After a radical prostatectomy I have been diagnosed with micrometastatic prostate cancer and am receiving hormone therapy. Has anybody else had a similar experience?
Hi Maurice J, when did you have your prostatectomy and what was your post op histology? Also, how long after prostatectomy did your PSA start to rise? How do they know you have micro mets? They don’t show up on scans.
If you read my profile I had prostatectomy July 23rd 2015 and my PSA rose to 0.3 by 1st September 2016 with a PSADT of 1.2 months. My oncologist has always been convinced I have micro metastasis. I had hormone therapy from December 2016 to April 2019 plus salvage radiotherapy in March/April 2017. My oncologist didn’t want to do the salvage radiotherapy but I got a second opinion and it went ahead. My last PSA was <0.1, I wouldn’t say I’m cured but it certainly has held things in check for 5 years now. All the best.
I was diagnosed with stage 3 prostate cancer in November 2019, my Gleeson score was 7 (4+3) and my PSA was <12.
I opted for surgery which was a doddle, but when I had my review in February 2020 my PSA had gone up to 32. I was told that the cancer was now incurable and they put me on hormones prior to chemo. They sent me for bone, MRI and CT scans to see where it had spread to, which scared the shit out of me, but all the scans came back negative.
The consultant said that the cause probably was something called micro-metastases which are microscopic cells that sometimes leave the prostate before the operation.
I’ve been on hormone implants since February 2020 and after 3 months my PSA was 0.32 which I was told was excellent. After another 6 months it had risen to 0.5 and I was then told to retest in 9 months. My latest PSA is 1.15 and I've ben told to retest in another 9 months.
Thanks Maurice J, sorry to read that your PSA never got to undetectable and that it had gone up a lot even after surgery. With a PSA of 32, no prostate and nothing showing up in scans micro mets are the only explanation. Nothing to target radiotherapy at so hormone therapy it is.
Have you discussed what happens if your PSA reaches a pre agreed level? It looks like some of the cancer cells have become hormone resistant. Has the oncologist discussed adding chemotherapy, Abiraterone or Enzalutamide at some point?
The consultant said that they will continue to monitor the situation on a 9 months basis and that they will not intervene until the PSA reaches double figures.
The problem with micro-metastases is finding them to treat them. Scanning technology is amazing and improving all the time, but some PSA-producing cancer is still currently undetectable. Hormone therapy should hold the cancer for a good while, and be sure that you get your regular checks. If and when it does rise into double figures, ask for a PET scan:
"The PSMA-PET scan was 92% accurate in detecting metastatic tumours (or the lack thereof), compared to only 65% accuracy for CT and bone scans."
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Heinous
If I can't beat this, I'm going for the draw.
Meanwhile, my priority is to live while I have the option.
