is the prostate bed so a decision has to be made whether to irradiate the whole pelvic area or to limit it to the site of the recurrence. Should he have HT with it for a short period. Again the recent indications are that the combination of HT and radiotherapy for higher risk patients gives improved time to recurrence. The initial PSA at diagnosis, Gleason and TNM all determine what risk category your husband is in. 

There is a video which can explain things and here is the link.

https://youtu.be/JXRhzi0Z6qQ?si=4hycHFqg7OKQEBQb

My husband has had RT and is on HT for life so I have no personal experience but I hope that by my replying it will bump your thread to the top and others will come along with their experience. There are a couple of other threads on a similar theme during the last 24 hours so have a quick scroll through.

Thank you.   My husband doesn't want the whole area doing so looks like we will need the PSMA PET scan which his consultant wasn't going to arrange until thr PSA reached 0.4.  We recently had a review with one if his colleagues when the reading was 0.27.  It looks like after discussion they have decided to see what oncology has to say .  We will have to see what they say on 17th.  It's so worrying knowing the op didn't get it all.

Hi !

Very sorry for the recurrence. One important thing to remember is that, even if PSMA Pet scans have high accuracy they can miss micromets because of how small they are.

So I think you definetly should evaluate the possibility of whole pelvic radiation, perhaps with some kind of boost to any suspected areas. Doing whole pelvic radiation, perhaps with short hormone therapy gives you a much higher chance of getting rid of it ones and for all. Doing a ’whacka mole’ radiation treatment might perhaps only lead to whole pelvic radiation anyhow in the end.

It could be good to have the MOs expert opinion and then after that decide 

Best wishes - Ulf

Sorry I am probably being dense but who is the MO ?

hi !

Sorry about at that. The doctor / Oncoligist / Radiologist that is the person that you’re having consultations with. So, that’s the one I call the MO 

The medical expert that you think you can address your specific questions regarding any radiation treatment plan for,your husband (normally a oncologist or radiaologist)

Best wishes - Ulf

Oh ok . Husband is worried about problems with bowel etc with the whole area radiotherapy.   He worked so hard to get over the incontinence after the op.  We will see what they say at the appointment.   Thank you for your help 

Hi ,

I fully understand. Radiation (like prostatetecromy) has much much lower rates of incontinence however but of course have othe side effects. But just looking at incontinence is actually i really minor concern when doing radiation