Rising Psa After Rp - Opinion On When To Start Rp

I am currently 49 and had RP 5 years ago this month.  Gleason 6 with positive margin.  PSA was <.1 until a little over a year ago.  Tests every three months have been .10, .11, .13,.13 and last week .14.  I am getting conflicting information from different doctors and radiologists on whether to start salvage radiation now or wait until the PSA hits .20. 

I do not want to have radiation unless I know I need it due to the potential side effects but also do not want to risk waiting too long and having some cancer relocate somewhere else in my body.  Wondering it the PSA rise could possibly be some benign prostate tissue left behind that is growing slightly.

Recovered well from the RP and have good erections and no incontinence so I am concerened that radiation will make those areas worse.  If anyone has some opinions please let me know.

Thanks

On 4/25/2008 wgekw wrote:

I am currently 49 and had RP 5 years ago this month.  Gleason 6 with positive margin.  PSA was <.1 until a little over a year ago.  Tests every three months have been .10, .11, .13,.13 and last week .14.  I am getting conflicting information from different doctors and radiologists on whether to start salvage radiation now or wait until the PSA hits .20. 

I do not want to have radiation unless I know I need it due to the potential side effects but also do not want to risk waiting too long and having some cancer relocate somewhere else in my body.  Wondering it the PSA rise could possibly be some benign prostate tissue left behind that is growing slightly.

Recovered well from the RP and have good erections and no incontinence so I am concerened that radiation will make those areas worse.  If anyone has some opinions please let me know.

Thanks

It is possible that  slow PSA rises after surgery can be due to benign causes.

Testing with DRE and biopsy can sometimes detect the location of any local recurrence. 

The usual criteria for additional treatment is when PSA rises above the  .2 you mentioned. Some are more agressive in instances when the rise happens soon after surgery with a short doubling time.

Hello.

I'm in the same boat as you, or you are in the same boat as me.

I had RP just over four years ago and had a positive margin. My first PSA was 0.008. I'm in BC Canada and due to the fact that I had a positive margin, my Urologist sent me to the Cancer Clinic for a consultation just in case. They said they would radiate if and when my PSA reached 0.5.

It took my PSA four years to get to 0.33.....then in a month it went to 0.45, then in a week it went to 0.53:..this was in February. I have since been on Lupron and Casodex....ie. two months.......and my PSA is under 0.01; got the results yesterday.

When I met with the Oncologist last week he told me they would keep me on Lupron and Casodex for six months.....radiate......then keep me on it for six more months.. I have a tentative radiation date of Aug 12th.

I'm 66......have a little bit of incontinence, and not much in the way of erections.

As a last note........the Oncologist told me that this was the best program in the world.

Good luck.............Stan.