On Tuesday I completed my 20th session of radiotherapy to the prostate, lymph nodes, and I think they did the seminal vesicles too. During my time in the waiting room, I met many men who were at various stages of their 20 sessions of RT. I started referring to us as the prostate gang!
Everyone was having different treatment, depending on their age, health, staging, and whatever else.
No one I met was as young as me (most were 20 to 30 years older), none had had chemotherapy, or had a PSA nearly as high as my 133.
What I found was that many of them had some suspected localized spread, either to lymph nodes or seminal vesicles, or had a tumour looking like it might break through the capsule, yet had PSAs of less than 10. In fact 8 seemed a common number.
There were two men who had PSAs in the 40s but neither had evidence of spread, although they were treating the lymph nodes of one of them as a precaution and because he was in very good health for his age.
Then there was me, clear bone and CT scans of lymph and vesicles. MRI showed an intact prostate capsule (as far as they can tell), Gleason 4+5, just one suspect lymph node on the PSMA PET scan. I am on HT for three years, six cycles of Docetaxel was given from March to mid June, SpaceOAR in the summer, and 20 sessions radiotherapy just finished.
Has anyone else had similar findings? Clearly the higher the PSA, the more likely it is that there is spread, but the range seems very large. What kind of indicator is PSA?
Has any research determined why some people have higher PSAs but less spread, or vice versa?
Hello Aboniskin
David2017 has stolen my thunder with his answer!!
My initial PSA was 182 T3aN0M0 Gleason 9 (5+4). Shadow on pelvic lymph nodes, no spread on MRI or bone scan so pelvic lymph nodes zapped "just in case"!
Everyone is different and every different NHS Health Trust appears to act in it's own way. My diagnosis is almost the same as yours yet Chemotherapy wasn't mentioned and my Trust are happy with the HT only route.
I always say that the PSA is an indicator and the MRI and Biopsy are the gold standard for the diagnosis. Remember there are folk out there who are low secretors and can't even rely on a PSA test.
Best wishes - Brian
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Hello Aboniskin
So if you have noticed then I have a "biological recurrence". The first scan was unable to find the little sods so I have had a second scan - results day is next Thursday.
As the consultant said I look now to be on lifelong HT but it would be nice to find just where the cancer is.
With a PSA of 182 I thought 3 years HT/RT and a "curative pathway" was a little optimistic but happy to go along with it.
Best wishes - Brian.
Macmillan Support Line - 0808 808 00 00, 7 days a week between 8am-8pm
Strength, Courage, Faith, Hope, Defiance, VICTORY.
I am a Macmillan volunteer.
