Re: Re: Slight rise in PSA

[Guest guest]

When you talk about changes in the hundredths (0.0X) there is no  accurateness in PSA tests.  These changes are meaningless.

 

>

> I'm also curious, and I'd like some opinions about other things that could

> cause a PSA reading to rise.

>

>

> * G. Coy*

> *shootingcpa@...*

I have nearly the exact same deal as you. Surgery with all clear and undetectable PSA for a couple years. Nasty infection of the colon in my case with surgery a couple months later. Then the annual checkup showed PSA of 0.07. Really shook me up. Followed with 3 month checks of 0.05, 0,06 and the latest of 0.05 after a year. I really wonder if maybe there was some tissue left that became active after the trauma of infection and treatment? Hard to say. But I did start drinking a daily glass of pomegranite juice that is reported to have some effect. Might be a marketing ploy but then again, maybe not. I was sure hoping that after having the surgery, old style like yours, that I could forget about this. I've asked around as to how accurate these tests really are, nobody seems to know much in that regard.

Tom.

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

*Register for our teleconference on Provenge by going to: http://bit.ly/kKuByH.   A call in number

and code will be emailed to you, along with info on how to ask your specific question of our guest.

The conferene will be on Monday, June 13 at 6 p.m. EDT.www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancer

www.malecare.org - information and support about prostate cancerhttp://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer

[Guest guest]

When you talk about changes in the hundredths (0.0X) there is no  accurateness in PSA tests.  These changes are meaningless.

 

>

> I'm also curious, and I'd like some opinions about other things that could

> cause a PSA reading to rise.

>

>

> * G. Coy*

> *shootingcpa@...*

I have nearly the exact same deal as you. Surgery with all clear and undetectable PSA for a couple years. Nasty infection of the colon in my case with surgery a couple months later. Then the annual checkup showed PSA of 0.07. Really shook me up. Followed with 3 month checks of 0.05, 0,06 and the latest of 0.05 after a year. I really wonder if maybe there was some tissue left that became active after the trauma of infection and treatment? Hard to say. But I did start drinking a daily glass of pomegranite juice that is reported to have some effect. Might be a marketing ploy but then again, maybe not. I was sure hoping that after having the surgery, old style like yours, that I could forget about this. I've asked around as to how accurate these tests really are, nobody seems to know much in that regard.

Tom.

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

*Register for our teleconference on Provenge by going to: http://bit.ly/kKuByH.   A call in number

and code will be emailed to you, along with info on how to ask your specific question of our guest.

The conferene will be on Monday, June 13 at 6 p.m. EDT.www.advancedprostatecancer.net - A blog about advanced and recurrent prostate cancer

www.malecare.org - information and support about prostate cancerhttp://health.groups.yahoo.com/group/advancedprostatecancer/ - an online support group for men and their families diagnosed with advanced and recurrent prostate cancer

[Guest guest]

Nowak

> When you talk about changes in the hundredths (0.0X) there is no

> accurateness in PSA tests. These changes are meaningless.

,

I think that depends on several factors:

1. The sensitivity of the test. Some of them really are accurate

to .01.

2. The care with which the test is processed - which affects

accuracy.

3. The variability in PSA due to non-cancer causes.

The article that Chuck cited appeared to me to claim that, for a

man who's prostate was removed, non-cancer causes can normally

only account for a PSA of up to .03. Perhaps there are

exceptions for some men, but apparently .03 is the norm.

That's not good for . However it isn't necessarily a death

sentence.

First of all, we don't know what kind of test was used. Maybe it

wasn't accurate to hundredths even though it was reported that

way.

Secondly, we don't know whether the guy who did the test did it

right, or reported it right, or that the machine that did the

measuring was operating properly and with accurate calibration.

The fact that the doctor's office said that other patients were

getting surprise PSA results may indicate that.

Thirdly, even if the test is right and there are some tumor

cells, they may be completely indolent. It may be that they will

not progress to metastasis.

Fourthly, if they are not indolent, they may be entirely curable

by radiation.

And finally, even if they are not indolent and not curable by

radiation, they may be entirely controlled by one or another type

of hormone therapy, even including " light " therapy that uses

Casodex, duatasteride, estradiol, or something else that is less

drastic than Lupron, to keep them from ever becoming a serious

problem. I think we have seen numerous cases like this of men

who attack the cancer early, before it is extensively mutated and

spread, and keep it under tight control.

,

I know that you must be worried as hell. How could you not be?

But I think it's important to recognize that you probably have an

excellent chance of living into old age and dying of something

other than PCa, no matter whether your cancer has recurred or

not.

If you're having trouble with this, and I don't know that you

are, please remember not to focus entirely on cancer to the

extent of wrecking your personal life. You've got a lot of

living left to do. We all have to battle our cancer, but we

don't want to give up living because we are afraid of dying.

Alan

[Guest guest]

Nowak

> When you talk about changes in the hundredths (0.0X) there is no

> accurateness in PSA tests. These changes are meaningless.

,

I think that depends on several factors:

1. The sensitivity of the test. Some of them really are accurate

to .01.

2. The care with which the test is processed - which affects

accuracy.

3. The variability in PSA due to non-cancer causes.

The article that Chuck cited appeared to me to claim that, for a

man who's prostate was removed, non-cancer causes can normally

only account for a PSA of up to .03. Perhaps there are

exceptions for some men, but apparently .03 is the norm.

That's not good for . However it isn't necessarily a death

sentence.

First of all, we don't know what kind of test was used. Maybe it

wasn't accurate to hundredths even though it was reported that

way.

Secondly, we don't know whether the guy who did the test did it

right, or reported it right, or that the machine that did the

measuring was operating properly and with accurate calibration.

The fact that the doctor's office said that other patients were

getting surprise PSA results may indicate that.

Thirdly, even if the test is right and there are some tumor

cells, they may be completely indolent. It may be that they will

not progress to metastasis.

Fourthly, if they are not indolent, they may be entirely curable

by radiation.

And finally, even if they are not indolent and not curable by

radiation, they may be entirely controlled by one or another type

of hormone therapy, even including " light " therapy that uses

Casodex, duatasteride, estradiol, or something else that is less

drastic than Lupron, to keep them from ever becoming a serious

problem. I think we have seen numerous cases like this of men

who attack the cancer early, before it is extensively mutated and

spread, and keep it under tight control.

,

I know that you must be worried as hell. How could you not be?

But I think it's important to recognize that you probably have an

excellent chance of living into old age and dying of something

other than PCa, no matter whether your cancer has recurred or

not.

If you're having trouble with this, and I don't know that you

are, please remember not to focus entirely on cancer to the

extent of wrecking your personal life. You've got a lot of

living left to do. We all have to battle our cancer, but we

don't want to give up living because we are afraid of dying.

Alan

[Guest guest]

To everyone: Thank you for all of you comments.  They are all appreciated very much.  You guys rock! After reflecting on every one's comments, my immediate action drill was to ask for and obtain a recheck.  I'm having another PSA test done tomorrow (June 14). AFAIK, the prior test was Hybritech.  I presume the retest will be the same.  FWIW, when I called to get an order for the retest another nurse there confirmed for me without any hesitation that several of their patients had unexplained increases in their PSA's, so their initial representation to me about the possibility of a lab error is not something they are making up to allay patient concerns.  I'm seeing the Uro on Thursday, June 16.  If the retest still shows elevated PSA, we will discuss a consultation with the Medical Oncologist. 

 I have not ever undergone any type of salvage therapy, so all of those options remain open to me, if necessary.  Also, I have had a great post-surgical experience.  My recovery has been good.  No difficulties.  Generally, my health is very good.

 I saw my ENT physician this morning as a routine follow up from my surgery on May 11.  It looks like the nasal infection I had post-surgery has settled down (this was not an unexpected thing at all). I want to believe this (and blood loss during surgery) is what caused my PSA to be up, but I know there is no proof of this.

 Finally, I asked my primary care physician to move up a general physical I had scheduled for June 30th (required and originally scheduled six months ago so I can attend Boy Scout camp with my son as one of the adult leaders).  I will be seeing him tomorrow, June 14th.

 As I've reflected upon this situation, it became clear that I needed to deal with this situation promptly, because of a time-critical decision my family is making.  My wife (who is 56 and in good health) has an attractive offer before her for early retirement.   She must decide by June 30th.  The acceptance is irrevocable.  It would be effective as of 12/31/2011.  If she accepts, we would lose her medical insurance coverage as of the end of 2011.  She would still be covered by medical insurance, but I would lose the luxury of also being covered by her policy. 

 This has become a primary concern of mine.  As a family, with two policies in place, we have seldom been required to pay anything out of pocket for any medical or dental care.  Prescription coverage is good on both policies, and my policy pays half of any vision care costs.

 So the question is, if my PCa is flaring up, do we want to forgo the " comfort " of having two health insurance plans in place? This is the reason I asked the Uro for the recheck of my PSA.  If necessary, I will press hard for the consultation with the Oncologist.  It is also why I got my physical rescheduled for an earlier time.   FWIW, when I explained the decision we are facing, both my Uro and my Primary Care Physician were very accommodating.  I was very pleased with their willingness to help

[Guest guest]

,

Your attitude is right and you seem to be doing the right things. You'll be in my thoughts and prayers. Regarding your wife's early retirement possibility, you have a tough decision. While having the second insurance is great, early retirement would allow the two of you to spend more time together, and that's important too, and may become more important. As an accountant you can probably figure out the present value of the second insurance, b ut I doubt you can calculate the present value of the additional time together.

Mike

Nowak

> When you talk about changes in the hundredths (0.0X) there is no> accurateness in PSA tests. These changes are meaningless.,I think that depends on several factors:1. The sensitivity of the test. Some of them really are accurateto .01.2. The care with which the test is processed - which affectsaccuracy.3. The variability in PSA due to non-cancer causes.The article that Chuck cited appeared to me to claim that, for aman who's prostate was removed, non-cancer causes can normallyonly account for a PSA of up to .03. Perhaps there areexceptions for some men, but apparently .03 is the norm.That's not good for . However it isn't necessarily a deathsentence.First of all, we don't know what kind of test was used. Maybe itwasn't accurate to hundredths even though it was reported thatway.Secondly, we

don't know whether the guy who did the test did itright, or reported it right, or that the machine that did themeasuring was operating properly and with accurate calibration.The fact that the doctor's office said that other patients weregetting surprise PSA results may indicate that.Thirdly, even if the test is right and there are some tumorcells, they may be completely indolent. It may be that they willnot progress to metastasis.Fourthly, if they are not indolent, they may be entirely curableby radiation.And finally, even if they are not indolent and not curable byradiation, they may be entirely controlled by one or another typeof hormone therapy, even including "light" therapy that usesCasodex, duatasteride, estradiol, or something else that is lessdrastic than Lupron, to keep them from ever becoming a seriousproblem. I think we have seen numerous cases like this of menwho

attack the cancer early, before it is extensively mutated andspread, and keep it under tight control.,I know that you must be worried as hell. How could you not be?But I think it's important to recognize that you probably have anexcellent chance of living into old age and dying of somethingother than PCa, no matter whether your cancer has recurred ornot.If you're having trouble with this, and I don't know that youare, please remember not to focus entirely on cancer to theextent of wrecking your personal life. You've got a lot ofliving left to do. We all have to battle our cancer, but wedon't want to give up living because we are afraid of dying.Alan

--

G. Coy

shootingcpa@...

"History does not entrust the care of freedom

to the weak or timid. " ... Dwight D. Eisenhower

[Guest guest]

Mike: Thank you.  I'm reminded of some advice the fictional character Gandalf gave one of the Hobbits (Frodo, I think) in one of the Lord of the Rings movies:  What's important is what we do with the time that we have. "

 Thank you again.  

 

,

          Your attitude is right and you seem to be doing the right things. You'll be in my thoughts and prayers. Regarding your wife's early retirement possibility, you have a tough decision. While having the second insurance is great, early retirement would allow the two of you to spend more time together, and that's important too, and may become more important. As an accountant you can probably figure out the present value of the second insurance, b ut I doubt you can calculate the present value of the additional time together.

           Mike   

 

Nowak

> When you talk about changes in the hundredths (0.0X) there is no> accurateness in PSA tests. These changes are meaningless.,I think that depends on several factors:

1. The sensitivity of the test. Some of them really are accurateto .01.2. The care with which the test is processed - which affectsaccuracy.3. The variability in PSA due to non-cancer causes.

The article that Chuck cited appeared to me to claim that, for aman who's prostate was removed, non-cancer causes can normallyonly account for a PSA of up to .03. Perhaps there areexceptions for some men, but apparently .03 is the norm.

That's not good for . However it isn't necessarily a deathsentence.First of all, we don't know what kind of test was used. Maybe itwasn't accurate to hundredths even though it was reported that

way.Secondly, we

don't know whether the guy who did the test did itright, or reported it right, or that the machine that did themeasuring was operating properly and with accurate calibration.The fact that the doctor's office said that other patients were

getting surprise PSA results may indicate that.Thirdly, even if the test is right and there are some tumorcells, they may be completely indolent. It may be that they willnot progress to metastasis.

Fourthly, if they are not indolent, they may be entirely curableby radiation.And finally, even if they are not indolent and not curable byradiation, they may be entirely controlled by one or another type

of hormone therapy, even including " light " therapy that usesCasodex, duatasteride, estradiol, or something else that is lessdrastic than Lupron, to keep them from ever becoming a seriousproblem. I think we have seen numerous cases like this of men

who

attack the cancer early, before it is extensively mutated andspread, and keep it under tight control.,I know that you must be worried as hell. How could you not be?But I think it's important to recognize that you probably have an

excellent chance of living into old age and dying of somethingother than PCa, no matter whether your cancer has recurred ornot.If you're having trouble with this, and I don't know that youare, please remember not to focus entirely on cancer to the

extent of wrecking your personal life. You've got a lot ofliving left to do. We all have to battle our cancer, but wedon't want to give up living because we are afraid of dying.Alan

--

 

G. Coy

shootingcpa@...

 

" History does not entrust the care of freedom

      to the weak or timid. "   ... Dwight D. Eisenhower

 

--  

G. Coy

shootingcpa@...

 

" History does not entrust the care of freedom

      to the weak or timid. "   ... Dwight D. Eisenhower