Re: 5th year postRP PSA Fluxuating?

[Guest guest]

(snip)

> 10/09: PSA 0.19 (Uro says " don't worry. " )

> 03/10: PSA 0.26 (ARG!)

> But, this time it dropped!

> 05/10: PSA 0.22

>

> Is this common? Should I consider changing labs? (It has been the same

> lab for all tests.) Is it way too soon to be concerned? Am I dead,

> yet??? (I hope not - I'm still having waaay too much fun with the

> needles. (lol)

Many say that a post-RP PSA of 0.2ng/mL indicates recurrence.

Others, if memory serves, say it's three consecutive tests at =/>

0.2.

I most strongly recommend that consult a real cancer

specialist, a medical oncologist; preferably one who is

well-educated in treatment of PCa. (S)he should be able to

recommend the next steps. That may be raditon, androgen

deprivation therapy, or other.

See the Help section of the encyclopedic website of the Prostate

Cancer Research Institute at

http://www.prostate-cancer.org/pcricms/node/89

for information on who & where.

The uro is a surgeon; he has done his job and is no longer useful.

> 11/04: RP " looks like we got it "

I always shudder and grit my teeth when I see that statement,

usually delivered with a big grin. The uro *does not know*

whether he " got it all. " He cannot.

Regards,

Steve J

[Guest guest]

Thanks for replying, Steve. You continue to participate in these PC forums

after all these years providing great advice. I will get the courage to tell my

uro that I need to find an onc and call that Help group you suggested. I don't

know why, but I had no denial when they all told me I had PC back in '04 and

that they needed to tear my innards apart to " take it out. " But, now, it's like

I have my head stuck in the sand chanting - " It can't come back - it can't come

back. " I know - I may be right - but, I'll probably be dead right.

(snip)

> I always shudder and grit my teeth when I see that statement,

> usually delivered with a big grin. The uro *does not know*

> whether he " got it all. " He cannot.

Yea, I knew that was a line of bs when he told me. And, you are right - with a

BIG smile on his face. (LOL) He convinced me that RP was my best bet (as

opposed to robotic) because HE " had his best chance of 'nerve sparing' and

determining if any 'c' was left behind if I was laid wide open. " Well, I got

laid.... he missed on both counts. And, NOW, all he does is robotics... ARG!

(snip)

> The uro is a surgeon; he has done his job and is no longer useful.

Not necessarily true: Once a year my " tri-mixologist " (lol) tells me that my

prescription for my 'needles' has run out...... Oh yea... I need him. LOL

Thanks again,

[Guest guest]

Somewhat in the same boat here, very similar. Had annual checkup in May, PSA

just registering at 0.07 for the first time. Uro says not to worry we'll check

in three months. But he went on to talk about hormone therapy and surgery maybe

when it gets to about 20. I had to keep reminding him that I have no prostate,

then I brought up salvage radiation. Sure have to agree with the previous

response, get into the cancer center and see an Oncologist when you get real

worried. But I wouldn't (and, myself, I'm not) get too worried about it yet,

keep checking and hope for the best. And if they are using up to date PSA

testing equipment it's pretty darn accurate down to very small readings these

days. Hard to believe that such a small freckle on the inside of our prostate

can cause such a disaster.

[Guest guest]

In 2007 the AUA defined a PSA in excess of 0.2 to indicate a biochemical recurrence post surgery.  ASTRO defined three PSA rises post radiation to be indicative of a prostate cancer recurrence.  Since you have a PSA that exceeds the 0.2 number post surgery one can say that you have had a recurrence using the AUA definition.

Remember, when PSA goes out to the hundreds places it is still very small and the measurement not necessarily reliable, so the difference between your 3/10 score of 0.26 and the 5/10 PSA of 0.22 may have no significant meaning. 

Even thought you used the same lab, check the written lab report and make sure all the tests actually used the same reagents.  The name of the reagent used will appear on the report.  The same lab can use different reagents making it so that you can not compare the test results. 

If you do have a recurrence there is a good chance that it is localized and might be " taken care of " with adjuvant radiation.  Adjuvant radiation has the best change of being sucessful if it is given prior to a PSA of 1.0, you seem to still have time. 

As suggested by others, if you do have a recurrence, you are best served moving your care on to a specialist, a medical oncologist who sees many men with advanced and recurrent prostate cancer.  Having a recurrence is NOT the end of the world, at an early stage it can be resolved and for those of us with more advanced recurrences we still have an excellent potential for many, many years of high quality life. 

To Mccartney7:Please don't ignore your PSA.  Consider what I have written and don't bury your head in the sand.  Recurrent prostate cancer can be mangaged, symptoms delayed and life extended, but not if you choose to ignore it.  We all have the right to decide what to do, what treatment to try, I respect that, so please don't misinterpret my concern.

 

Mid last year I posted my shock that my PSA was no longer " less than .1 " shortly before my 5th year postRP. (.19) Since then...

10/09: PSA 0.19 (Uro says " don't worry. " )

03/10: PSA 0.26 (ARG!)

But, this time it dropped!

05/10: PSA 0.22

Is this common? Should I consider changing labs? (It has been the same lab for all tests.) Is it way too soon to be concerned? Am I dead, yet??? (I hope not - I'm still having waaay too much fun with the needles. (lol)

Age: 68

10/04: PSA = 10.4,12 needle biopsy - Gleason 7 ( " in a few samples " ), T1C

11/04: RP " looks like we got it " - sparing one and a half bundles of nerves

08/08: PSA = less than 0.1 every year since RP

05/09: PSA 0.19 (next test late 09/09 – a little worried)

10/09: PSA 0.19 (Uro says " don't worry. " )

03/10: PSA 0.26 (ARG!)

05/10: PSA 0.22

03/10: Good bladder control – STILL no usable erections w/o " injections " – using " tri-mix " w/ 31 ga. needles

-- T Nowak MA, MSWDirector for Advocacy and  Advanced Prostate Cancer Programs, Malecare Inc. Men Fighting Cancer, TogetherSurvivor - Recurrent Prostate, Thyroid, Melanoma and Renal Cancers

www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare.com - information and support about prostate cancer

http://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer

[Guest guest]

,

Gee I had 4 post radiation rises in a row, with the last being 2.39( a 300% increase) and to hear all the comments from this group how did I know I had a recocurance. I should have quoted according to ASTRO guidelines. Thanks for the information , I can now refer to there own definition.

Dan

Mid last year I posted my shock that my PSA was no longer "less than .1" shortly before my 5th year postRP. (.19) Since then...10/09: PSA 0.19 (Uro says "don't worry.")03/10: PSA 0.26 (ARG!)But, this time it dropped!05/10: PSA 0.22Is this common? Should I consider changing labs? (It has been the same lab for all tests.) Is it way too soon to be concerned? Am I dead, yet??? (I hope not - I'm still having waaay too much fun with the needles. (lol)Age: 6810/04: PSA = 10.4,12 needle biopsy - Gleason 7 ("in a few samples"), T1C11/04: RP "looks like we got it" - sparing one and a half bundles of nerves08/08: PSA = less than 0.1 every year since RP05/09: PSA 0.19 (next test late 09/09 – a little worried)10/09: PSA 0.19 (Uro says "don't worry.")03/10: PSA 0.26 (ARG!)05/10: PSA 0.2203/10: Good bladder control – STILL no usable erections w/o "injections" – using "tri-mix" w/

31 ga. needles

-- T Nowak MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Men Fighting Cancer, TogetherSurvivor - Recurrent Prostate, Thyroid, Melanoma and Renal Cancerswww.advancedprostat ecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare. com - information and support about prostate cancerhttp://health. groups.yahoo. com/group/ advancedprostate cancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate

cancer

[Guest guest]

,

Gee I had 4 post radiation rises in a row, with the last being 2.39( a 300% increase) and to hear all the comments from this group how did I know I had a recocurance. I should have quoted according to ASTRO guidelines. Thanks for the information , I can now refer to there own definition.

Dan

Mid last year I posted my shock that my PSA was no longer "less than .1" shortly before my 5th year postRP. (.19) Since then...10/09: PSA 0.19 (Uro says "don't worry.")03/10: PSA 0.26 (ARG!)But, this time it dropped!05/10: PSA 0.22Is this common? Should I consider changing labs? (It has been the same lab for all tests.) Is it way too soon to be concerned? Am I dead, yet??? (I hope not - I'm still having waaay too much fun with the needles. (lol)Age: 6810/04: PSA = 10.4,12 needle biopsy - Gleason 7 ("in a few samples"), T1C11/04: RP "looks like we got it" - sparing one and a half bundles of nerves08/08: PSA = less than 0.1 every year since RP05/09: PSA 0.19 (next test late 09/09 – a little worried)10/09: PSA 0.19 (Uro says "don't worry.")03/10: PSA 0.26 (ARG!)05/10: PSA 0.2203/10: Good bladder control – STILL no usable erections w/o "injections" – using "tri-mix" w/

31 ga. needles

-- T Nowak MA, MSWDirector for Advocacy and Advanced Prostate Cancer Programs, Malecare Inc. Men Fighting Cancer, TogetherSurvivor - Recurrent Prostate, Thyroid, Melanoma and Renal Cancerswww.advancedprostat ecancer.net - A blog about advanced and recurrent prostate cancerwww.malecare. com - information and support about prostate cancerhttp://health. groups.yahoo. com/group/ advancedprostate cancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate

cancer