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Recurrent prostate cancer after rrp and radiation i remained with a psa of .2 for about 8 years. this spring it rose to .3. my urologist prescribed finastaride and that has lowered the psa to .01 within 2 months. he has said we would get concerned when

4 doctor answers10 doctors weighed in
Dr. Lauren Stegman
Radiation Oncology 27 years experience
I : I am sorry to hear that your psa is rising. The psa should generally be undetectable after a rrp, if there is still some psa found in the blood it means that either there is some residual cancer or a bit of your prostate was left inside. The fact that the psa has remained relatively low and seems to be rising slowly are very good signs that if any cancer is left it is a very slow growing one. However, if there are cancer cells left Finasteride and other hormone therapy cannot cure the disease; it could only hold it in check for some time. On the other hand, radiation therapy has the potential to cure the disease and get rid of it for good with minimal side effects. This is called "salvage" radiation therapy and is a widely used treatment for a rising psa after surgery. The radiation is directed only at the "bed" where your prostate used to be, so it works best when there are cells only in this area. It would not be effective if the cancer has already spread to other parts of your body. In order to determine the chance that radiation would be effective you should see a radiation oncologist. He or she should be able to give you an accurate estimate of whether there are cancer cells left in the bed where your prostate used to be and an idea of what the cure rate after radiation would be. He or she will need to know information about your cancer before and after the surgery such as the psa, the gleason score, the stage, and the margin status to give you the most accurate information. It is always best to start salvage radiation when the psa is low, preferably below 0.6 ng/ml.
Dr. Richard Sarle
Urology 22 years experience
Recurrent cancer: In this setting you have failed primary treatment and salvage radiation. While the fact that Finasteride dropped your psa is good news, many docs would place you on hormone ablation in this setting.
Dr. Andrew Turrisi
Radiation Oncology 47 years experience
You have done really: Well. You now suffer with psa-osis. The psa rises trivially, and you quake. No one has ever died of a psa rise. It does mean you are not cured, but you live many years well with these levels. It would have helped to know original gleason, psa and use of big anti-hormones (lupron/goseralin). Celebrate your life, do not take treatment that you will regret.
Dr. Francisco R. Rodriguez
Urology 9 years experience
PSA: If you had radiation after your rrp means that probably there was some residual tissue left after your surgery which caused your psa to be elevated. That tissue usually left at the bladder neck or urethral margin could have been benign tissue. Since you responded so well to the Finasteride i would not be too concerned.

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Last updated Nov 17, 2019

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