PSA has risen to 0.2 1 year after RALP

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. 

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 Kenco222 

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 (mstev2) 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.

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!!!

You really need to seek advice from your team. The views of different specialist vary considerably throughout the UK which is obvious from the posts in this forum. Some will carry out salvage radiotherapy at 0.2 but others will prefer to wait and see. I believe it also depends upon the likely location and PSA rate of rise. Views on combining radiotherapy and HT also vary. My team prefer to wait until the cell location can be determined and then target that area. I had to wait until my PSA was 0.5 in January just gone for a PSMA Pet scan but the results were inconclusive. I am having another scan early next year. I will not be having HT. This is primarily as I have Type 2 diabetes.

I think I agree with static.

I would rather wait and see if cancer cells can be located rather than doing a random salvage RT. Just my opinion obviously 

Not sure if HT is done with salvage radiotherapy.

Best wishes 

Steve 

Thanks Static,

it is concerning that different treatment paths could be considered for the same person symptons.

I’ve watch a lot of Mark Scholz MD YouTube videos  which I will now re-watch at this different stage of my journey. I’m pretty sure that with a positive margin he recommends radiotherapy of the prostate bed at PSA  0.2, as it is most probable that cancer cells are in that area.

I can’t say I’m keen on waiting for PSA to rise, and I thought the choice between radon & surgery was a difficult one!!!

let’s see what the ‘experts’ say at Urology.

Hello Kenco222,

I'm sorry to hear of your problem and hope you make progress very soon.

Putting my insurance hat on, I think it would be advisable to notify the insurer of your current position ASAP if you've made or have to make any non-refunable payments that you would want to claim for in the unlikely event you need to cancel before your trip, otherwise they will most likely refuse to pay out. 

Derek.

Hi Kenco222 , the advice so far has been spot on.  You pose several questions and my take is as follows.

• Definitely notify your insurers
• Don‘t worry about your holiday, they can work round any dates
• PCa is slow growing and you are G7 which is even better
• Stay in the NHS (use private for second opinions but not for treatment)
• Get on HT asap if that is your teams suggestion and definitely RT to follow

Thanks David,

your advice is greatly appreciated.