Prostate relapse

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Sukishe1
New Member


Date Joined Sep 2017
Total Posts : 3
   Posted 9/12/2017 1:35 PM (GMT -7)   
Diagnosed in 2013, had surgery for a gleason score of 4+3 plus a tertiary score of 5. My PSA never went to undetectable, and Fourteen months after surgery had a doubling of PSA which required 38 sessions of Salvage radiation and hormonal therapy (Lupron). Now about 18 months later my PSA which had been undetectable has now risen slightly and no longer undetectable. Based on my situation I expect that my PSA will continue to increase, how quickly is any ones guess. Any thoughts?

alephnull
Veteran Member


Date Joined Dec 2013
Total Posts : 705
   Posted 9/12/2017 1:51 PM (GMT -7)   
Because that was your first rise it really would be just a guess. You need to wait for the next couple tests to determine PSADT.

InTheShop
Veteran Member


Date Joined Jan 2012
Total Posts : 7924
   Posted 9/12/2017 4:31 PM (GMT -7)   
Welcome to HW.

Could just be the Lupron wearing off. Could be lots of stuff.

Not much to do but wait for the next couple of tests and watch the trend.

hang in there, waiting is the hard part.
Andrew
I'll be in the shop.
Age 57, 52 at DX
PSA:
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16, .4 5/17
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

Sukishe1
New Member


Date Joined Sep 2017
Total Posts : 3
   Posted 9/12/2017 4:47 PM (GMT -7)   
Thank you both for your replies, this is my second rise it happened in 2014 which required radiation and hormonal therapy. My last Lupron shot was April of 2015.

Break60
Veteran Member


Date Joined Jun 2013
Total Posts : 1763
   Posted 9/12/2017 5:02 PM (GMT -7)   
Post your pathology results after RP and your PSA history and future test results so we can help you . This is a typical recurrence trend for mid to high risk PCa.
Bob
DOB January 1944 (now age 73)
PSA: 8/12 2.7; 5/13, 6.6 (actually double due to finasteride)
7/13 (age 69) Bx GS 4+5=9 (Epstein); 2 of 6 cores, 10%, 40%; stage Pt1c
9/13 ORRP, GS 4+5=9, BLSVIs+, margin+ (4mm,G7), EPE, 10 Nodes resected (clear); stage upgraded to pt3bN0M0
PSA: 11/13 0.1; 2/14 0.2; 5/14 0.3
6/14 SRT by IMRT/IGRT, 68.2 grays/38 Fx to prostate bed, ADT (6 months Lupron)
PSA: 9/14 to 8/15: <.1, <.1, .1, .3, .7, 1.2
9/15 MRI, CT-PET finds two iliac lymph nodes suspicious for PCa; organs and soft tissue clear ; Start ADT3 plus plus Metformin, Cabergoline, Estradiol patch, Prolia , Vitamin D3, calcium. IMRT 75 grays/50 Fx to pelvic lymph nodes. Stopped ADT 11/16.
11/15-5/17: PSA rises from .03 to 2.3.
5/17: F-18 Fluciclovine (axumin) PET/CT scan finds abnormal uptake in intertrochanteric region of the proximal right femur compatible with skeletal metastasis measuring approx. 9 mm. No other adverse findings. Restart ADT3; start monthly Xgeva
6/17 SBRT, 30 grays/ 3 Fx to femur met.
7/17 PSA 0.3, T 3.0

Sukishe1
New Member


Date Joined Sep 2017
Total Posts : 3
   Posted 9/13/2017 6:28 AM (GMT -7)   
Thank you break60, My PSA in 2013 was 4.3, dre was suspicious leading to biopsies. Right side of prostate completely inhabited by cancer cells as well as extensive extraprostatic extension, thought to be 3+4 gleason score. After surgery my PSA never went lower than 0.10, which continued at that lever until 14 months later then went to 0.20, leading to radiation and Lupron. After that combination my PSA went undetectable <0.03 for approximately 18 months, last week it went up slightly to a detectable level
of 0.05. My cancer was classified as pt3A. Margins were clear and seminal vessels were also clear.

Break60
Veteran Member


Date Joined Jun 2013
Total Posts : 1763
   Posted 9/13/2017 7:33 AM (GMT -7)   
Clear margins and no SVI are good news! I guess ur in the wait and see mode now which isn't fun!
Good luck!
Bob
DOB January 1944 (now age 73)
PSA: 8/12 2.7; 5/13, 6.6 (actually double due to finasteride)
7/13 (age 69) Bx GS 4+5=9 (Epstein); 2 of 6 cores, 10%, 40%; stage Pt1c
9/13 ORRP, GS 4+5=9, BLSVIs+, margin+ (4mm,G7), EPE, 10 Nodes resected (clear); stage upgraded to pt3bN0M0
PSA: 11/13 0.1; 2/14 0.2; 5/14 0.3
6/14 SRT by IMRT/IGRT, 68.2 grays/38 Fx to prostate bed, ADT (6 months Lupron)
PSA: 9/14 to 8/15: <.1, <.1, .1, .3, .7, 1.2
9/15 MRI, CT-PET finds two iliac lymph nodes suspicious for PCa; organs and soft tissue clear ; Start ADT3 plus plus Metformin, Cabergoline, Estradiol patch, Prolia , Vitamin D3, calcium. IMRT 75 grays/50 Fx to pelvic lymph nodes. Stopped ADT 11/16.
11/15-5/17: PSA rises from .03 to 2.3.
5/17: F-18 Fluciclovine (axumin) PET/CT scan finds abnormal uptake in intertrochanteric region of the proximal right femur compatible with skeletal metastasis measuring approx. 9 mm. No other adverse findings. Restart ADT3; start monthly Xgeva
6/17 SBRT, 30 grays/ 3 Fx to femur met.
7/17 PSA 0.3, T 3.0

NKinney
Veteran Member


Date Joined Oct 2013
Total Posts : 686
   Posted 9/13/2017 7:47 AM (GMT -7)   
Sukishe1 said...
Diagnosed in 2013, had surgery for a gleason score of 4+3 plus a tertiary score of 5. My PSA never went to undetectable, and Fourteen months after surgery had a doubling of PSA which required 38 sessions of Salvage radiation and hormonal therapy (Lupron). Now about 18 months later my PSA which had been undetectable has now risen slightly and no longer undetectable. Based on my situation I expect that my PSA will continue to increase, how quickly is any ones guess. Any thoughts?



Yes. This is the nature of recurrent prostate cancer. As long as your body continues to respond favorably to the temporary suppression of PSA (which is a suitable measure of your recurrent prostate cancer's growth), you will likely undergo more similar cycles. (Specifically, cycles of "on" lupron" to suppress PSA, then "off" lupron and wait until PSA rises again, then back "on.") Once the suppression becomes ineffective, there are multiple other (albeit more onerous) treatments available.
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