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What Causes Elevated PSA Levels Even After Prostate Cancer Surgery?
Question: Hello,
My dad in-law was diagnosed with prostate cancer about 10 years ago. He eventually got surgery and we thought everything was fine. Earlier this year he finally greed to get a PSA test and came back with a whopping 70 count. The doctors recommended and enacted 13 radiation treatments on him. During his recovery he was also on a natural sour sop regiment and b-17 regiment. His PSA level was supposed to go down. This past Friday he got the test result back for his PSA level check and it climbed to 210. Can you please advise me on what to expect or what options we currently have?
My dad in-law was diagnosed with prostate cancer about 10 years ago. He eventually got surgery and we thought everything was fine. Earlier this year he finally greed to get a PSA test and came back with a whopping 70 count. The doctors recommended and enacted 13 radiation treatments on him. During his recovery he was also on a natural sour sop regiment and b-17 regiment. His PSA level was supposed to go down. This past Friday he got the test result back for his PSA level check and it climbed to 210. Can you please advise me on what to expect or what options we currently have?
Brief Answer:
Ct scan and bone scan is needed to stage his PrCA
Detailed Answer:
Good Day and thank you for being with Healthcare Magic!
a few questions for clarifications
1. When you say surgery few years back do you mean a radical prostatectomy? what was the PSA before the surgery and after? what was the pathology result? gleasons score?
2. what there a ct scan done and bone scan now that the PSA is at 70 prior to radiation treatment? What is current stage of his prostate cancer now?
If your father was my patient I would get an abdominal ct scans and a total body bone scan to be able to stage his prostate cancer better. If there are no distant metastasis or spread then I can recommend radiation treatment with hormonal treatment. I would suggest asking your doctor about LHRH agonist injections which is better than casodex in controlling the hormones that will surely affect the PSA.
If the PSA doesn't still go down then chemotherapy may be instituted for patients for who are healthy enough to receive the drug. Also there are 2nd line treatments like abiraterone acetete that you may ask your urologist about.
I would also suggest going to a high-volume center since they have a better experience and generally better outcomes in cancer care.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.
Ct scan and bone scan is needed to stage his PrCA
Detailed Answer:
Good Day and thank you for being with Healthcare Magic!
a few questions for clarifications
1. When you say surgery few years back do you mean a radical prostatectomy? what was the PSA before the surgery and after? what was the pathology result? gleasons score?
2. what there a ct scan done and bone scan now that the PSA is at 70 prior to radiation treatment? What is current stage of his prostate cancer now?
If your father was my patient I would get an abdominal ct scans and a total body bone scan to be able to stage his prostate cancer better. If there are no distant metastasis or spread then I can recommend radiation treatment with hormonal treatment. I would suggest asking your doctor about LHRH agonist injections which is better than casodex in controlling the hormones that will surely affect the PSA.
If the PSA doesn't still go down then chemotherapy may be instituted for patients for who are healthy enough to receive the drug. Also there are 2nd line treatments like abiraterone acetete that you may ask your urologist about.
I would also suggest going to a high-volume center since they have a better experience and generally better outcomes in cancer care.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello:
In 2006 he was diagnosed and had his testes removed and also had radio therapy. His PSA was 23 before he had his testes removed. He was on casodex during recovery. After this, his PSA dropped to -1. He neglected to keep up with his treatment for years and only decided to test his PSA level January of 2014. This is when ww discovered a PSA of 70. He did have a ct scan and bone scan and discovered the cancer to be in his bone. He is currently at stage M-1B. It is in his bones but not in hia organs. Currently, since discovering a PSA of 210 on Friday, he has began chemotherapy right away. The doctors will test the PSA soon after. He began radiation treatment this January, along with hormone treatment and the LHRH injection. This has not helped the PSa level since it has now more than doubled.
Can you also tell me more about this 2nd line treatment as well? )abiraterone acetet e
In 2006 he was diagnosed and had his testes removed and also had radio therapy. His PSA was 23 before he had his testes removed. He was on casodex during recovery. After this, his PSA dropped to -1. He neglected to keep up with his treatment for years and only decided to test his PSA level January of 2014. This is when ww discovered a PSA of 70. He did have a ct scan and bone scan and discovered the cancer to be in his bone. He is currently at stage M-1B. It is in his bones but not in hia organs. Currently, since discovering a PSA of 210 on Friday, he has began chemotherapy right away. The doctors will test the PSA soon after. He began radiation treatment this January, along with hormone treatment and the LHRH injection. This has not helped the PSa level since it has now more than doubled.
Can you also tell me more about this 2nd line treatment as well? )abiraterone acetet e
Brief Answer:
Maybe too early to say that chemo failed.
Detailed Answer:
Treatment for metastatic prostate cancer would be hormonal treatment (Casodex and LHRH injections) and Chemotherapy (Docetaxel). After cycles of docetaxel if there is no change in the PSA then that is the time to try the 2nd line treatment which is abiraterone acetate.
Abiraterone acetate is like docetaxel and is given though IV and is usually given after failure of docetaxel chemotherapy. This has been shown to decrease PSA, time to radiographic and decrease in pain due to cancer.
I personally think that it maybe too early to say that the chemotherapy is not working and we should wait for a few more treatment cycles.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.
Maybe too early to say that chemo failed.
Detailed Answer:
Treatment for metastatic prostate cancer would be hormonal treatment (Casodex and LHRH injections) and Chemotherapy (Docetaxel). After cycles of docetaxel if there is no change in the PSA then that is the time to try the 2nd line treatment which is abiraterone acetate.
Abiraterone acetate is like docetaxel and is given though IV and is usually given after failure of docetaxel chemotherapy. This has been shown to decrease PSA, time to radiographic and decrease in pain due to cancer.
I personally think that it maybe too early to say that the chemotherapy is not working and we should wait for a few more treatment cycles.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Last question, can you give me an estimated time for the side effect of chemo adter each one?
Brief Answer:
Side effects are usually immediate.
Detailed Answer:
the estimated time for the side effects are usually dependent on the sites that are affected by the chemotherapy. Usually the side effects starts to appear around immediately and some would be after the 2nd or 3rd cycle already. Common side effects would be fatigue, diarrhea or constipation, back pain, edema, and derangement in liver enzymes and blood sodium and potassium.
mostly these side effects are mild and well controllable with supplemental drugs.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.
Regards,
Manuel C. See IV, M.D. DPBU FPUA
Side effects are usually immediate.
Detailed Answer:
the estimated time for the side effects are usually dependent on the sites that are affected by the chemotherapy. Usually the side effects starts to appear around immediately and some would be after the 2nd or 3rd cycle already. Common side effects would be fatigue, diarrhea or constipation, back pain, edema, and derangement in liver enzymes and blood sodium and potassium.
mostly these side effects are mild and well controllable with supplemental drugs.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: http://www.HealthcareMagic.com/doctors/dr-manuel-c-see-iv/66014 I would gladly help you. Best wishes.
Regards,
Manuel C. See IV, M.D. DPBU FPUA
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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