PSA has risen to 0.2 1 year after RALP

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On 1st October 2024 I had RALP with 1 side of nerve bundles removed.

I’m 56, T2N0M0, Gleason 7 (3+4), 

pT2 Adenocarcinoma, positive margins at the apex.

My PSA tests after this have been 0.04/0.08/0.07/0.14/0.20 which has just been flagged as abnormal & I have been referred to Urology.

I have full private health care through work, but all my care so far has been NHS.

What can I expect going forward?

I suspect salvage radiotherapy of the prostate bed, as I understand PSMA PET scans will not likely show anything at this low PSA level?

Am I likely to have to have HT also?

Does anyone have experience of timescales? I presume I’ll see Urology within 2 weeks? What happens next? Will I have an MRI? surely not another Biopsy (as I have no prostate)?

I have a holiday booked for 31st January, will this be at risk?

Thanks in advance for any comments…

  • I am not sure of his TNM or Gleason Score but a good friend of mine had a similar experience to this. 

    He seemed to be treated in the timescale you have mentioned, and received 33 fractions of radiotherapy after 3 months of hormone therapy. When I last saw him that was to be continued to 6 months and then reviewed. 

    This seems to be one possible path that you would travel. 

    I am sure that others will be along to comment. 

    If you followed the exact timetable then your holiday would be at risk but your own medical team will likely work around your plans. 

    Steve

    Changed, but not diminished.
  • Mstev2,

    Thanks for your reply, I didn’t expect HT 1st, then a wait for Radio, but I suppose that makes sense for the testosterone to reduce and start starving the cancer cells.

  • Hello  

    I think you will have a Urology appointment but possibly not within 2 week as the PSA rise is slow. I would have though that they won't use a CT or MRI scan as 0.2 would not show up. (A PSMA-PET scan is expensive and where I am only used at 0.5 and above) No biopsy thank goodness. I think they may just rely on the PSA reading.

    I agree with Steve ( above Hormone Therapy to stop the cancer from spreading and then radiotherapy to kill the little sods off. HT for 6 months?

    It shouldn't derail your holiday plans and they can work around your radiotherapy dates - the issue here is I found travel insurance cheaper after any planned radiotherapy.

    I hope the above helps and you get sorted soon.

    Best wishes - Brian.

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  • Thanks Millibob,

    Another great response.

    i have travel insurance with my bank Nationwide flex plus, but I haven’t declared the recent medical status with them as yet. Don’t want to get rinsed!!!