RT and Hormone therapy

Hello Whittaker 

Wow - a difference of opinion, and they are the professionals.

My personal view (not Macmillan advice) is that your OH has had surgery and the little bast**ds have escaped and are causing the increased PSA.  Hormone Therapy will deprive your OH of their food (Testosterone), they will go to sleep. Your oncologist will do a scan and then kill them off for good with salvage radiotherapy. Yes there are side effects of Hormone Therapy - I've been on it for 3 years and had every side effect going - would i do it again for a "curative pathway", yes I would.

The surgeon wants to wait as a PET scan is more accurate at 0.04 but he didn't get the job done in the first place!! I would go with the oncologist but it's personal choice, possibly influenced by me not having surgery as a choice.

A tough choice and i hope my "ramblings" help.

Best wishes - Brian.

Hi thank you for your input much appreciated its all so confusing and as he feels really well its a difficult decision for him.  Obviously we hoped the surgery had got it all.  They are going to do a bone scan as he has developed pain in his shoulder but hopefully it's not connected.  I just want it gone!

Thanks again Jacqui 

Hi Whittaker and sorry to hear

Firstly how much have the readings gone up, u say .27 now but what were the previous readings ?

Just my opinion obviously but I would wait until next reading.

Yes side effects a concern especially as he still has them from the surgery.

But if continues to rise than salvage looks the best way forward.

All the best

Steve 

Hi thank u for your response  sorry if I have given confusing info.  Except for ED he has recovered from all other side effects of the surgery.   His reading after the op was 0.07 went up to 0.10 then 0.20 now 0.27 more bloods taken today results on Thursday 

Ok ,good he's recovering well.

So looks like gone up from .07 to .27 over a period of about 3 years, still very low.

It is a difficult one but if it was me I think I would wait a bit longer , would be helpful if a scan can show where any remaining cancer is .

Please remember just my opinion, doesn't mean that is the right thing to do.

How often does he have a psa test by the way?

Best wishes 

Steve 

Hello Steve (Grundo) 

Just to point out Whittaker has had a radical prostatectomy so not having a prostate anymore his PSA should be undetectable or below 0.1 hence the need for some action.

Best wishes - Brian

Hi the readings were below 0.08 for nearly 2 years and then started to climb.  Oncologist advised that at 0.27 a scan would not show anything and she would prefer to start the salvage treatment whilst the PSA is low rather thsn waiting.  He has the blood tests every  3 months last one in November and they are running another with results on Thursday .  Just had a phone call and they want us to go back to see them on 7th January 

Yes Brian , my mistake, of course PSA after surgery should be near zero.

Apologies 

Regards 

Steve 

This is a tough one.  Yes, a PSMA PET scan should show up small lesions if you wait till PSA 0.4.  However, what if there are micromets as well, that don’t show up? So you could end up waiting and targeting the ones you can see, whilst the micro mets quietly wait in the wings for their chance to grow. I’m with your oncologist on this one (especially as OH was staged T3b after surgery prostatectomy) - I would want go straight to hormone therapy and radiotherapy to the whole pelvic area. This is a personal opinion and I have been through this pelvic radiotherapy with no bladder or bowel problems (so far: the radiotherapy ended 10 months ago), so I’m bound to be biased. Radiotherapy is way more advanced than it was 20 years ago: the side effects on surrounding organs are recorded in a low percentage of patients (2-3%, I believe). Anyway, I’d push to follow the oncologist’s pathway- HT now and get on and blast through with radiotherapy. Check out the bios on here - the vast majority of radiotherapy patients say that the worst bit is the drive and the parking!   AW

Hi W

Sorry, My mistake as have mentioned to Brian, PSA should stay near zero after surgery,

Yes, scan probably will not show anything as PSA too low.

Must admit probably best option is to start HT with salvage to follow.

Hope all goes well in the New Year.

Best wishes 

Steve