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A friend has HRPC. Cancer was first diagnosed in Dec 2004 with gleason score 4+3=7 & PSA 120. He had Orchiestomy and was on harmone therapy for 4/5 years till his PSA again started rising in 2009 end to 30 along with Pelvic lymph nodes metastasis. He received IGRT in early 2010 which brought his PSA down to 0.3. In 2011 his PSA again started rising, he tried Ketaconazole without success. Thereafter he tried homoeopathy for 6 months without any success. PSA kept rising, went upto 250. Yesterday he had urine retention, his creative rose to 8.2, K to 6.9. CT scan revealed compression of both ureters by neighboring lymph nodes blocking urine flow. He has been operated today for ureter stenting. Please advise next line of treatment.
Mon, 8 Sep 2014
Hello and welcome to HCM,
Prostate cancer has to be monitored after treatment with serum PSA levels.
Rise of PSA levels after treatment suggests recurrence or metastasis of prostate cancer.
The PSA levels rose rose to very high levels (250) suggesting recurrence or metastasis.
On investigation, enlarged lymph nodes (due to prostatic cancer metastasis) were found compressing the ureters and thus causing kidney dysfunction due to back pressure changes.
Ureteric stents will open the blocked ureters and thus relive urinary retention and will improve the kidney function.
Hormonal therapy and/ radiotherapy may be required. Discuss about this aspect with your treating doctor.
Now, in future PSA level should be closely monitored.
Any increase should be promptly reported to your treating doctor for prompt action.
Thanks and take care
Dr Shailja P Wahal
Prostate cancer has to be monitored after treatment with serum PSA levels.
Rise of PSA levels after treatment suggests recurrence or metastasis of prostate cancer.
The PSA levels rose rose to very high levels (250) suggesting recurrence or metastasis.
On investigation, enlarged lymph nodes (due to prostatic cancer metastasis) were found compressing the ureters and thus causing kidney dysfunction due to back pressure changes.
Ureteric stents will open the blocked ureters and thus relive urinary retention and will improve the kidney function.
Hormonal therapy and/ radiotherapy may be required. Discuss about this aspect with your treating doctor.
Now, in future PSA level should be closely monitored.
Any increase should be promptly reported to your treating doctor for prompt action.
Thanks and take care
Dr Shailja P Wahal
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