PSA rising

I am not sure whether they would give him hormone treatment after he has had surgery, but I a know you will shortly get replies from those who will know.

Unfortunately, after having the hormone treatment, my husband's cancer is no longer responding to it and it is rising every three months, now standing at 78.  He cannot have any other treatment as has heart problems, so he is just under palliative care now. 

Regards

Gina

Hi Gloria 

Yes difficult one , first trying to find where the cancer remains, hopefully pet scan can find it.

Then onto the salvage Radiotherapy which can potentially finish it off and therefore still curable.

So fingers crossed that the Pet scan shows something and treatment can.start

All the best 

Steve 

Hello GC Gloria 

After surgery he should have had a meeting with his team and discussed the histology of the surgery and if the margins around where the prostate was removed were clear (which I assume they were).

Following on from surgery it's the normal for further intervention if his PSA is above 0.2 or has risen on 3 consecutive PSA tests.

A PSMA-PET scan doesn't always pick up the cancer with a PSA of under 0.2 so it might not show up on this scan.

The normal treatments for rising PSA  after surgery would be Hormone Therapy and Radiotherapy.

Best wishes - Brian.

• Thank you so much. Yes, we had all the info on the histology after surgery, which had looked good and is why I feel so sad for him that it keeps rising even though they are tiny rises each time. Thanks for giving me some idea about reaching 0.2 PSA - it gives us some idea of a possible next step. A previous PET scan showed nothing, but there's clearly something still lurking. I really appreciate your help , thank you again.

Thanks Steve, radiotherapy and hormone treatment were offered as an alternative to the surgery but we just wanted it out. Just feeling sad for him that he'll probably be doing both as a next step. But thank you, really appreciate your post.

Thank you Gina, im sorry youre facing this situation and the PC is still carrying on despite all the treatment. It is clear we are only really at the beginning of this. I just feel so sad for him, but know that he is just one of many many people. Wishing you and your husband care and comfort from others.

Hi as you can see from my OH bio he had the surgery 3 years ago and according to the surgeon it was all gone.   Unfortunately after 2 years PSA started to rise and when it got to 0.3 the oncologist decided to put him on HT and he finished 33 sessions of radiotherapy 5 weeks ago.  Except for fatigue and the  ED which he has had since the op no other side effects from the RT.  Keeping fingers crossed that the treatment has seen it off completely this time.  He has never had a pet scan as his readings have not been high enough.  We were advised they needed to be over 0.4 for anything to show .  Like yourselves disappointed that the op wasn't a complete success but at least there is a second line of defence.   Hope all goes OK for your OH.

Thank you so much, this is really helpful and gives me some idea of what can happen next. I have no idea why they're giving him another pet scan , he had one just before Christmas too. The radiotherapy sounds exhausting. Of course we as partners just have to watch our other halves facing it and not really bring able to do much but support and focus on the practical. Thank you for your reply and wishing you both well.

hi , you mentioned normally further intervention at psa 0.2 , I’ve always been told . Action taken when psa has reached 2 . 

Hi !

No, a PSA of 0.2 after PROSTATECTOMY is grounds for looking into the possibility for salvage radiation after probable recurrence

The PSA of 2 is for people having had radiation as primary treatment and the 2 is how much over the persons Nadir before it’s considered a recurrence. With todays possibility of PSMA Pet scans I assume that no oncologist actually waits for a PSA rise of 2 over Nadir and more go for the other option, I think 3 consecutive rises in PSA and that trigger PSMA Pet Scan at approx 0.4 / 0.5 and upwards

So a PSA of 2 after prostatectomy is really not good in any terms