General Question

sujenk7422's avatar

Is Prostate Cancer treatable? My friend had his prostate removed in 2010 but now has a PSA of 7.3?

Asked by sujenk7422 (557 points ) February 27th, 2014

I don’t understand how a gland can be removed and PSA is still being created. The doctor says that it means that the prostate cancer is back. How can this be without having a Prostate? What are the treatment methods? Does anyone know?

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11 Answers

gailcalled's avatar

I am sending this to one of our members who has dealt, successfully with prostate cancer. He may be able to help.

gailcalled's avatar

I got curious and found this:

“There is no way to know for certain if prostate cancer cells have migrated outside the surgical area, and so it is these cells that may trigger a cancer recurrence.”

“The two treatment options for prostate cancer that has recurred after prostatectomy are radiation and hormone therapy. Some physicians recommend radiation therapy alone, while others suggest a combination of radiation and hormone therapy.” Source

Adirondackwannabe's avatar

I was listening to the news tonight and they were saying prostate cancer treatments were successful in almost every case today. Is that true?

Brian1946's avatar

Here’s what I’ve gleaned from this source:

“PSA is very sensitive in detecting any recurrence of cancer. That’s because only prostate cells make PSA—so if it goes up after a radical prostatectomy, it means prostate cells are still present somewhere. For all intents and purposes, it means that a few cells escaped the prostate before it was removed, and now have grown to the point where they’re producing enough PSA to be detected.”

“Fortunately, for most men with organ-confined cancer, this never happens. However, for men who had more advanced disease at the time of surgery, the return of PSA is extremely frightening.”

“The first thing many patients want to know is, how long are they going to live?
And the first thing many doctors want to know is, when should they begin treatment, and how should they treat these patients?
Does the man have a local recurrence of cancer that would respond to radiation, or does this represent micrometastases to lymph nodes and bone?”

“On average, it took eight years from the time a man’s PSA first went up until he developed metastatic disease—which suggests that there is no need to panic at the first sign of a rise in PSA.”

LuckyGuy's avatar

I am not a doc. I have not examined him. I do not know his case. (Enough disclaimers?)

Ok. If the guy had his prostate removed in 2010 and he now has a PSA of 7.3, unless he is 98, this is bad news. Don’t let anyone blow sunshine up his butt. He has entered the twilight zone.
I will ask some questions and give the probable answer.
Did he get scanned? Yes. They found nothing. (Of course. The mets are too small and the technology is not good enough to find the small ones.)
What was his pathology? T3b, T4?
What was his Gleason Score? 9?
What was his post surgery 3 month PSA? 0.2.

He will be faced with some ugly treatment choices. If they can find a place to radiate, great. But it has very likely spread. That means he will need some systemic treatment. Hormone therapy. Lupron and Casodex. There are others. The side effects are unpleasant.
If he is a straight shooter and can look at statistics honestly, Sloan Kettering has a website that will give him his odds of survival for 1 year, or 5 years. (they won’t bother with 10 years.) He enters his stats, his pathology, his PSA doubling time and a few other things and they pop out the number based upon hundreds of thousands of cases..
I based some of my treatment options on the Sloan Kettering data – and I “won”.
My odds were nowhere near as long as your friend’s.

PM me if he wants to talk. Really. I can recommend some sites for support.

LuckyGuy's avatar

I just ran the numbers making a bunch of assumptions He is 60 years old.
I was wrong. SK gives him a 71% chance at 2 years, 49% at 5years and 30% at 10 years.

He should do the numbers himself if, and only if, he has the stomach for it.

Coloma's avatar

It certainly can be, but, it can also re-manifest years, decades later. My ex FIL is dying right now from prostate cancer that reappeared and had spread to his bones about 18 months ago.
He was originally diagnosed with Prostate cancer when he was 50 and was cancer free for another 20 something years until it came back and spread to his bones.
As of this writing he has one week to live. He is 76.5 and managed to gain another 26 years from the original diagnosis.

Adirondackwannabe's avatar

@LuckyGuy That was an amazingly ballsy and brave and honest answer. That was nice to see. It reaffirmed my belief in the good in jellies and fluther.

Cruiser's avatar

@Coloma Blessings are abundant in your ex FIL’s life. I lost my dad last Feb at 77.11 years old and he played in a golf tournament before his surgery where he died. Blessings that he did not have to suffer from the cancer that was going to kill him in short order.

@LuckyGuy Bro hug for your answer

filmfann's avatar

A friend of mine is undergoing radiation therapy for prostate cancer, even though his was removed a few years back (if his name is Mike, and his wife is Debbie, we are talking about the same person). He tested positive because the cancer began regrowing in the material that surrounded his now removed prostate. While very treatable, he dreaded going through radiation therapy a second time. He told me this was not uncommon.

LuckyGuy's avatar

@filmfann Since your friend “Mike” is getting radiation that means they believe the growth is localized and has not spread. That is the better option of the two bad scenarios. Radiation is not without complications that often show up as long as 2 years down the road. Also there is no assurance that the cancer has not spread. Small mets are not easy to find. The treatment consists of multiple visits to the radiation center: quick, easy, painless. And he will get a few free tattoos.
The first post-prostatectomy PSA test (the one given at 3 months) is a strong predictor of future biochemical recurrence. You want that number to be less than 0.04 ng/dl. If it is greater than 0.15 the patient should prepare himself for a battle.

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