I suspect that what Ben refers to is *PSA*, meaning prostate specific
antigen. "PCa" means "prostate cancer."

I must now go into "wet blanket " mode.

IMO, Ben is overly optimistic.

What were Ben's symptoms? In other words, why was the DR*E* (digital
rectal examination) performed? What does the "65" mean? Cubic
centimeters? Other?

This is possible evidence of a serious problem that requires investigation.

Meaning very little except that there are no metastases that the scan
could detect.

The "T" stage is determined by DRE, not by biopsy.

It appears that Ben had a "sextant" (six-specimen) biopsy. This is known
to be inadequate and was so known in 2004. I call this "third-world
medicine."

Why Cipro? This is used to treat infections.

Ben's PSA has risen .6 in five months. Red flag! The PCa might be
systemic. If so, no local treatments such as radiation will help.

I recommend that Ben run, not walk, to the nearest MEDICAL oncologist (a
real live cancer specialist), preferably one who is familiar with PCa. A
listing of some PCa specialists will be found on the authoritative
website of the Prostate Cancer Research Institute (PCRI) at
http://prostate-cancer.org/index.html
Search on Resources, then click on PC Doctors.

A competent med onc should be able to recommend the best means of
addressing the situation.

Ben should also educate himself so that he is prepared to participate in
treatment decisions.

Being empowered could just save his life.

I know that this is not pleasant for Ben to read. Sorry, but I am not
here to hold hands and moo about everything being just fine. If I can
help Ben to preserve his life, I will have accomplished my purpose.

Regards,

Steve J

Ben,

I'd hate to be the bearer of bad news, but you had 0.1 for more than two
years.  This 0.7 represents a significant spike.

Unless you meant 0.07.

Ben,

It seems to me that your latest follow-up could have been far,
far worse than it was.  As the two Steves have said, you're not
yet known to be cancer free.  However I think it is possible that
you are cancer free and also possible that, if you're not, you're
still in reasonably good shape and will die of something other
than prostate cancer.

The first thing to notice is that we don't yet know whether your
PSA is rising, falling, or staying the same.  The rise from .1 to
.7 doesn't tell us because the .1 was due to the Zoladex.  It is
possible that your underlying PSA would have been higher than .7
one year ago, but the Zoladex brought it down.

Secondly, we don't know the cause of your current .7 reading.  It
might be PSA being expressed by aging tumor cells that were
stressed by radiation and, though still alive and expressing PSA,
they are not able to divide and multiply.  It might be due to
prostatitis (yes, radiation patients can have prostatitis and
yes, it does raise the PSA.)  Or it might be due to active
cancer.

Thirdly, if you still have active cancer, it is possible that
it's a local recurrence that could be definitively treated by
HIFU.

Fourthly, if you still have active cancer, and it is metastatic
or otherwise un-amenable to local treatment, it may be slow
growing enough that it can be managed for the rest of your life,
perhaps with intermittent hormone therapy and/or some of the new
drugs.

Finally, it could be an active cancer that will kill you.

I'm not a doctor, but I'm thinking that the odds are in your
favor at this time.

Steve J's suggestion to see a medical oncologist specializing in
PCa is never bad advice, but it seems to me that it is premature
to seek additional medical treatment at this time.  I think
(remember that what I think isn't worth much!) that you need to
have real evidence that you still have cancer before you accept
any further treatment.  Three successive rising PSA's is a
commonly accepted, though not absolutely conclusive, indication
of the presence of cancer after radiation treatment.  You don't
really know for sure that you've even had one rise (because the
Zoladex masked the previous readings.)  So I wouldn't jump into
hormone therapy yet.

You might ask for more frequent PSA tests.  It might be a good
idea to get them every one, two, or three months instead of the 6
month schedule you appear to be on.  I suggest you ask your
doctor about this.  If you still have active cancer you will find
out sooner and have a little more time to plan further treatment.

When my PSA began to bounce around my rad onc gave me monthly
tests until he saw a significant drop.  Then he increased the
interval so that now it's at one year.

Best of luck.

   Alan