Biochemical Recurrence

[Chris W]

I've just learned that my PSA level has risen to 0.28, some 3½ years after my robotic prostatectomy.

My doctor (thanks only to my intervention) has referred me to a Urologist at Frimley Park, but because I respect your authority on this subject, I thought I would ask your opinion on what you feel is the best course of treatment for me?

Previously, you advised that the risk of me succumbing to prostate cancer within the next 15 years was only 2%. Have I really been that unlucky and what sort of life expectancy can I expect a) with your recommended treatment and b) without any treatment whatsoever?

Previous PSA Readings:
May 2016 – 0.08
Jun 2016 – 0.04
Dec 2016 – 0.04
May 2017 – 0.09
May 2018 – 0.08
Nov 2018 – 0.17
Sep 2019 – 0.28

[professoreden]

Chris, you need to be referred to an Oncologist rather than a Urologist. They are likely to request a PET CT scan to determine to site of your PSA generation to look to see if it can be specifically targeted. You have been unlucky, but your tumour was locally advanced (T3) at the time of surgery, which increases the risk of recurrence. Your 15-year probability of survival is likely to be very high but more information is needed to be more precise (specifically, scan results and response to treatment). Good luck and best wishes.

[Chris W]

Understood. Much appreciated Professor. Chris

[Chris W]

Dear Professor Eden,

6½ years after my radical prostatectomy and 2 years after receiving 33 sessions of salvage radiotherapy, I am delighted to report that my current PSA level is 0.025 ng/ml.

While we cannot use the terms 'cured' or 'in remission', I couldn't be happier with this result and my personal opinion is that I will die with it, not because of it.

What do you think?

Of course, none of this would have been possible without having the best surgeon in the country to perform my radical prostatectomy, for which I will be eternally grateful.

With my sincere thanks,

Chris.