In 2011, I had brachytherapy for prostate cancer diagnosed as G6. In 2016, a second biopsy found extraprostatic recurrence. I had cyberknife in January 2017 for it together with ADT from October 2016 to April 2017. PSA went down to undetectable (< 0.1) very rapidly and stayed there until January 2018. Then it started rapidly: April 6: 0.2, July 13: 0.9, August 28: 1.3 and October 4: 1.8. The PSA doubling time using these values is 2.14 month.
In August, a bone scan and a CT scan were negative. I have an Axumin PET/CT scan scheduled for coming Friday and I will see an MO the following Monday.
My URO is ready to start intermittent ADT treatment. What troubles me is the very short PSADT. How long can I wait before starting ADT?
I know I will get some replies pointing out that perhaps some higher grade cancer was missed by the initial TRUS biopsy in 2011 because G6 cancer cannot spread. Please don't bother. I have heard it too many times and I am very much aware of what G6 cancer can or cannot do.
What I would welcome is suggestions on future course of treatment. I know the choice is very limited. I am hoping that the Axumin PET/CT scan will yield some answer for my re-recurrent cancer.
Age at initial diagnosis 70. March 2011 biopsy finds Gleason 3 + 3 prostate cancer (2/12 core 10%)
Brachytherapy June 2011. PSA falls to 0.2 by Dec 2012
Rising PSA 2015-2016
Biopsy finds cancer in extra capsular mass.
ADT and Cyberknife completed by April 2017
PSA remains undetectable until January 2018
PSA April 2018: 0.2, July 2018: 0.9, Aug 2018: 1.3 PSADT: 1.7 months
Post Edited (Going for brachy) : 10/6/2018 5:44:52 PM (GMT-6)