That is a relatively high PSA and I would make sure there is no obvious metastatic disease. You may want to consider a sodium fluoride PET scan which is much more sensitive than a conventional bone scan.
Hormone therapy in the setting of metastatic disease typically works for 18 months (according to the literature), but in real life this is often much longer.
You should speak with your urologist about the side effects of hormone therapy and maintaining bone health. You may want to consider taking Prolia at the same time.
Fortunately when the hormones stop working we are in an era when there are several options for patients who become hormone resistant. (CRPC).
There is considerable new data about the use of MRI in patient's with elevated PSA and or strong family history. This can typically be done without an endorectal coil. (probe in rectum). I would still say digital exam and PSA are the first starting points, but I suspect that in the future an MRI may very well become standard of care prior to any biopsy.View Thread
Labs can vary. You should also inquire as to whether it in an ultra-sensitive PSA test or not. Different institutions use different PSA cutoffs to define BCR. HIstorically is was .4 and in some cases .2. In real life, we know on an ultra-sensitive PSA it should definitely be less than .1.
Bottom line is I would recheck it. a BCR will be obvious in that the rate will rise.View Thread
This is likely a side effect from hormonal therapy. When the testosterone is low that means the hormonal treatment is still giving a response. It will improve once the T rises. In the meantime you can ask your doctor if he can prescribe something such as Megace to help w/ the hot flashes.View Thread
That is a great question. Typically benign tissue left behind will result in an immediately detectable PSA after surgery which is usually very low (like in your case) and either stays stable or rises very slowly over time. A steadily rising PSA, however, should be considered cancer until proven otherwise.View Thread
The answer is yes. The only part of that story that is unusual is the psa of 24.6 -- that is a very high PSA for a supposedly small volume Gleason 6. Either the PSA was high for other reasons (prostatitis? infection? -- have you re-checked it recently) or the disease is understaged on the biopsy.View Thread
The slow rate of rise suggests a local recurrence as opposed to metastatic disease. Make sure they are checking an ultra-sensitive PSA. I would go ahead and get plugged in to see a radiation oncologist. You are young and you should treat aggressively. I would get an MRI and then start radiation therapy.View Thread
With all prostate cancer diagnoses you and your doctor should discuss:
1. active surveillance 2. radical prostatectomy 3. radiation 4. cryotherapy
The decision is made based on the aggressiveness of the tumor/PSA/Gleason score, etc as well as the patient's age and health. If you have more questions and want a second opinion do not be afraid to seek this out.
Take your time and make a decision you will be comfortable with.