Posted by Vincent J Gnanapragasam on March 25, 2000 at 07:57:49:
In Reply to: Post RRP Biochem. recurrence posted by Chit Sin on March 14, 2000 at 02:07:14:
: 59-year-old. 18 month after RRP for Gleason 7 tumour. Nodes & margins free but PSA remained detectable post-op and gradually crept up to 1.0 over 18 months. What would you do?
Dear Dr Loh
If I may venture an opinion. What stage was the disease at presentation? A review of the histology may be useful particularly as the PSA never fell post surgery. A CT/MRI of the region may be useful if residual disease is suspected and to investgatthe status of other nodes in the pelvis.
I presume that pre-op Bone scans were negative.
Treatment options will depend on the above findings. In the case of residual disease in the pelvis, external beam radiotherapy may be warranted if the patients urinary control is good.
It is probabaly too late for adjunctive antiandrogens but may be useful should the patient prove to have metastatic disease.
Regards
Dr.Vincent J Gnanapragasam
Newcastle upon Tyne
United Kingdom