PSA Anxiety

[Guest guest]

Here I quote my friend Bob Marckini, founder of the " Brotherhood of

the Balloon. " From his November 2008 BoB Tales Newsletter:

" PSA ANXIETY "

" Hardly a month goes by when I don't hear from a member who is

anxious or upset because his PSA bumped up or didn't drop as

expected. They want to know if others have seen this. My first

reaction is to say, " I'm not a doctor, so I cannot give medical

advice. " Then I say, " Yes, I see this all the time. "

We former patients often spend too much time worrying about our

individual PSA test results. And I admit having been guilty of this

myself. My first 4 month PSA result was wonderful – it had dropped

from a pretreatment level of 8.0 to 3.6. But, six months later it had

only dropped to 3.3. I was expecting something much lower. " My Lord,

I've reached my nadir, " I thought. Of course it later continued

downward. But, there was a bump at 18 months and another at 30

months. More anxiety. It eventually settled down, reached its real

nadir and has remained there ever since.

I have come to learn that post treatment bumps are common, and are

usually nothing to be concerned about. PSA numbers can bump for any

number of reasons including test error, test method change, random

variation in the test, numerical rounding (e.g. 0.54 is reported as

0.5, but 0.55 is reported as 0.6), infection, stimulation of the

prostate (e.g. ejaculation, DRE), and yes, a recurrence of the

cancer. But, based on my own research, and the non-scientific

information I've collected over the past 8 years, the majority of the

time, these bumps are false alarms.

Keep in mind, the PSA test is reporting results in ng/ml … or

nanograms per milliliter. What's this? It's billionths of a gram per

thousandth of a liter. And in the example I used above there was a

change in the second decimal point. This represents a one-one

hundredth of a billionth of a gram change, per thousandth of a liter.

Hmmm.

One physician I spoke with a couple of years ago said, " With all

other cancers and most other diseases, we doctors analyze the data,

interpret the results and present our conclusions to the patient.

With prostate cancer, the patient is getting the raw data and drawing

his own conclusions. That isn't always in the best interest of the

patient. "

Bottom line: We certainly should be having our PSA measured

regularly, as recommended by our doctors, but we shouldn't become

alarmed or jump to conclusions when we see one number that is

different from what we had expected, particularly during the first

three years. Always consult your physician if you have a question,

and discuss with him/her a retest if you suspect the result was

erroneous. "

A new PCa " Motto: " Don't Let PSA Anxiety Get You Down! "

Note: The " BoB " now has more than 3.000 members. If interested, go

here: www.protonbob.com

Fuller

> Due for a checkup at the end of the month. Had surgery in Feb. 06.

> Getting nervous all over again. 30% recurrence, ouch. Fingers

crossed.

>