Is this as bad as I think it is?

Carter had his blood draw Friday and received the results this morning. His PSA has gone up again, to 1.9. To quickly review, his primary treatment was IMRT, 45 sessions. Original PSA was 6.7, and he was a Gleason 7, with cancer found in 10% or 20% of one core (depending on which lab report we're to believe) with some high grade PIN. His prostate was small. No HT given or recommended. He is now 62 years old.

Treatment was from November 2010 to January 2011. First PSA at three months following end of treatment was 1.4. Next, at 9 months post-treatment: .9. Next, at 15 months post-treatment: 1.4. Now, at 21 months post-treatment, up again to 1.9.

If relevant, his biopsies (2) were only six core.

Okay, trying to calm down. Is this the bounce or is this a trend? I can't imagine how anxious I'm going to be six months from now for the next test. Would you guys suggest waiting to panic, or would you think we should begin to find an oncologist now? Any opinions appreciated!

I just find it so hard to believe that treatment could have failed.

Mel, we're in Texas.

First off, don't panic.....it looks a trend but it is still quite likely a bounce....in the last several years in my support group, we have had 3-4 guys with similiar PSA bounces.....I believe 3 were indeed bounces, and one was a treatment failure. As my docs often will say " right now we need another data point" to see what is going on....retest in another 45-60 days and then reassess ....

That's a tough one. It could be a bounce but it looks like trend. I'd go see both an RO and a medical oncologist in the next few weeks. I think you need a good medical opinion for either some piece of mind or to start a new action plan.

Sorry you have even be thinking about that.

All the best,
Andrew

Juliet

You and Carter need to do whatever is going to put your minds at rest.

My two cents - go back and see the RO.

That said - My Oncologist would not do anything with a single PSA reading. But I'd not wait 6 months:) Two yes.

Hugs to you and Carter

Bud

We will beat this crap

Juliet, where in Texas are you. Are you close to Houston or Dallas? In Houston you have MD Anderson and in Dallas you have the SouthWest Medical Center. San Antonio also has some good oncologist. By the way, I live in Austin.

If IMRT failed then it can't be repeated. The urologist usually does hormone therapy if there is recurrence.
I'm thinking a urologist will be most involved after a recurrence at first. And oncologist if hormone therapy / androgen deprivation therapy fails. The oncologist could give an opinion about recurrence now. My 2 cents. Good luck....Robert C

Juliet,

It is easy in this PC experience to let our imagination run wild, and allow every test result, or pain send us scurrying.

You have to just settle back, deal with the facts, get 2nd and 3rd opinions, examine all of those facts and opinions, and come up with a plan of attack that makes sense.

This is a slow growing disease, and you do have time to make good decisions. I know the progression of PSA's is worrisome, but it is still low.

Not meaning to lecture, just repeating what I say to myself everyday.

Best of luck to both of you. I certainly agree with the advice of getting to a major cancer center.

In your situation I would be interviewing very good medical oncologists that do a lot of prostate work. That will take the next 90 days, within which you will have another PSA test to see if it continues to rise, moderates, or drops. Part of the med-onc questioning can be the issue of a bounce and see what they say.

On the positive side, please live life expecting this to be a bounce that is somewhat normal and be pleased when the PSA stabilizes or drops. However, have a very good med-onc in the back pocket to work with should this progression need treatment. I think it is too early to worry or lose sleep. Have a healthy concern and learn what you can and do the proper preparation. For most of us, this will be a disease we will manage for a long time, but not be cured. Thus we have to be vigilent, but not let it control us any more than other chronic conditions would.

I'm missing something here. Why shouldn't you wait six months? I mean I would also see an oncologist in the meantime but the PSA is still pretty low and not progressing too fast if we are talking BCR.

The next test can be definitive. What if you retest in two months and the PSA creeps up to 2. Would you consider that the third rise that confirms BCR?

Good luck in whatever you decide.

ed

Juliet, just sending you a hug. Try and stay calm, hopefully this is just a 'bounce'.
Wishing you both well.
Susan
x

Good points, all. Susan, thanks for the hug!

We started thinking about the issue of waiting six months for the next PSA test. It might just muddy the waters to have one sooner than that. Like some of you pointed out, the fact that Pca is slow growing in the first place probably means that a few months would make no difference if this is indeed a trend instead of a bounce. And maybe it would give more time for a bounce to make itself obvious, resulting in a lower number in six months.

So, I think we are going to begin to line up an oncologist with prostate experience and just prepare ourselves. For some reason, I just don't believe it. There is no good reason the radiation should have failed in his case. Trying to be optimistic, not naive!

Thanks again for the replies and I will be watching all of your own stories...

Juliet