Post Radical Prostatectomy.

Jan52021 2 months ago

5 replies
170 subscribers
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Hi everybody,

I had my operation nearly four years ago. My last PSA was 0.12, I thought further treatment started at 0.1 and I expected to be referred to the prostate team but was told the NICE guidelines have placed a 0.2 level on the referral.

Has anybody else had this issue?

Can anybody point me to the document that identifies the 0.2 value?

Huffies 2 months ago

Hi, this is what I found on NICE guidelines.

Take into account that biochemical relapse (a rising PSA) alone should not mean an immediate change in treatment is needed. [2008]

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Estimate PSA doubling time if biochemical relapse occurs. Base this on a minimum of 3 measurements over at least a 6‑month period. [2008]

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Offer people with biochemical relapse after radical prostatectomy, with no known metastases, radical radiotherapy to the prostatic bed. [2008]

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Consider entry to appropriate clinical trials for people with biochemical relapse. [2008]

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Do not routinely offer hormonal therapy to people with prostate cancer who have a biochemical relapse unless they have:

symptomatic local disease progression or
any proven metastases or
a PSA doubling time of less than 3 months.

There was no mention of an absolute PSA score that I saw. I wonder what the baseline is for an assessment of doubling.

All the best.

Jan52021 2 months ago in reply to Huffies

Hi Huffies

I have so far not been able to find specific values.

Thanks for looking, I will see if I can find a PSA doubling time tool, although I know my doubling time is much higher than 3 months.

Alwayshope 2 months ago

Hi Jan52021 .

I was also finding it difficult to find information on the NICE site but generally a doubling in less than 6 months is considered to be significant. There are other factors involved. I hope this article might give you a starter for an informed conversation with the experts.

https://www.verywellhealth.com/doubling-time-in-men-with-prostate-cancer-relapse-4047467#:~:text=If%20your%20PSA%20doubling%20time,18%20months%20of%20Lupron%20Depot.

Alwayshope 2 months ago

There has been a similar thread about relapse after prostatectomy which has additional information.

New to site but not to PCa unfortunately

Lexi26 2 months ago

Hi Jan52021

my husband had his surgery July 2020. His post op PSA was 0.2 so he was referred straight to the Oncologist.
In all my reading I seem to recall that two consecutive detectable PSA readings are required (when at 0.1).

My husband had RT just 14wks after his surgery. His PSA remained undetectable <0.1 until now, it’s 0.2. So we are back to the beginning and awaiting an MRI scan before seeing the Consultant in December.

Best wishes.

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