rising PSA after 14 years

[drillah]

My prostate was surgically removed in Dec 1993 at age 54. PSA registered 0.2 for 14 years. Since 2007 it has increased to 1.4. My urologist said a PET scan wouldn't help. Do I have any options other than hormonal treatment down the line at an older age? I would not want radiation if the cancer?(if any) cannot be located.

[purelife53]

Are these blood tests routine, or perhaps better stated should they be? Low PSA with high Gleason scores often have reverted to an embryonic state in which the PSA secreation is markedly reduced, in these cases checking serum for abnormal markers such as CGA {chromogranin A} NSE {neuron Specific Enolase} CEA {carcino Embbryonic Antigen} PAP {prostatic acid phosphatase} and my addition Testosterone...Is a good way to check for advancement of the disease because in these cases {my pt3a} still non-detecable psa 7 months post op Robotic and no other followup so far? "In such cases, normal guidlines for PSA velocity and doubling time may not be applicable."  So the big advantage that prostate cancer has over most other cancers, The PSA test after treatment, is not always accurate? Just my luck! LOL.

[Ash Tewari, MD, M.Ch.]

Thank you for your question. PET scans are used to detect high levels of metabolism. PET scans have limited use in detection of prostate cancer metastases and bone scans are often used.

Salvage radiation often occurs shortly after surgery (4-6 months). Given your time after surgery, hormones are the standard of care.

Thank you for your question.

Sincerely,

Ashutosh (Ash) Tewari, MD

http://www.cornellroboticprostate.org

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