PSA rising after 16 years

Reply to colwickchris:  Chris the EBRT salvage rationale following BCR after prostatectomy was wide beam, which was considered the norm at the time. SBRT in Australia has now become the treatment of choice following BCR but the key is early detection with a PSMA Pet Scan. If as you say, you now have distant mets, then the efficacy of SBRT is questionable, and more difficult particularly in relation to adjoining organs/structures. Given that you have already begun ADT, I suspect you may be offered Lutetium 177 in the future when you become castrate resistant. Trials in Australia have shown very encouraging results for Lutetium 177 for 30%, mild improvement for a further 30%, and no change whatsoever for the remaining. Biochemical markers are thought to be the catalyst. The Australian trial results for Lutetium 177 are on youtube. Hope that helps.

Rely to microcolei:  Hi Jules, nice to see another Aussie on here. I did not realise the advanced rad stuff was available in Port. At the Base Hosp or Genesis? In my day the Mater in Newie was the furtherest northern Rad Tx Centre.

I did have a read of your profile history and I suspect you are on the same trajectory as myself. Your period on ADT of course does tend to muddy the waters somewhat re progression. I think your clinicians baseline for BCR is reasonable at 1 ng/ml. I chose to wait until my psa reached 3 ng/ml but I had 16 years of remission, my doubling time was over 1.5 years, and my cardio vascular co-morbidity in all likelihood  was going to cure my PCa recurrence anyway, and still might.

I suspect you know where you are heading. Aside from the fitness issue a reasonable quality of life still awaits you. I suspect at some point you may be offered Lutetium 177. If so, jump at it. Keep in touch I come on here every now and then.