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Update on Rising PSA after Brachytherapy

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Prostate Cancer
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Posted 8/10/2016 8:15 PM (GMT -5)
In an earlier posting, I mentioned that my PSA started rising 30 months after brachytherapy in June 2011. It rose slowly from 0.1 to 0.4 over a period of 18 months. Then in the last one year it rose from 0.4 to 1.5. I had an appointment with urologist today. He found hardness in my prostate in DRE. I also felt some pain when he pressed on the hard part. A biopsy has been scheduled for August 31. I have very reason to assume that the biopsy would be positive. So I need to think of treatment options.
Posted 8/10/2016 8:40 PM (GMT -5)
You have every reason to assume it's not a recurrence. Pain on DRE is more typical of prostatitis than PC. It could be a lot of other things too - a cyst, scar tissue, inflamed necrotic tissue, brachy seed poking into the urethra and causing infection, stricture, fistula...

If you are having a biopsy, you should have an mpMRI-targeted biopsy, a PET/MRI scan. or a transperineal mapping biopsy. Then, if they find some cancer, they can target it. If they find some cancer and a cold spot (i.e., a place where the seeds didn't cover it well), they can simply re-treat the cold spot. Focal salvage ablation (cryo or HIFU) can be used. Recently, one RO has used focal salvage SBRT.

- Allen
Posted 8/10/2016 9:08 PM (GMT -5)
What did your uro say?
Posted 8/11/2016 2:24 PM (GMT -5)
Uro thinks recurrence
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