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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 34672
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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PSA..17.1 and biopsy..migration of cancer cells beyond the prostate

Customer Question

I was diagnosed with prostate cancer in 2007. PSA was 17.1 and biopsy showed positive cancer with Gleason score of 9/10. Surgery performed to remove prostate, but removal of lymph nodes showed a migration of cancer cells beyond the prostate. Removal of prostate not proceeded with. Received hormone treatment, which worked for a while keeping PSA low, less than one. But levels kept climbingback to 2. Had radiotherapy in 2010 on prostate area.
Good result. PSA back below one. But PSA this year has kept rising - from 16, to 38, then 193, then 288 over a 4 months period. Had recent bone scan & CT scan. These show positive cancer in the bones & in lymph nodes. At present in hands of a medical Oncologist. It is likely that chemo & bone strengthing treatment will be starting soon. I am otherwise well & also eating well. I keep active & have taken aboard new strategies re food intake. I do not take any other medication. Any views on what should happen next? I recently had a course of Chinese herbal alternative medication. I will be having another blood test on 14 Sept to see what the result of this treatment has been.
Submitted: 5 years ago.
Category: Medical
Expert:  Dr. Arun Phophalia replied 5 years ago.

I am sorry to hear about your problem. It is good that you are keeping fit and eating well.

No guidelines have been set for treating patients with advanced prostate cancer in whom local therapy has failed. A balance between disease control and minimization of the toxicity and intolerance of the treatment is the aim. Intermittent androgen suppression may be considered by your doctor. Following may be considered by your oncologist;

1) Bisphosphonates to strengthen the bones.

2) Chemohormonal therapy;
a) Docetaxel
b) Suramin
c) Cabazitaxel
d) Sipuleucel-T
e) Abiraterone acetate

Following dietary measures are helpful (which you must be doing):

a) Diet comprising mainly vegetables, fruits, grains, and fish, combined with restricted caloric intake and exercise. Such a diet provides multiple micronutrients packaged in their most effective form. Whole-grain bread provides fiber, iron, vitamin E, and folate.
b) Fruit juices such as pomegranate juice provide antioxidants.

Please feel free for your follow up questions.


I would be happy to assist you further, if you need any more information.


Dr. Arun

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