PSA - 14 yrs after Radical Prostatectomy

[Ireanna]

My dad is 65 yrs old, and had RP 14 yrs ago and was said FREE after year 10!  Now he has a PSA level of 3.  They did bone scans and xrays and he was told he has cancer "somewhere" in his body but they don't know where (huh?) I urged him to get 2nd & 3rd Opinion, (doc #2 feels that it is in a lymph node and doc #3 feels it could be in the 10th rib due, but doc#1 said doesn't jump around like that..)


He was given hormone pills SOLELY to take and said to follow up in 3 months time to test PSA again.  I'm worried this is too long if it is in lymph node (doesn't it spread quickly from there?)


What are your thoughts on waiting 3 months while trying solely just the hormone pills?  Shouldn't this be used in combination with shots?  Any ideas if an MRI or another test would help to pinpoint where the cancer is and whether it is in that lymph node?  ANYONE ELSE GO THROUGH the surgery and have it return after 10 years?  Thanks!!!

[Ash Tewari, MD, M.Ch.]

Hello Madam,

After reviewing the brief history you provided, it would be reasonable to suggest a full metastatic workup. A post-operative PSA of 3, we would generally recommend a medical oncology or radiation oncology workup. A bone scan is a good place to start, prostate cancer most commonly metastasizes to the bone, spine, lymph nodes and have it interpreted by radiology. I'm not sure what kind of doctor you saw previously and hormone and radiation therapy are generally left to the experts, but at this point surgical care is no longer necessary. We do recommend consultation with an expert, a medical oncologist or radiation oncologist. Please let us know if we can provide any other help.

Thanks!

[prostate98]

I had RP in '98 and am almost 70 now. My PSA went to 10 from last year's 1.08. Like  your Dad, they say my cancer is back but they don't know where it is, even after bone scan and CT Scan. Two days from now I start daily radiation treatments to the prostate "bed" area which will last 2 months (39 treatments-5 days/wk). Who knows what will work? Only can wait and see. Thought I would pass this "in the same boat" info along.

[dave734]

A related discussion, prostate cancer was started.