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increase in psa

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Prostate Cancer
increase of psa from .19 to .37 past six months to today. prostatectomy for prostate cancer 7 years ago
prostate cancer - 100.0% - 2 votes
increase in psa .19 to .37 in six months - 0.0% - 0 votes
prostatectomy 7 years ago for prostate cancer - 0.0% - 0 votes
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Posted 2/26/2018 1:04 PM (GMT -5)
hi. my brother had prostatectomy 7 years ago for prostate cancer. 6 months ago had psa of .19 six months later today has psa of .37 should he be very concerned. please contact me. thanks
Posted 2/26/2018 1:09 PM (GMT -5)
He should definitely be talking to a radiation oncologist about his recurrence.

(BTW- you opened two similar threads - I suggest you delete the other one, or ask the moderators to lock it.)
Posted 2/26/2018 1:26 PM (GMT -5)
yes concerned (not very concerned, but concerned).

Call the RO, he'll need to discuss getting more treatment.

He has plenty of treatment options left.

Andrew
Posted 2/26/2018 2:18 PM (GMT -5)
JJ:

I noticed that you had made a failed first attempt at starting this discussion thread. I've deleted the other stray posting for you.

His PSA has risen above the threshold that makes it certain that he is having a recurrence. That's unfortunate but, on the other hand, the fact that it has taken six or seven years to get there is a generally good sign. He needs to talk to a radiation oncologist about additional treatment. The chances are good he is still easily curable.

Do you happen to know his Gleason score from his post-op pathology report after his surgery? That's a number written as the sum of two other numbers. Mine is Gleason 9(4+5) which is high risk. Most men diagnosed with prostate cancer are Gleason 6(3+3) which is much less dangerous.

It would also help us to know your brother's age. Different treatments make more or less sense depending on how old a man is.

Welcome to the Forum, by the way, sorry you had to look for us but glad you found us. Hope we can help.
Posted 3/8/2018 7:28 AM (GMT -5)
thank you guys for you immediate response. the medical profession needs your level of dedication and concern. I promise to keep you updated. I am going to get my brothers initial values gleason score and stage. he had a radical prostatectomy 7 yrs ago. the cancer did extend some into the seminal vesicle. the doctor performed a complete extensive excision and said they "got it all" the final pathology did say that the margins of the excision borders had no cancer. yet his psa just recently rose. he is 64 years old. he is getting a repeat psa in 3 months. thanks again
Posted 3/8/2018 7:30 AM (GMT -5)
hi. his psa rose from .19 to .37 in past 6 months. he is getting repeat psa in 3 months. thanks
Posted 3/8/2018 7:45 AM (GMT -5)
hi. I got his info. gleason score G7(4,3). had 41 cores cancer in 9 cores. surgery sept 2011. preop psa 20.0
Posted 3/8/2018 7:54 AM (GMT -5)
cancer in 29 cores out of 41 cores. sorry my old computer sometimes skips when I put in numbers
Posted 3/8/2018 8:13 AM (GMT -5)
According to his grade he is in the unfavorable intermediate category (group 3 of 5). But his SV invasion puts him in the very high risk category even without positive margins. Said that, his 7 year low PSA without any adjuvant therapy before this recurrence is a good indicator of a less aggresive behavior. Now he has a double psa period of 6 months that is not too bad, but not good either. I would recommend to visit a radiation oncologist without waiting those 3 additional months, but I understand that his doctor opinion may prevail.
Posted 3/8/2018 12:32 PM (GMT -5)
thanks jmadrid so much for your advice. my brother did have one course of hormone therapy and one course of radiation 6 years ago. I am glad to see that your psa is .08 thank you
Posted 3/8/2018 12:41 PM (GMT -5)
I'm no doctor, but based on this pathology and the increase in PSA to .37, I'm not sure I'd want to wait three months for another PSA test. Was that on the advice of his surgeon or an RO? If he doesn't have an RO lined up, I think that should be his first priority.
Posted 3/8/2018 12:49 PM (GMT -5)
I agree with Michael_T and jmadrid... I don't think he should wait 3 months before seeing a radiation oncologist. That is a very rapid PSA doubling time, and with his high initial PSA, stage T3b, predominant Gleason pattern 4, his risk for metastases is very high. he should ask for an Axumin scan to start with to rule out distant metastases (if there are distant mets, salvage radiation is futile).
Posted 3/8/2018 1:00 PM (GMT -5)
Jasonjames,
My advice was assuming a first rise after surgery. An increase after ADT + SRT is different. Maybe it is better to wait to see a trend before the scan, as your doctor recommends. Anyway, it is something to carefully follow but a long time since surgery is a good indicator of a not so aggresive relapse. Good luck.

I am not very happy with my psa 0.08 and exotic 5+3 grade. Also waiting for a trend.
Posted 3/8/2018 1:08 PM (GMT -5)
A note to other responders...poster did say his bro did have a course of radiation and HT 6 years ago...this tells me systemic and Urological/Medical Oncologist is what he needs...like now... ps I see Jmadrid caught the rad/adt treatment..
Posted 3/8/2018 1:15 PM (GMT -5)
I should point out that a year after surgery with the adt/srt indicates someone saw a bcr and acted on it...so dulls the point long time to bcr...I think...not there are not boards{surfer speak} in the quiver still
Posted 3/8/2018 1:33 PM (GMT -5)
Thanks logo...I had missed the post about having ADT and SRT.

jasonjames, that info does make this more challenging and I'm not knowledgable enough the various scans available to know what would be an appropriate next step, but it seems that might be a possibility. Do keep us posted and best of luck to your brother.
Posted 3/8/2018 2:41 PM (GMT -5)
Logosdilat,
I agree, my comment about the long time before his second relapse is not based in anything I have read. I think a more aggresive disease would relapse earlier, but this is just a intuitive opinion and my intuition fails often. Maybe others have more useful information about it.
Posted 3/8/2018 3:25 PM (GMT -5)
Why do you guys say he had SRT already? There's nothing in this thread about that. Jasonjames - please include a signature for your brother.
Posted 3/8/2018 4:06 PM (GMT -5)
TA,
jasonjames has posted his brother has received ADT+ radiation after surgery. It is not clear if it was adjuvant or after a recurrence so that I incorrectly mentioned SRT and a second relapse. But I guess the main point is that he had radiation as second line therapy.
Posted 3/8/2018 4:08 PM (GMT -5)
TA He said his brother had one course of HT and one course of radiation 6 years ago...admittedly one course is ambiguous..{in the post above MichaelT which is above yours}.hopefully you can define what he meant by that and set the the thread on a correct...well...a correct course
Posted 3/8/2018 4:16 PM (GMT -5)
No I think you are correct on yhat Jmadrid...prognosis is better with greater period between initial treatment and "bcr" or secondary.I have no idea where adjuvent fits in to this strange cocltail having said that hopefully either TA and/or brother Jason james can clear up by what is a clear reference to HT and radiation in his very last post on his thread... also this is the very danger of internet medical advice...one man ...TA or any one...can not and should not have to sort out all the misinformation...we are all human... this is and will always be an internet forum...no thing or one can change that...caveat emptor ps I have maintained since being a member that a signature should be a requirement for posting...no idea if that is logistically possible so perhaps it is just a dream within a dream without sig-nificance : confused
Posted 3/8/2018 5:01 PM (GMT -5)
Thanks, jmadrid.

Jasonjames - is there any way you can convince your brother to join HW? He would certainly know more about his case, and there is less danger of info being lost in translation.
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