I'm back

Hey there, below is the history

Short story, G6, RALP 11 year ago. at 0.2 PSA now and considering radiation
Its been a long slow climb to 0.2 and its been the same for some time

My biggest concern is the additional side effects of radiation. Comments on your experience would be helpful



11/24 Consulted with RO, recommend treatment now while PSA is low
PSA 0.2 (H) 10/15/2024
PSMA Pet Scan - Negative
New urologist, recommended PSMA PET Scan
PSA 0.2 (H) 04/05/2024
PSA 0.2 (H) 01/11/2024
PSA 0.1 (H) 10/10/2023
PSA 0.1 (H) 07/30/2023
PSA 0.2 (H) 05/31/2023
PSA 0.2 (H) 02/18/2023
PSA 0.2 11/20/2022
PSA 0.2 08/28/2022
PSA 0.2 (H) 08/14/2022
PSA 0.1 08/29/2021
PSA 0.1 08/09/2020
PSA 0.1 (H) 02/23/2020
PSA<0.1 06/02/2019
PSA 0.1 (H) 02/24/2019
PSA 0.1 12/02/2018
PSA<0.1 01/27/2018
PSA<0.1 07/08/2017
PSA<0.1 12/22/2016
PSA<0.1 07/29/2016
PSA<0.1 01/29/2016
PSA<0.1 12/07/2015
PSA<0.1 07/08/2015
PSA<0.1 12/29/2014
PSA<0.1 07/07/2014
PSA<0.1 01/13/2014


More G6 found in pathology, positive margin at bladder neck
RALP 11/2013

BIOPSY G6 a few positive cores
PSA 14.6 (H) 08/20/2013
PSA 14.7 (H) 06/24/2013



SURGICAL PATHOLOGY CANCER SUMMARY: Prostate cancer. (Based on AJCC/UICC TNM, 7th edition; CAP Protocol web posting date: June, 2012).
SPECIMEN TYPE: Prostate.
PROCEDURE: Radical resection.
SPECIMEN WEIGHT: 65 g.
HISTOLOGIC TYPE: Adenocarcinoma, conventional type.
HISTOLOGIC GRADE (GLEASON):
PRIMARY PATTERN: 3.
SECONDARY PATTERN: 3.
TERTIARY PATTERN: None.
TOTAL GLEASON SCORE: 6.
PERCENT OF PROSTATE VOLUME WITH CARCINOMA: Less than 5%.
TUMOR SIZE: Multiple small tumor nodules are identified. Three of the tumor nodules are located in the right lobe, the largest of which measures 0.6 cm. The left lobe additionally contains a smaller tumor nodule that measures 0.7 cm.
EXTENT OF INVOLVEMENT: Not extensive and appears to be confined to prostate.
EXTRA-PROSTATIC EXTENSION: Not definitively identified. However, the tumor cells are focally transected at the bladder neck margin.
SEMINAL VESICLE INVASION: Absent.
LYMPHO-VASCULAR INVASION: Absent.
PERINEURAL INVASION: Present.
MARGINS: The tumor cells are focally transected at the bladder neck margin. In addition, they are located less than 0.1 cm from the left anterior and right anterior edges of the prostate, 0.15 cm from the left posterior, 0.25 cm from the apex margin and 0.9 cm from the right posterior edges of the prostate.
LYMPH NODES: Not submitted for pathologic evaluation.
TREATMENT EFFECT: N/A.
ADDITIONAL FINDINGS: High-grade prostatic intraepithelial neoplasia.
PATHOLOGIC STAGE: pT2c, pN0.
BEST TUMOR BLOCK(S) IF REQUIRED FOR ADDITIONAL STUDIES: A8, A18, A19, A13, A11.

Post Edited (Patrick M) : 12/4/2024 5:36:58 PM (GMT-5)

Since your PSA tests only go out to 1 decimal place it’s hard to truly know what’s been going on all these years. I’m not sure PSMA scan would show anything at PSA of 0.2. Maybe just see what an RO says.

My adjuvant radiation was not the worst thing that ever happened to me. I continued working but I always made sure I knew the location of the nearest restroom.

Hi Patrick,

I had 39 rounds of radiation beginning 9 months after surgery (Oct. - Dec. '21), along with 6 months of ADT. Like you, I had bladder neck invasion as part of my pathology and a negative PET scan prior to treatment. You can see other details in my signature.

Only one side effect to note...I had regained nearly 100% of bladder control before beginning radiation. Now, I now need 1 pad/day.

Good luck with your decision.

Hello Patrick - Your PSA history is quite amazing and quite inconclusive. You seem to have a persistently low PSA that is going nowhere fast. That is good news.

It seems odd that you would get quarterly testing and then measure PSA at 0.x, lots of approximate data? However, whatever your PSA is doing is very slow and apparently not aggressive in nature.

I think I would get some other opinions on possible treatment from some prostate specialists that might include another PSMA scan at 0.30. I had adjuvant radiation starting 5 mos after surgery and did not have any lasting side effects so I would say it was not a big deal other than a good time waster. Others have had different experiences so I would not volunteer for RT unless there was a compelling reason to.

Normally someone would look at doubling rate as an indicator but your PSA is not really showing a doubling concern as it creeps along nor does it show your PSA is > 0.20 so still not technically meeting the recurrence criteria.

That’s all I got.

Patrick, not much to add to the excellent responses you've gotten. Except, like the others, I had negligible side effects from 40 rounds of salvage. The Hormone Therapy was not fun, but very manageable, and side effects from that were temporary

Seems with such a slow rise, you can be confident this is not an urgent situation, to say the least

Well, I had an Ultra Sensitive PSA and the reading was 0.15, That is some good news to wrap up the year

I'll see about getting another in 6 months.