Re: What to make of new PSA result

[Guest guest]

Any change in diet or supplements, Sy? Was your PSA in August

performed after either riding a bike or having sexual relations

within the previous 72 hours? Or was a DRE performed just prior to

the blood draw for the PSA test? Those could evidence why a higher

PSA last August and a lower one now. And the biopsy that determined

your Gleason 3+3=6 - was it read by a pathologist who is known to be

an expert in reading prostate cancer tissue? And in the biopsy, of

the core samples extracted, how many evidenced PC? Have a local man

who was diagnosed with Gleason 6 with supposedly two core samples

evidencing 5% of PC on each. He opted for Active Surveillance while

he began the journey of researching and studying our damned men's

disease to determine which treatment option he might prefer when

diagnostics indicated it was time for action. In the course of two

years he changed his diet and added appropriate supplements, and with

a recent Color Doppler Ultrasound imaging biopsy by Duke Bahn, an

artist in this procedure, there is now no evidence of the existence

of any PC. Questionable is if his initial biopsy was read correctly.

Chuck

(Chuck) Maack

Prostate Cancer Advocate

Wichita, Kansas Chapter, Us TOO

Bio: http://www.ustoowichita.org/leaders.cfm?content=bio & id=1

Email: maack1@...

>

> DIAGNOSED AUGUST 2007 AND THESE TESTS AND RESULTS ENSUED:

>

> Age-59

> T1c

> Gleason score 6 (3+3)

> PSA 3.17 as of August, 2007

> PSA had doubled in 22 months

> Bone Scan-Negative

> CAT Scan-Negative

> DRE-Negative

> Active Surveillance

>

> Had PSA test on January 9, 2008

>

> PSA test result was 2.13

>

> What is one to make of this?

>

> Thanks,

>

> Sy

>

[Guest guest]

Its not uncommon to see a fluctuation in PSA. It's possible that the original number was a little high due to a little bit of infection or inflamation or possibly even sexual activity prior to the test? Do you think this is possible? I'm sure the members in the group that do Active Surveillance can comment. Mick sytech wrote: DIAGNOSED AUGUST 2007 AND THESE TESTS AND RESULTS ENSUED:Age-59T1c

Gleason score 6 (3+3)PSA 3.17 as of August, 2007PSA had doubled in 22 monthsBone Scan-NegativeCAT Scan-NegativeDRE-NegativeActive SurveillanceHad PSA test on January 9, 2008PSA test result was 2.13What is one to make of this?Thanks,SyGod rewards those that keep on keeping on. Stay positive. Think positive. Pray positive. And talk positive.

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[Guest guest]

Hello Sy,

As others have noted, PSAs can have a normal variance from test to test as much as 25%. Inflammation from prostatitis can increase one's PSA by 2 or more ng/ml.

More important than figuring PSA velocities or doubling times betweeen two tests is the trend of 3 or more tests over 6 months or more. If you are following Active Surveillance, you should be getting PSAs at 3-month intervals. Look at the trends for your entire PSA history. If you wish you can send me your PSA numbers and I'll do a regression analysis of the longer-term doubling time and send you the results, or, I can send you an excel spreadsheet you can use to compute the statistical doubling times and plot the results.

Most centers following Active Surveillance consider a reliable doubling time of less than 3 years may be a sign that more proactive treatment should be considered. However, this means using three or more tests over a period of more than 6 months to estimate the doubling time.

An excellent article on PSA kinetics for Active Surveillance can be downloaded in a PDF file of the Canadian Publication "Our Voice" at:

http://procure.ca/tiki-download_file.php?fileId=70

The excel spreadsheet I use includes the GLM (General Linear Model) developed by Sunnybrook, Toronto, and mentioned in the article by Lablaw in the publication above.

In addition to PSA monitoring, I am having annual tests for PAP (prostatic acid phosphatase) and % free PSA. Literature suggests that a PAP greater than 3.0 may indicate more aggressive cancer. Some labs have dropped PAP tests as its use for suggesting biopsies has declined compared to PSA. However, post-diagnosis increases in PAP or decreases in % free can be indications that the cancer is getting more active.

I'm also having annual color Doppler Ultrasound (CDU) scans done by Dr. Duke Bahn in Ventura CA to monitor what has been identified as a single small tumor (less than 0.5 cc).

The Best to You and Yours!

Jon

>> DIAGNOSED AUGUST 2007 AND THESE TESTS AND RESULTS ENSUED:> > Age-59> T1c > Gleason score 6 (3+3)> PSA 3.17 as of August, 2007> PSA had doubled in 22 months> Bone Scan-Negative> CAT Scan-Negative> DRE-Negative> Active Surveillance> > Had PSA test on January 9, 2008> > PSA test result was 2.13> > What is one to make of this?> > Thanks,> > Sy>