PSA, Side Effects, & Monitoring after Surgery or Radiation | Answering YouTube Comments #75 | PCRI
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- เผยแพร่เมื่อ 26 ต.ค. 2024
- Medical oncologist Mark Scholz, MD answers patients' questions from our TH-cam comments on the topics of radiation as initial therapy, salvage radiation and its unique considerations after surgery, and the monitoring process after radiation.
0:10 I had Gleason 6 prostate cancer and 46 rounds of radiation, but my PSA is still around 3.0-4.0 a few months later. Is it normal for the PSA to not drop?
3:21 My father had a radical prostatectomy a month ago, and now the doctors are recommending salvage radiation. The post-surgery pathology report came back as negative for spread. Should he really get radiation?
6:04 How long does it take the PSA to fall after radical prostatectomy (surgery for prostate cancer)?
6:11 What are the side effects of salvage radiation after a radical prostatectomy?
7:09 What is the PSA monitoring process like after salvage radiation?
7:51 What is the target PSA nadir (a patient's PSA low-point) in a patient after salvage radiation?
9:17 I am 48-years old and I had a radical prostatectomy. My PSA is now at 0.5 and my doctor is recommending radiation and hormone therapy. Is that treatment plan too aggressive?
10:30 I had 28 rounds of radiation and my doctor wants me to get Lupron for a total of two years. Should I be monitoring with scans if my PSA is below 0.1 while on treatment?
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I made my treatment decision listening to this guy. I really had little support , and lacked solid advice. The surgeons at Addenbrookes were keen to operate and leave me absolutely no hope of a sex life in the future. Luckily for me I was offered a pace clinical trial. So I had SBRT treatment. 5 higher doses of radiation in 7 days . Hormone treatment etc. now I’m post treatment by 3 months and I’ve started to get my libido back !! So guys listen to this doctor he is a very wise man
I am right now in the middle of 5 higher doses of SBRT over 10 days. My bladder did not fill up correctly and the second treatment had to be canceled on a Friday (yesterday 10/7) . Now its the weekend and no treatment for 2 more days. So no way to do it skipping every other day (or a weekend) in 10 days without having treatment 3 days in a row next week. What was your sequence for the 5 treatments in 7 days? I really hope you see this soon and can answer on 10/8 or 10/9 Thanks
He provides the best information on this topic I've seen, If only our own doctors would be so forthcoming.
Alex & Dr Scholz produce topics most relevant to patients deciding treatment options. These videos prepared me for the PCa journey. Thanks PCRI....for staging my disease, then deciding ...Beam, Brachy, or Radical.
I really appreciate the quality of and format of these videos. These have been very helpful for me and my family these past few months, when my father got diagnosed with Gleason 4+4.
These are just the right length, easy to grasp tidbits of knowledge that help educate patients and their loved ones on things related to prostate cancer, treatments, and more.
This video series is very illuminating and instructional. Both interviewer and interviewee are very clear-thinking and methodical and avoid ambiguity successfully.
Just had a PSMA PET scan. Cost me $150 on a Medicare Advantage Plan insurance.
G'day guys, I'd just like to say, your platform is excellent, the information very helpful and informative l, the Doctor's are top of their game respectful, speaks volumes about them, thanks from Australia.
Informative, as usual. Thanks!
You talk about PSA Doubling Time, and my question is how many data points going how far back should you use in calculating it?
In my case, I had surgery in January 2011 and my PSA became detectable again at 0.05 in September 2016. Ever since then, it's been slowly climbing to where it's currently at 0.26 (Jan. 2022). If I use the MSK PSA Doubling Time calculator using all values from the beginning, my PSA DT is 41.5 months; if I use just the last two years' of values, it's 26.6 months.
Also, you mentioned that you PSMA PET scans can locate the cancer when PSA is down to 0.2. I went to UCLA for a PSMA PET scan when my PSA was 0.22 (Oct. 2021; scan Nov. 30, 2021), and the scan didn't show any cancer in the pelvic region nor any distant metastases. That's good and bad. We know the PSA has been steadily increasing since 2016, so something is there someplace. The PSMA PET couldn't find it at my PSA level.
By the way, UCLA charged $3,300 for the scan and, as my insurance wouldn't cover it until my PSA hit 1.0, I had to pay out-of-pocket.
Hello,
Feel free to contact our free helpline. We have a patient advocate who will call you and may be able to provide you with some information: pcri.org/helpline
Insurance coverage for PSMA is a dynamic situation. If you ever need another one, you may have better luck getting the commercial version, Pylarify, covered (www.pylarify.com/). They have a customer service phone number available on their website and they should be able to give you more information.
Thanks for the reassurance. You are a great resource for us. All the best wishes!
Very grateful for all the information.
thank you for your videos. they really help
I am 63yrs old and in Dec 2020 was diagnosed with Gleason 6 prostate cancer. I was also dealing with BPH problems that were not being helped with medications so I had a TURP Procedure in Nov 2021. I was initially planning on doing active surveillance but after the Turp my urologist recommended that I get radiation treatment. His reasoning is that I am in good health and that it would be better to get it done now than waiting till later when it maybe more difficult to cure. He also said that radiation treatments would slow the growth of my prostate and would delay the need for another TURP. I was wondering if you agree with this assessment.
Can't get enough, your videos are on point and very informative. Q: can you get spaceOAr applied if your cancer is on your seminal vesels?
On the last topic discussed, PSA levels below 0.1 showing remission without a need for additional PET-CT scans, I think there was an exception presented by Dr. Kwon. He talked about advanced types of diffuse prostate cancer (neuroendocrine or small cell) that can spread while PSA remains lower than 0.1. Would it be possible to talk a little bit more about those sorts of cases and how to approach them?
Timestamp in Dr. Kwon's talk: th-cam.com/video/IEToOBuca1Q/w-d-xo.html
Thank you for these great videos!
Hello,
I will add this question to our list for future videos.
Thank you for some really good information! I was diagnosed with prostate cancer in 2016, 4+3 gleason score. I had a radical prosectomy followed by salvage radiation when psa was at .08. I was put on trt about 20 years ago. After having undetectable psa for 2 years I went back on trt. After a few months my psa is back up to .06. I stopped the trt. I was wondering if you had any advice regarding trt use in the future? I'm also curious if a PSMAT scan is too early at this point? Thank you very much!
Hello, we have a patient advocate on our helpline that might be able to help with your question. You can find our contact information here PCRI.org/helpline.
Question on Lupron 3-month dosage for 2 years and or ones that are on Lupron for longer than 2 years, during this treatment is it recommended to stay on the 3-month dosage during the duration and not go with a higher dosage as in the 6-month during the 2+ years? When there was a shortage of the 3-month of Lupron, I was offered the Lupron 6-month or Eligard 3-month. I had chosen to go with the Eligard 3-month instead. This would be good info for others to know. Thank you
Ed here, I had one dose lupron, & hate the side effects. PSA 0 1/26/22
I HAD 42 radiation treatments and need to check my PSA LEVEL AND SEE IF IT HAS GONE DOWN
Help me understand, why after a RP isn't standard for urologist to give a psma a month after surgery?...
Hello,
I will add that to our list of questions for future videos. There is not much that is standard in prostate cancer which is a big part of why patient education is our mission.
@@ThePCRI what was the conclusion?
For the last five years my psa has now reach 0.056 there was a bounce but a new assay was applied.thre months ago it eas 0.043 now 0.056 i feel that the nee asssy may be very sensitive.how can i have a stable psa.should i be concerned
Thank u for ur great knowlege 🇨🇮💛⚘☘👏🌹
Great information!
My question is after a prosectomy my husbands psa was creeping up to 0.3 now on hormone therapy ( pill form) does the psa always come back undetected because of the hormone therapy. And should it be 0 after the pill is no longer taking?
Well I’ve been told it should be monitored . They recommend about every 3 years , for cologuard . So I don’t know .
I don’t want it to spread from my prostate to my colon . Those organs are right next to each other . Ya know ?
What's the highest PSA you have seen?
7,000 on recent youtube