increase in psa

increase of psa from .19 to .37 past six months to today. prostatectomy for prostate cancer 7 years ago
2
prostate cancer - 100.0%
0
increase in psa .19 to .37 in six months - 0.0%
0
prostatectomy 7 years ago for prostate cancer - 0.0%

 
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jasonjames
New Member


Date Joined Feb 2018
Total Posts : 8
   Posted 2/26/2018 12:04 PM (GMT -6)   
hi. my brother had prostatectomy 7 years ago for prostate cancer. 6 months ago had psa of .19 six months later today has psa of .37 should he be very concerned. please contact me. thanks

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10129
   Posted 2/26/2018 12:09 PM (GMT -6)   
He should definitely be talking to a radiation oncologist about his recurrence.

(BTW- you opened two similar threads - I suggest you delete the other one, or ask the moderators to lock it.)
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

InTheShop
Veteran Member


Date Joined Jan 2012
Total Posts : 8618
   Posted 2/26/2018 12:26 PM (GMT -6)   
yes concerned (not very concerned, but concerned).

Call the RO, he'll need to discuss getting more treatment.

He has plenty of treatment options left.

Andrew
I'll be in the shop.
Age 58, 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, .3 10/17
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

PeterDisAbelard.
Forum Moderator


Date Joined Jul 2012
Total Posts : 5865
   Posted 2/26/2018 1:18 PM (GMT -6)   
JJ:

I noticed that you had made a failed first attempt at starting this discussion thread. I've deleted the other stray posting for you.

His PSA has risen above the threshold that makes it certain that he is having a recurrence. That's unfortunate but, on the other hand, the fact that it has taken six or seven years to get there is a generally good sign. He needs to talk to a radiation oncologist about additional treatment. The chances are good he is still easily curable.

Do you happen to know his Gleason score from his post-op pathology report after his surgery? That's a number written as the sum of two other numbers. Mine is Gleason 9(4+5) which is high risk. Most men diagnosed with prostate cancer are Gleason 6(3+3) which is much less dangerous.

It would also help us to know your brother's age. Different treatments make more or less sense depending on how old a man is.

Welcome to the Forum, by the way, sorry you had to look for us but glad you found us. Hope we can help.
65 Slow PSA rise 2007-2012: 1.4=>8
4 bxs 2010-2012: 1&2 neg, 3 pos 1/14 6(3+3) 3-4% (2nd opn. 7(3+4)), 4 neg
DaVinci 6/14/12. "some" nerve sparing on left
Path: pT3a pN0 R1 GS9(4+5) Pos margins on rt
24 mo ADT3 7/12 - 7/14
Adj IMRT 66.6 Gy 10/17/12-12/13/12
8/2012-3/2015: Incont., Trimix, VED, PSA<0.015.
AUS & IPP installed 3/5/2015
Forum Moderator - Not a medical professional

jasonjames
New Member


Date Joined Feb 2018
Total Posts : 8
   Posted 3/8/2018 6:28 AM (GMT -6)   
thank you guys for you immediate response. the medical profession needs your level of dedication and concern. I promise to keep you updated. I am going to get my brothers initial values gleason score and stage. he had a radical prostatectomy 7 yrs ago. the cancer did extend some into the seminal vesicle. the doctor performed a complete extensive excision and said they "got it all" the final pathology did say that the margins of the excision borders had no cancer. yet his psa just recently rose. he is 64 years old. he is getting a repeat psa in 3 months. thanks again

jasonjames
New Member


Date Joined Feb 2018
Total Posts : 8
   Posted 3/8/2018 6:30 AM (GMT -6)   
hi. his psa rose from .19 to .37 in past 6 months. he is getting repeat psa in 3 months. thanks

jasonjames
New Member


Date Joined Feb 2018
Total Posts : 8
   Posted 3/8/2018 6:45 AM (GMT -6)   
hi. I got his info. gleason score G7(4,3). had 41 cores cancer in 9 cores. surgery sept 2011. preop psa 20.0

jasonjames
New Member


Date Joined Feb 2018
Total Posts : 8
   Posted 3/8/2018 6:54 AM (GMT -6)   
cancer in 29 cores out of 41 cores. sorry my old computer sometimes skips when I put in numbers

jmadrid
Regular Member


Date Joined Sep 2017
Total Posts : 153
   Posted 3/8/2018 7:13 AM (GMT -6)   
According to his grade he is in the unfavorable intermediate category (group 3 of 5). But his SV invasion puts him in the very high risk category even without positive margins. Said that, his 7 year low PSA without any adjuvant therapy before this recurrence is a good indicator of a less aggresive behavior. Now he has a double psa period of 6 months that is not too bad, but not good either. I would recommend to visit a radiation oncologist without waiting those 3 additional months, but I understand that his doctor opinion may prevail.
67 years old.
PSA: 2008:2.8; 2012-2016: 4.5-5.5. 2013: two biopsies (ASAP and neg) and a neg mpMRI.
Feb, May, July 2017: 5.5, 6.1, 7.6; free: 25%-20%
mpMRI, July 2017: PIRAD5 5.
Dx August 2017,Gleason 3+3, 2 cores, left 5%, right 3%.
Prostate more than 100 g. DRE +.
Manual LRP, november 6, 2017.
Bilat., 30% and 5%. G 5+3. Clean margins, not other features.
January 31, 2018: psa 0.08

Post Edited (jmadrid) : 3/8/2018 6:27:13 AM (GMT-7)


jasonjames
New Member


Date Joined Feb 2018
Total Posts : 8
   Posted 3/8/2018 11:32 AM (GMT -6)   
thanks jmadrid so much for your advice. my brother did have one course of hormone therapy and one course of radiation 6 years ago. I am glad to see that your psa is .08 thank you

Michael_T
Veteran Member


Date Joined Sep 2012
Total Posts : 2815
   Posted 3/8/2018 11:41 AM (GMT -6)   
I'm no doctor, but based on this pathology and the increase in PSA to .37, I'm not sure I'd want to wait three months for another PSA test. Was that on the advice of his surgeon or an RO? If he doesn't have an RO lined up, I think that should be his first priority.
Age 57, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
Completed HT (18 months) in April 2014
9/17: PSA = 0.1

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10129
   Posted 3/8/2018 11:49 AM (GMT -6)   
I agree with Michael_T and jmadrid... I don't think he should wait 3 months before seeing a radiation oncologist. That is a very rapid PSA doubling time, and with his high initial PSA, stage T3b, predominant Gleason pattern 4, his risk for metastases is very high. he should ask for an Axumin scan to start with to rule out distant metastases (if there are distant mets, salvage radiation is futile).
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

jmadrid
Regular Member


Date Joined Sep 2017
Total Posts : 153
   Posted 3/8/2018 12:00 PM (GMT -6)   
Jasonjames,
My advice was assuming a first rise after surgery. An increase after ADT + SRT is different. Maybe it is better to wait to see a trend before the scan, as your doctor recommends. Anyway, it is something to carefully follow but a long time since surgery is a good indicator of a not so aggresive relapse. Good luck.

I am not very happy with my psa 0.08 and exotic 5+3 grade. Also waiting for a trend.
67 years old.
PSA: 2008:2.8; 2012-2016: 4.5-5.5. 2013: two biopsies (ASAP and neg) and a neg mpMRI.
Feb, May, July 2017: 5.5, 6.1, 7.6; free: 25%-20%
mpMRI, July 2017: PIRAD5 5.
Dx August 2017,Gleason 3+3, 2 cores, left 5%, right 3%.
Prostate more than 100 g. DRE +.
Manual LRP, november 6, 2017.
Bilat., 30% and 5%. G 5+3. Clean margins, not other features.
January 31, 2018: psa 0.08

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5835
   Posted 3/8/2018 12:08 PM (GMT -6)   
A note to other responders...poster did say his bro did have a course of radiation and HT 6 years ago...this tells me systemic and Urological/Medical Oncologist is what he needs...like now... ps I see Jmadrid caught the rad/adt treatment..
gleason 9 contained stopped psa testing jan 2015 with two consecutive psa's a year apart at 0.15
surgery 10/09 only treatment...eyes wide open...no sand...gonna live til I die...not the reverse forgive my virtues as well as my sins...

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5835
   Posted 3/8/2018 12:15 PM (GMT -6)   
I should point out that a year after surgery with the adt/srt indicates someone saw a bcr and acted on it...so dulls the point long time to bcr...I think...not there are not boards{surfer speak} in the quiver still
gleason 9 contained stopped psa testing jan 2015 with two consecutive psa's a year apart at 0.15
surgery 10/09 only treatment...eyes wide open...no sand...gonna live til I die...not the reverse forgive my virtues as well as my sins...

Michael_T
Veteran Member


Date Joined Sep 2012
Total Posts : 2815
   Posted 3/8/2018 12:33 PM (GMT -6)   
Thanks logo...I had missed the post about having ADT and SRT.

jasonjames, that info does make this more challenging and I'm not knowledgable enough the various scans available to know what would be an appropriate next step, but it seems that might be a possibility. Do keep us posted and best of luck to your brother.
Age 57, Diagnosed at 51
PSA 9.6, Gleason: 9 (5+4), three 7s (3+4)
Chose triple play of HDR brachy, IMRT and HT (Casodex, Lupron and Zytiga)
Completed HT (18 months) in April 2014
9/17: PSA = 0.1

jmadrid
Regular Member


Date Joined Sep 2017
Total Posts : 153
   Posted 3/8/2018 1:41 PM (GMT -6)   
Logosdilat,
I agree, my comment about the long time before his second relapse is not based in anything I have read. I think a more aggresive disease would relapse earlier, but this is just a intuitive opinion and my intuition fails often. Maybe others have more useful information about it.
67 years old.
PSA: 2008:2.8; 2012-2016: 4.5-5.5. 2013: two biopsies (ASAP and neg) and a neg mpMRI.
Feb, May, July 2017: 5.5, 6.1, 7.6; free: 25%-20%
mpMRI, July 2017: PIRAD5 5.
Dx August 2017,Gleason 3+3, 2 cores, left 5%, right 3%.
Prostate more than 100 g. DRE +.
Manual LRP, november 6, 2017.
Bilat., 30% and 5%. G 5+3. Clean margins, not other features.
January 31, 2018: psa 0.08

Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10129
   Posted 3/8/2018 2:25 PM (GMT -6)   
Why do you guys say he had SRT already? There's nothing in this thread about that. Jasonjames - please include a signature for your brother.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

jmadrid
Regular Member


Date Joined Sep 2017
Total Posts : 153
   Posted 3/8/2018 3:06 PM (GMT -6)   
TA,
jasonjames has posted his brother has received ADT+ radiation after surgery. It is not clear if it was adjuvant or after a recurrence so that I incorrectly mentioned SRT and a second relapse. But I guess the main point is that he had radiation as second line therapy.

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5835
   Posted 3/8/2018 3:08 PM (GMT -6)   
TA He said his brother had one course of HT and one course of radiation 6 years ago...admittedly one course is ambiguous..{in the post above MichaelT which is above yours}.hopefully you can define what he meant by that and set the the thread on a correct...well...a correct course
gleason 9 contained stopped psa testing jan 2015 with two consecutive psa's a year apart at 0.15
surgery 10/09 only treatment...eyes wide open...no sand...gonna live til I die...not the reverse forgive my virtues as well as my sins...

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5835
   Posted 3/8/2018 3:16 PM (GMT -6)   
No I think you are correct on yhat Jmadrid...prognosis is better with greater period between initial treatment and "bcr" or secondary.I have no idea where adjuvent fits in to this strange cocltail having said that hopefully either TA and/or brother Jason james can clear up by what is a clear reference to HT and radiation in his very last post on his thread... also this is the very danger of internet medical advice...one man ...TA or any one...can not and should not have to sort out all the misinformation...we are all human... this is and will always be an internet forum...no thing or one can change that...caveat emptor ps I have maintained since being a member that a signature should be a requirement for posting...no idea if that is logistically possible so perhaps it is just a dream within a dream without sig-nificance : confused
gleason 9 contained stopped psa testing jan 2015 with two consecutive psa's a year apart at 0.15
surgery 10/09 only treatment...eyes wide open...no sand...gonna live til I die...not the reverse forgive my virtues as well as my sins...

Post Edited (logoslidat) : 3/8/2018 2:28:55 PM (GMT-7)


Tall Allen
Elite Member


Date Joined Jul 2012
Total Posts : 10129
   Posted 3/8/2018 4:01 PM (GMT -6)   
Thanks, jmadrid.

Jasonjames - is there any way you can convince your brother to join HW? He would certainly know more about his case, and there is less danger of info being lost in translation.
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog
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