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PSA on the rise after RP and radiotherapy

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Posted 7/29/2015 4:40 PM (GMT -5)
Hello everyone,

This is the story of my Dad's prostate cancer:

Jul 2010 - PSA 16, no symptoms
Aug 2010 RP - Adonecarcinoma acinare prostatae, Gleason score 4+3=7, pT3bN0MX, left bladder - Infiltratio carcinomatosa, nodes left & right - Lymphonodulitis reactiva (0/3)
1st Sept 2010 - PSA 0,238 | 24th Sept - PSA 0,169
Oct/Dec 2010 Radiotherapy, 64 Gy/g in 32 fractions

01/2011 - PSA 0,164
03/2011 - PSA 0,092
06/2011 - PSA 0,064
09/2011 - PSA 0,05
01/2012 - PSA 0,048
06/2012 - PSA 0,04
01/2013 - PSA 0,036
07/2013 - PSA 0,035
01/2014 - PSA 0,034
07/2014 - PSA 0,032
01/2015 - PSA 0,037
07/2015 - PSA 0,046

Could you please express any opinions?
Any suggestions what to do next?

Thanks in advance
Maciek
Posted 7/29/2015 4:48 PM (GMT -5)
welcome to HW, sorry you need to be talking to us.

How old is you dad?

That isn't a bad set of numbers, still very low PSA. If the upward trend continues then he need some additional hormone treatments at some point. The question would be when to start that. He'd want to avoid the side effects for awhile. The next step would be to consult with a medical oncologist who specializes in PC.

In his place I'd want that last test confirmed before making any decisions so perhaps a retest in 3 months and then start talking to the doctors again.

Andrew
Posted 7/29/2015 4:58 PM (GMT -5)
Hi Andrew,

He is 56.
Are there any other ways of treatments instead of hormone treatments? (Brachytherapy?)

Best wishes
Maciek
Posted 7/29/2015 5:12 PM (GMT -5)
At this point you're options are narrowing. Brachy isn't an option after the prostate has been removed. In general you can radiate an area once and he's likely has his limit to the prostate bed. HT is the next step if it's needed.

The question is what is causing the PSA raise. If it's mets somewhere else in his body then when they are big enough to see on a scan they can be treated with spot treated with RT.

For now, watching and waiting are likely fine for the moment. But if the trend continues he'll need to decide when to start another treatment.
Andrew
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