jkwleo

Seems that you made the correct choice. Radiating all those lymph nodes and ADT would probably not have accomplished much other than temporarily lowering your PSA during the treatment period. I am sure the Uro and RO are scratching their heads and wondering just like you are doing.

Take the recovery slow as you may feel better than your body actually is in a few days. Keep up the walking and don’t lift heavy objects, etc.

Sounds like monitoring your PSA and periodic PSMA and other scans may be on the horizon. There are other tracers that can be used also that may be more effective in your case. Not much you can do if you can’t find the cancer other that chemicals which are premature at this point in my layman’s opinion.

Hang in there...plenty of water and fiber...soon your gut will wake up and the relief will be tremendous.

I am hanging tight for sure... taking Laxative every 8 hrs... do some walking. feeling kind of weak with no energy.
hopefully a couple of more days will get my energy back.

what do your recommend? something like Metamucil ? Dr gave me senokot,

ps: Milk of Magnesia is supposed to work well also.

The tramadol is an opiate, and may be part of the constipation situation. Personally, after my RALP, I had dilaudid IV at the hospital, and took 1 dose of percoset for the drive home (2 hrs in the car, wife driving), and then one dose the next day and I was done--I really don't like what opiods do to me.

I'd suggest trying to transition to ibuprofen or naloxone away from the tramadol as quickly as possible. The risks of the opiods are just too high IMO

no catheter for me, instead, I had a bottle & a tube attached to stomach to suck the fluids out of my body for about two days. I sent the volume with picture of the fluids to surgeon 3-4 times a day.
Right now, it is still painful when pee-pee... and I also notice that my "sausage" is swollen a little.

one week after the surgery,

1. I still have pain when pee-pee and frequency is significantly higher,
2. swollen down there, has not improved at this point,
3. some bruises on my stomach,
4. trying to walk 45 mins a day,
5. energy is slowly getting back,

Constipation is improving once I stop Tramadol. It needs more time to go back to normal...

So, to be clear: you had SBRT 7 years ago, had a recurrence, and then surgery? And now, your PSA is still on the rise.

It's a head scratcher, to be sure. I have a feeling you're headed for more scans, so they know where to shoot.

28 lymph nodes surgery removed last month and all negative.
I am wondering what PSA is still going upward? something is hidden and PET didn't detect?
What are my options now moving forward?
Your opinions are most welcome !

PSMA (on cancer cells) and PSA (blood test) are not directly related so it is always possible to have a variation that does not produce much PSMA. There are a couple of PSMA tracers plus a few older tracers so it may be possible to try another tracer that might provide better results in your situation. This is where a radiologist may have some expertise about tracers. You may have to go to a different facility to find the best tracer though given short half lives of some.

Suggest seeing a good medical oncologist that specializes in prostate cancer. IHMO, you will need more scans with different tracers to find the PSA source. That is really your only option prior to going on ADT to control the situation.

You need someone aggressive and willing to fight with the insurance companies on your behalf. Can not think of much else at this point in your journey.