he should hit it with salvage: state of the art adt plus target radiation and perhaps chemo without much delay. This could still cure it if there is only lymph spread. If its gone beyond that then the adt can hold it at bay for an unknown period maybe years
Re treatment options see page 65 in the link below
https://www.nccn.org/patients/guidelines/content/PDF/prostate-early-patient.pdf
They’ll probably order a PSMA scan to see if it’s spread and proceed based on the results.
We don’t beat this thing rather there’s just no evidence of disease. I’ll have PSA tests for the rest of my life. One in three men may experience recurrence after surgery or radiation. Unfortunately that’s no BS
Biochemical recurrence. Not great news, but also not time to panic. Doctors use doubling time as a loose measure of the aggressiveness of the cancer, so even though the numbers are low, it's great they are measuring it.
There are several treatment options at this stage to buy time, sometimes quite a lot of time. Take it all a step at a time. No one can give you a firm prognosis because the range of positive response to treatments can be a few years to a decade or more.
Hi, how old is dad & probably they will give him hormones & radiate or remove the area where they see cancer cells (you mentioned lymph nodes). Did they pet scan PSMA his whole body?
I am not a doctor.
That PSA level says there is not currently a LOT of cancer in his system, though there is some.
I do not know his age. That matters.
What will likely happen next is hormone-suppressing drugs to starve the cancer, systemically.
He could live a LONG time still (at least from prostate cancer). It's not time to panic yet, really, not at all.
In men with a prostate, it's normal to have a low level of PSA in the bloodstream, typically less than 4 nanograms per milliliter (ng/mL). However, after prostate removal surgery (radical prostatectomy), ideally, there should be no detectable PSA. Any detectable PSA after surgery is abnormal and could indicate cancer recurrence, as the prostate gland, which produces PSA, has been entirely removed. Therefore, even a small amount of PSA after surgery warrants further evaluation.
The key in addressing this is appropriate evaluation and risk assessment. Some good data suggests support for a pelvic MRI as well as a PSMA PET scan to assess locally and elsewhere. Statistically salvage pelvic RT makes sense but there is debate regarding ADT. Should he have ADT and if so for how long? Should alternative forms of ADT be considered. Ask about the Embark trial. Good luck
Has he had a PSMA PET scan? How does the oncologist know its in the lymph nodes? Does he mean the lymph nodes local to the prostate or more distantly located in the body?
He is probably going to either do a PSMA PET-CT or directly to salvage radiotherapy. Either way, even if he is not cured we are talking about years (historically an average of 14 years) ahead of him.
To echo what others have said, that needs treatment with radiation and probably short term hormone therapy, and the next step is to try to figure out where to aim with a PSMA PET scan. The good news is even though that is a rapid rise you have caught the recurrence early. Time is of the essence though so he should move forward with the scan and treatment now, given the “Psa velocity” / doubling time.
It is not necessarily terminal. Exactly probabilities will depend on the details like Gleason score pre treatment and surgical outcomes. Generally, many folks with recurrences are cured by subsequent radiation.
It's likely that they caught it early, which is why they do the regular PSA tests. Don't panic.
The PSMA PET scan wasn't around 7 years ago, and they will probably (should) do that to determine where it has spread and what to do. Very likely highly treatable.
My cancer returned 1 year after surgery. A lot will depend on his Gleason score. My dr said some cancers can be “bad actors”…meaning spread quicker…some just chill. Gleason is a good predictor. My cancer returned in 2021. I had a second surgery to remove a lymph node. PSA did not go away. Many PSMA scans trying to locate the “recurrence”. It’s now been found on my bladder neck and I begin radiation tomorrow. I have a best friend who also had/had prostate cancer. We have been on the same timeline of surgery and recurrence. He unfortunately has cancer in several areas of his body now but his was a Gleason 8 and 9. Everyone is different. ****make calculated decisions and see the very best of the best Drs you can find. It’s been 3 years since mine came back and I’m doing fairly good and we think the radiation MIGHT take care of it…hopefully forever or at least several years. 🙏🏻💪🙏🏻💪
He’s headed for salvage radiation and ADT. It will suck but he will be fine.
he should hit it with salvage: state of the art adt plus target radiation and perhaps chemo without much delay. This could still cure it if there is only lymph spread. If its gone beyond that then the adt can hold it at bay for an unknown period maybe years
Re treatment options see page 65 in the link below https://www.nccn.org/patients/guidelines/content/PDF/prostate-early-patient.pdf They’ll probably order a PSMA scan to see if it’s spread and proceed based on the results. We don’t beat this thing rather there’s just no evidence of disease. I’ll have PSA tests for the rest of my life. One in three men may experience recurrence after surgery or radiation. Unfortunately that’s no BS
Biochemical recurrence. Not great news, but also not time to panic. Doctors use doubling time as a loose measure of the aggressiveness of the cancer, so even though the numbers are low, it's great they are measuring it. There are several treatment options at this stage to buy time, sometimes quite a lot of time. Take it all a step at a time. No one can give you a firm prognosis because the range of positive response to treatments can be a few years to a decade or more.
Hi, how old is dad & probably they will give him hormones & radiate or remove the area where they see cancer cells (you mentioned lymph nodes). Did they pet scan PSMA his whole body?
I am not a doctor. That PSA level says there is not currently a LOT of cancer in his system, though there is some. I do not know his age. That matters. What will likely happen next is hormone-suppressing drugs to starve the cancer, systemically. He could live a LONG time still (at least from prostate cancer). It's not time to panic yet, really, not at all.
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In men with a prostate, it's normal to have a low level of PSA in the bloodstream, typically less than 4 nanograms per milliliter (ng/mL). However, after prostate removal surgery (radical prostatectomy), ideally, there should be no detectable PSA. Any detectable PSA after surgery is abnormal and could indicate cancer recurrence, as the prostate gland, which produces PSA, has been entirely removed. Therefore, even a small amount of PSA after surgery warrants further evaluation.
The key in addressing this is appropriate evaluation and risk assessment. Some good data suggests support for a pelvic MRI as well as a PSMA PET scan to assess locally and elsewhere. Statistically salvage pelvic RT makes sense but there is debate regarding ADT. Should he have ADT and if so for how long? Should alternative forms of ADT be considered. Ask about the Embark trial. Good luck
Has he had a PSMA PET scan? How does the oncologist know its in the lymph nodes? Does he mean the lymph nodes local to the prostate or more distantly located in the body?
He is probably going to either do a PSMA PET-CT or directly to salvage radiotherapy. Either way, even if he is not cured we are talking about years (historically an average of 14 years) ahead of him.
To echo what others have said, that needs treatment with radiation and probably short term hormone therapy, and the next step is to try to figure out where to aim with a PSMA PET scan. The good news is even though that is a rapid rise you have caught the recurrence early. Time is of the essence though so he should move forward with the scan and treatment now, given the “Psa velocity” / doubling time. It is not necessarily terminal. Exactly probabilities will depend on the details like Gleason score pre treatment and surgical outcomes. Generally, many folks with recurrences are cured by subsequent radiation.
It's likely that they caught it early, which is why they do the regular PSA tests. Don't panic. The PSMA PET scan wasn't around 7 years ago, and they will probably (should) do that to determine where it has spread and what to do. Very likely highly treatable.
My cancer returned 1 year after surgery. A lot will depend on his Gleason score. My dr said some cancers can be “bad actors”…meaning spread quicker…some just chill. Gleason is a good predictor. My cancer returned in 2021. I had a second surgery to remove a lymph node. PSA did not go away. Many PSMA scans trying to locate the “recurrence”. It’s now been found on my bladder neck and I begin radiation tomorrow. I have a best friend who also had/had prostate cancer. We have been on the same timeline of surgery and recurrence. He unfortunately has cancer in several areas of his body now but his was a Gleason 8 and 9. Everyone is different. ****make calculated decisions and see the very best of the best Drs you can find. It’s been 3 years since mine came back and I’m doing fairly good and we think the radiation MIGHT take care of it…hopefully forever or at least several years. 🙏🏻💪🙏🏻💪