Yesterday I got my PSA result – up from 0.574 in July to 0.732 now, an increase of 0.158. That’s not a massive jump but it’s gone up a bit faster in the last 3 months than it did in the previous 3, when the increase was 0.082.
Today I saw my oncologist and wondered if, because I’ve had a series of small increases instead of one major jump, that she’d just carry on with what we’re already doing, i.e. a daily 150mg Bicalutamide tablet and regular 3 monthly check ups.
It’s not that I want my PSA to suddenly soar but without a big jump there’s always the possibility that nothing new will be done, since the rate of PSA increase is just as relevant as the increase itself. I should have remembered that “inaction” is not in my oncologist’s vocabulary.
I had a Choline PET Scan at the start of 2015 and she’s referred me for another one to see where the cancer has spread to now. Being referred for a PET Scan is partly down to my series of small but steady PSA increases but also due to some enlarged lymph nodes that the MRI I had a couple of months ago revealed. Those should have measured around 10mm in diameter but mine varied between 15mm and 17mm. I forgot to ask if 50% to 70% more than normal is massive or no big deal.
Assuming the enlarged nodes are cancerous (I guess they might not be), the best result the latest PET Scan could give is that they are the only ones that are but, if that’s the case, they also need to be located just above the areas I had irradiated back in 2015 and 2016, my prostate bed and my pelvic lymph nodes. They could then be suitable for some targeted zapping by something called SABR, which is a type of radiotherapy. SABR is not widely available and, like everything else right now, there are “challenges” with funding, but my oncologist is hopeful.
The second best result requires the cancerous nodes still to be the only ones, but higher up, because then I might be ok to have regular palliative radiotherapy on them. Not quite as targeted as SABR but not a bad option.
Neither would be a cure but both could give me more time without mucking up my quality of life and having more time is important in lots of ways, not least because it leaves open the possibility that I’ll still be around when a cure is found.