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Lorraine is a nurse specialist and sex therapist and volunteers here to answer your...
My husband appointment with consultant on Monday has been put to 10 min call due to health crisis He had 30 radio therapy sessions and still 3 mth hormone injections what should he be listening for on results is it psa count or cleared no more treatment . Can we ask for it to be confirmed by letter we have waited so long for results and now feeling anxious in case he doesn't pick up what consultant saying because my husband just keeps saying everything fine even if it's not Questions to ask would be appreciated
you don't say when the RT was completed.
Normally not much happens after it does finish because it can take a while for the Psa to go down plus if he is still on HT that can mask any possible increase in PSA or make it appear lower.
I had a PSA test at 6 months after RT completed and had this done at GP, hospital then tel for result.
It finished January I thought they could show if it was still contained /not spreading and results of blood tests taken and what happens in future. Usually when face to face they explain it slowly and gives you time to ask questions. Feeling a 10 min call is hard to understand outcome and my husband will not ask. Was hoping for closure or next plan I understand nhs is under pressure just now but now I'm feeling anxious again
I think that I am right in saying that no further scans r carried out after RT unless psa shows that the cancer has come back or never went away.
You really won't know much until the first psa is done, I should ask when they telephone when that will happen, usually 3 or 6 months after treatment is completed.
You could also ask about any possible future scans especially as he is still on HT which can mask a PSA increase.
Thankyou for advice will write it down
Just for clarity, are you saying whilst still receiving HT, it can give a false low PSA reading?.
Or is it that the HT can reduce the PSA but the cancer may well be spreading?
Don't let your good days be spoilt by the worry of a bad day, that may or may not come along.
I don't think that I worded it very well.
Lets assume that 6 months after RT is completed the Psa is 1.5. If you were not on HT then obviously the Psa could rise after this if the cancer was not totally eradicated.
If you were on HT then this could stop the Psa increasing until u finish with the HT , then it could increase, at some point when the HT effects have worn off.
So in answer to your questions I would say the answers are yes and no.
Not sure if that is any clearer and it's only my understanding of RT and HT, perhaps others may have a different view?
Not even my consultant could explain this properly to me but that's as I understand it too. It is a false reading in the sense that the reading may go up a little after coming off HT or actually even months after coming off HT as the HT stays in your system for quite a while. Of course it may stay stable but small rises are nothing to worry about - not that we don't worry of course! As I wasn't on HT after RT it was something that didn't concern me too much but I still had the HT and had some side effects for 6 to 9 months after stopping the HT and the PSA reading did change slightly but always by about .001 or so. The consultant did give me a PSA number it should not go above and so far it has stayed undetectable.
Do you keep on 3 monthly injections indefinitely or do you come off it after consultant sees you . Does that mean we will never really know if RT was successful for a long time. . My husband has been fine except for weight gain not put any weight on just rounder ha I'm allowed to say that .Owing to him having heart problems he can only do dog walking nothing to physical but as we are in isolation just now hopefully keeps well
I think that Des is the expert on this one but I don't think that u r on injections indefinitely.
At some point after the RT has finished, normally decided by the specialist , anytme between just after RT finishes and two to three years later the HT will stop and after the effects have worn off u should get an accurate psa reading that can be the baseline for following PSA Tests.
Ask the specialist how long he has to stay on HT
An oncologist would normally discuss how long you are likely to be on HT. the decision is generally based around the grade and stage of the cancer with higher risk men staying on HT for longer than lower risk. See more info here https://prostatecanceruk.org/prostate-information/treatments/external-beam-radiotherapy
Thankyou will ask on phone call consultation I honestly thought after RT and going to consultant they could tell us it was clear.and successful . Everything is a waiting game
Unfortunately Bar, after RT we never get to hear those words 'clear and successful'.
It all hinges on the Psa, hopefully he can come off HT fairly soon and then get a true Psa reading a few months after that, the lower the better but anything around 2/3 ish would be acceptable with further falls as the months go by.
Well that's good information we must have been naïve in thinking this would be final hurdle of treatment. Thankyou for replying
Not naive bar, just too much info take in.
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