Prostate Salvage

Offline Ianw23 over 5 years ago

In 2017, I was treated for Bladder Cancer and had a radical cystectomy. My histology revealed that I also incidental prostate cancer. My scans have all been clear although I did have to have a kidney removed due to surgerical complications.

In Nov 2019, my PSA level had risen to .02, but Consultant and Clinical Nurse were not unduly worried. In fact, I was told it still very low and it would be monitored. I am under 2 hospitals, but would like to know, if I have to have Salvage Treatment, what can I expect?

Offline telemando over 5 years ago

Hi Ianw23.
My, you've been through the mill.
I'm not a doctor, but I had a radical prostatectomy back in 2010.
My understanding is that the first line of salvage therapy after a failed radical prostatectomy is a course of X-rays in the region of the prostate bed. This may be accompanied by hormone therapy.
As your consultant says, 0.02 is very low; the presence of two figures after the decimal point indicate that your PSA is being measured by a high precision PSA machine. Most machines only record to 1 decimal value and on such a machine, your PSA would be recorded as < 0.1
You haven't yet reached the point of "biochemical relapse", which is when the PSA reaches some point at or above 0.2 (there is some discussion about what the actual figure should be). Nevertheless, I can understand why this is a worrying development. No doubt your PSA will continue to be monitored, and we can hope that it stabilises at a figure well below 0.1.
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Offline Ianw23 over 5 years ago in reply to telemando

Hi thanks for that.
Have your PSA levels fluctuated?
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Offline telemando over 5 years ago in reply to Ianw23

No. So far my PSA has been < 0.1 at each reading, but of course you can never be certain about the next reading!
Can you remember your PSA before the operation, and what your Gleason score was for your prostate cancer?
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Offline Ianw23 over 5 years ago in reply to telemando

Without going back to old letters, I can't remember by Gleeson score, but it had a combined score of 7. The PSA level was low, but the PC was only discovered after surgery and was contained to the Prostate.
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Offline telemando over 5 years ago in reply to Ianw23

Again, I'm not an expert, but a Gleason 7 cancer that was confined to the prostate with a low PSA isn't likely to spread. This might just be some artifact of the machine that measures the PSA. It's far more sensitive than the usual machines, and it's working at the limit of its sensitivity. If your blood had been assessed by the more common machines it would still be at < 0.1 and you wouldn't be worrying.
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Offline Ianw23 over 5 years ago in reply to telemando

Thank you for your help it's greatly appreciated
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Offline Ianw23 over 5 years ago in reply to telemando

Sorry I meant to add that you've been very reassuring.
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