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Questions posted in the
The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.
Question Title: Recurrent PSA elevations post PostatectomyForum: The Urology Forum
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My ex- husband is living in Oklahoma and has had on going problems with elevated PSA tests. After multiple BX a positive test ocurred and he had a prostatectomy and radiation. Now a few months later his PSA's are rising ...5 to 7 to 9. His urologist has been unable to find a reason for this and is now recmmending either medication q3months or having testicles removed. What is current therapy and where in Oklahoma or where are the best centers where he could go to have a second opinion. Thanks, mah
= Dear Mary Ann Thanks for your questions. A PSA rising after radiation / radical prostatectomy means he had advancing cancer left behind at surgery or it had already spread to elsewhere in the body before the surgery and radiation. The next line of treatment is hormonal blocking therapy (i.e. a shot every three months or removing the testicles). This treatment can include a daily oral medication to block the production of testosterone from the adrenal glands ( small steroid producing glands above the kidneys). This form of treatment is not a cure and is usually palliative until the cancer becomes resistant( usually a couple of years). Once he starts hormonal blocker treatment, his PSA should be followed for a response which is very likely. If the PSA continues to rise, the cancer has become resistant to hormone blocking therapy. I agree with his urologist current treatment plan of hormonal blocker therapy. More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians’ notes and lab test results that you may be able to obtain. These will help us greatly. This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.
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