Slow PSA Rise in 8 years

[80sturgis]

I'm 58yo had a radical prostatectomy in Aug. 2008. My psa levels were checked every 6 months and would go from .01 and slowly increase usually .01 every time and sometimes down, to my latest of .25 in Jan. 2011. My Gleason was 6.5 with neg. margins. Thru  out this time I've seen 3 different oncologist, including Mary Ellen Taplin at Dana Farber in Boston. I'm going to see another 1 now because my doctor suggested it. Is radiation the only treatment option I'm going to be given? My slow rise up and down and the many answers I'm given on what to do are confusing. I've been told .2 is the cut off and others say wait. Any suggestions. I'm healthy and no symtoms. Thank you

[jbgood289]

I would not get the rad treatment or the HT.  I have had both and the HT has been hell.  I was lucky that I picked the Tomotherapy (43 sessions) which did not leave me with incontinence.  I have done a lot of research since I was first told I had PCa.  I had a PSA of 39.6 and a Gleason of 8 (Apr 2009).  My PSA is currently at 0.033 and going down.  If I had it all to do it all over again I would go for the alternate treatment first and if (which I doubt) that did not work go for the conventional treatment.  The conventional doctors just dont tell you all of your options.  There are many (over 350) ways to treat cancer.  If you need help and some web sites to look at I can help.    

[80sturgis]

Just had a pelvic-abdominal scan but haven't heard from the doc. yet. Would like to stay away from rad. if possible. And yes, the rad. oncologist doesn't tell you of other available treaments. I believe taking Pomegranite slowed my doubling time considerably. Was thinking of going back to Dana Farber in Boston for another opinion. Have checked some things on the web, but gets pretty confusing, lot of sales pitching. Would like to find alternative ways to slow the PSA rise. Thanks

[fleatrainer]

I had the same surgery 5 Aug 2008 at age 62 here is my story. My biopsy showed PSA 5 and Gleason 7 but pathology of my prostate when it was removed it was actually a Gleason 9, 3 months after surgery my PSA was 22 which meant cancer cells are still somewhere in the body. We decided the best approach for me would be both Radiation and Hormone Therapy. I had 9 weeks of Radiation, then normally the HT would consist of having an injection under the skin of Zoladex, however I had a bad reaction to the injection so I was put on Casodex pills 150 mg per day for 2 years, and I am still on them. I have incontinence very bad with no improvements so I wear diapers 24/7. Last year I started  bleeding at the rectum due to the radiation, so far I have had 5 procedures and one set for Feb 9 similar to a colonoscopy to try and stop the bleeding with cauterizing and it has helped. If I were in your shoes with that small PSA rise I would not do anything but watch and wait. I hope this helps you.

[curmudgen]

There is a great book that all men and their partners should read...title "Invasion of the Prostate Snatchers"  written by a prostate oncologist and co-authored by someone who have PC.  Best balanced read out there on the subject...to me watchful waiting seems a good alternative considering the risks of invasive procedures.

[DRwillieH]

I am 64 yo. Had been using the tostesteron for over a year now and have been checking my PSA ever 3 months. Last October it was at 2.2 consitently for the last 3 years. Last week during my regular PSA check up it went up to 5.1. The urologist scheduled me for a biopsy this week and I have seen articles about the biopsy risk. Has anyone experience any issues with Biopsy? I also have PCan with my Dad. He has the XRays treatment and got rid of it with minimal issues.

Please let me know the other options available as my family doctor warned me that the urologist are more incline to cut you up and do not advise you of all the options available.

Thank you.

[fleatrainer]

No there is nothing that can be done for my incontinence. If my bladder is full it flows, if I laugh, sneeze, cough or lift anything it flows. The worst side affects from the radiation for me is incontinence and rectal bleeding (proctitis). I will say again, if I were you, I would not have radiation until you absolutely had to. Good luck and thanks.

[80sturgis]

Thanks for the input. I just saw another Rad. Oncologist. After talking with him I'm going to have a pelvic-abdominal scan and if nothing shows I will have another PSA test in 3months. Being at .25 after 8 years seemed still low, but he suggested radiation in 3 mo. if it goes up again. Drinking Pomegranite I believe has slowed my doubling time a lot. Incontinence is the worst of the radiation side affects, even tho the R.O. says it's minimal. And not knowing if this is where the cancer is, it could be a treatment I may regret. Most R.O. say .2 PSA is the cut-off, but I've read where a lot of people have way higher than that and don't do anything. Can they do anything for your incontinence? I hope things get better for you.