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Urology (Expert Forum)
prostate removed----PSA now rising
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
prostate removed----PSA now rising
by jim2719, Jul 26, 2004 12:00AM
28 months ago my cancerous prostate was surgically removed.
My first post-op. PSA was 0.3. My PSA has risen slowly but steadily to a current 1.7.
Radiation has been recommended BUT my MDs cannot tell me specificly where the residual (suspected) cancer is located.Their best estimate is that the cancer is in 'the prostate bed area".
Under the above circumbstances, radiation seems to me to be a "shotgun" form of treatment using a very dangerious weapon, namely radiation.
Three questions follow from the above:
1. Are there some diagonstic tools or tests which can identify the location of my supposed residual cancer with reasonable accuracy so a more accurate/focused treatment can be developed for me?
2. Is there evidence that the use of CALCIUM D-GLUCARATE
has been successful in controlling and/or eliminating such
residual cancer?
3. OR should I be exploring other treatment options?
Thank you, jim e.
My first post-op. PSA was 0.3. My PSA has risen slowly but steadily to a current 1.7.
Radiation has been recommended BUT my MDs cannot tell me specificly where the residual (suspected) cancer is located.Their best estimate is that the cancer is in 'the prostate bed area".
Under the above circumbstances, radiation seems to me to be a "shotgun" form of treatment using a very dangerious weapon, namely radiation.
Three questions follow from the above:
1. Are there some diagonstic tools or tests which can identify the location of my supposed residual cancer with reasonable accuracy so a more accurate/focused treatment can be developed for me?
2. Is there evidence that the use of CALCIUM D-GLUCARATE
has been successful in controlling and/or eliminating such
residual cancer?
3. OR should I be exploring other treatment options?
Thank you, jim e.
Doctor's Answer
by Kevin Pho, MD, Jul 30, 2004 12:00AM
, Jul 30, 2004 12:00AM
To answer your questions:
1) There are several options for this scenario. In terms of diagnostic tests, bone scan with CT scan, a radiolabeled monoclonal antibody imaging test known as a Prostascint scan are options. Investigational studies include an endorectal MRI as well as PET scanning.
Treatment options can include prostate bed radiation for surgery patients, salvage surgery, cryotherapy or brachytherapy for radiation patients, traditional or non-traditional hormonal therapy, and observation.
In general, radiation for PSA-recurrence after radical prostatectomy provides durable benefit for men and should be discussed.
2) I am not aware of studies involving Calcium glucarate in your situation.
3) Other treatment options (listed above) should all be discussed with your personal urologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Bibliography:
Moul. Management of rising serum PSA following local therapy for prostate cancer. UptoDate, 2004.
1) There are several options for this scenario. In terms of diagnostic tests, bone scan with CT scan, a radiolabeled monoclonal antibody imaging test known as a Prostascint scan are options. Investigational studies include an endorectal MRI as well as PET scanning.
Treatment options can include prostate bed radiation for surgery patients, salvage surgery, cryotherapy or brachytherapy for radiation patients, traditional or non-traditional hormonal therapy, and observation.
In general, radiation for PSA-recurrence after radical prostatectomy provides durable benefit for men and should be discussed.
2) I am not aware of studies involving Calcium glucarate in your situation.
3) Other treatment options (listed above) should all be discussed with your personal urologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
Medical Weblog:
kevinmd_b
Bibliography:
Moul. Management of rising serum PSA following local therapy for prostate cancer. UptoDate, 2004.
