Good evening, pt with prostate cancer & turp done for him in 2010 & now on hormonal therapy but the tpsa level increased > 70. why? what to do? thanks

Biochemical relapse: Most likely this is a case of biochemical relapse. However, metastatic disease should be ruled out ( ct scan, bone scan) . If there is no site of metastatic disease- then it is biochemical relapse. Then in that case, he should see a radiation oncologist for local radiation to the prostatic area, in addition to hormonal therapy. Discuss further with oncology team.

Castrate resistant: I am not certain exactly what form of hormone deprivation he is on, but if it is an lhrh agonist or orchidectomy and the psa climbs, it typically means the cancer is "escaping" the effect of androgen deprivation. A review of his meds with an oncologist would be helpful and possibly add other drugs or consider next line therapy if his health permits. Best of luck to you.