Re: Question About Rising PSA

[Guest guest]

Roy,I have never seen any research that evaluates the role of stress on PSA, but I personally believe there is at least a correlation.  I have had two support group members with very high stress jobs who when diagnosed with low grade cancer quit their jobs.  They both did very well and their cancer was under control once they left their employment.  They both were lured back to their jobs and quickly suffered major setbacks which included large PSA jumps, eventually they both passed away from prostate cancer.  It is non-scientific evidence, but I do believe that stress played a part in their disease progression.

Getting a PSA at a different lab is not a good idea.  Different labs use different reagents and the results are often not comparable.

 

Hi,

I've been pursuing an AS strategy for my cancer. Just got my latest PSA which was 5.8 taken June 3rd. In February, my score was 5.0 which had been my reading for most of the last year (my highest previous reading was 5.5 that then went back to 5.0). I've been under a lot of non-cancer related stress over the last few months and wonder if there can be a correlation? Also, I'm wondering if another PSA at a different lab is a reasonable response. Should this level of changing PSA set off major alarms? My PCP thinks I should have had surgery a month after diagnosis. I'm 59 with 3+3 = 6 Gleason, and 5 of 12 cores showing cancer, all on the right lobe. Thanks.

Roy

-- 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.org - 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]

Roy:

I can't really see a physiology reason for stress increasing PSA levels.

PSA is produced by prostate cells and cancerous prostate cells produce even more

of it.

Stress being basically psychological isn't going to change how much PSA is

expressed by those cells. Sex can increase PSA but that is simply because the

muscles that ejaculate semen push more PSA into the bloodstream temporarily.

So, I don't see a physiological cause at work.

[Guest guest]

Roy Wilkinson wrote:

> I've been pursuing an AS strategy for my cancer. Just got my

> latest PSA which was 5.8 taken June 3rd. In February, my score

> was 5.0 which had been my reading for most of the last year (my

> highest previous reading was 5.5 that then went back to 5.0).

> I've been under a lot of non-cancer related stress over the

> last few months and wonder if there can be a correlation?

> Also, I'm wondering if another PSA at a different lab is a

> reasonable response. Should this level of changing PSA set off

> major alarms? My PCP thinks I should have had surgery a month

> after diagnosis. I'm 59 with 3+3 = 6 Gleason, and 5 of 12

> cores showing cancer, all on the right lobe. Thanks.

Roy,

It is apparently the case that there can be very significant day

to day variation in PSA. A doctor at the National Cancer

Institute told me that the variation could be as much as 30% and

no one knew why. I know that my own PSA has gone up and down

significantly due to prostatitis, both before and after my

radiation treatment.

So I would say that, at worst, this rise should only set off a

minor alarm, not a major one. There's a very good chance that it

will go back down again.

If it continues to rise one or two more times then I think the

alarm should become more urgent. In that case perhaps it will be

time to activate the " active " part of " active surveillance " .

Since you already know that you have cancer, and since you are

still only 59 years old and could live 20 or more years if the

cancer doesn't get you first, I think it would be a good idea to

create a plan for yourself. Figure out what will decide you in

favor of treatment. It may be a PSA threshold or maybe a

different threshold for different ages. If you have a plan it

will remove some of the anxiety from AS. You'll know what you

are looking for, not just asking: Is this it? Is that it? What

should I do now?

If you haven't done so already, and if your biopsy slides are

still available, it's probably a good idea to get a second

opinion on them. If it comes back Gleason 7, then maybe you

should accelerate your decision.

Best of luck.

Alan

[Guest guest]

Thanks . I appreciate your thoughts.Subject: Re: Question About Rising PSATo: ProstateCancerSupport Date: Monday, June 20, 2011, 5:18 PM

Roy:

I can't really see a physiology reason for stress increasing PSA levels.

PSA is produced by prostate cells and cancerous prostate cells produce even more of it.

Stress being basically psychological isn't going to change how much PSA is expressed by those cells. Sex can increase PSA but that is simply because the muscles that ejaculate semen push more PSA into the bloodstream temporarily.

So, I don't see a physiological cause at work.

[Guest guest]

Thanks Terry. Your information is very helpful. Stay well!RoySubject: RE: Question About Rising PSATo: ProstateCancerSupport Date: Monday, June 20, 2011, 5:41 PM

Roy, The PSA test is not a very accurate test

and, as I hope you know, is not prostate cancer specific. Changes of the type

you describe can be due to any number of causes, from lab errors to prostate

cancer, but prostate cancer is the least likely. Prostate cancer related PSA

generally rises in a consistent and ever increasing rate: PSA associated with

other issues tends to go down as well as up. Like you I chose AS (Active Surveillance)

and ten years ago, in an effort to learn a little more about PSA I ran a little

experiment having a PSA test every day for 28 days to see what variance might

result. You can read about this http://www.yananow.org/PSAexperiment.htm

and there are links to other commentaries on the experiment. Of course it has

njo s cientific value at all, but it does give some insight into variability of

the tests.

All the best Prostate men need enlightening, not

frightening Terry Herbert - diagnosed in 1996 and

still going strong Read A Strange Place for unbiased information at http://www.yananow.org/StrangePlace/index.html

From:

ProstateCancerSupport

[mailto:ProstateCancerSupport ] On Behalf Of Roy Wilkinson

Sent: Tuesday, 21 June 2011 2:06

AM

To:

ProstateCancerSupport

Subject:

Question About Rising PSA

Hi,

I've been pursuing an AS strategy for my cancer. Just got my latest PSA which

was 5.8 taken June 3rd. In February, my score was 5.0 which had been my reading

for most of the last year (my highest previous reading was 5.5 that then went

back to 5.0). I've been under a lot of non-cancer related stress over the last

few months and wonder if there can be a correlation? Also, I'm wondering if

another PSA at a different lab is a reasonable response. Should this level of

changing PSA set off major alarms? My PCP thinks I should have had surgery a

month after diagnosis. I'm 59 with 3+3 = 6 Gleason, and 5 of 12 cores showing

cancer, all on the right lobe. Thanks.

Roy

[Guest guest]

Thanks Alan. I really appreciate your words of guidance. All the best!Roy

> I've been pursuing an AS strategy for my cancer. Just got my

> latest PSA which was 5.8 taken June 3rd. In February, my score

> was 5.0 which had been my reading for most of the last year (my

> highest previous reading was 5.5 that then went back to 5.0).

> I've been under a lot of non-cancer related stress over the

> last few months and wonder if there can be a correlation?

> Also, I'm wondering if another PSA at a different lab is a

> reasonable response. Should this level of changing PSA set off

> major alarms? My PCP thinks I should have had surgery a month

> after diagnosis. I'm 59 with 3+3 = 6 Gleason, and 5 of 12

> cores showing cancer, all on the right lobe. Thanks.

Roy,

It is apparently the case that there can be very significant day

to day variation in PSA. A doctor at the National Cancer

Institute told me that the variation could be as much as 30% and

no one knew why. I know that my own PSA has gone up and down

significantly due to prostatitis, both before and after my

radiation treatment.

So I would say that, at worst, this rise should only set off a

minor alarm, not a major one. There's a very good chance that it

will go back down again.

If it continues to rise one or two more times then I think the

alarm should become more urgent. In that case perhaps it will be

time to activate the "active" part of "active surveillance".

Since you already know that you have cancer, and since you are

still only 59 years old and could live 20 or more years if the

cancer doesn't get you first, I think it would be a good idea to

create a plan for yourself. Figure out what will decide you in

favor of treatment. It may be a PSA threshold or maybe a

different threshold for different ages. If you have a plan it

will remove some of the anxiety from AS. You'll know what you

are looking for, not just asking: Is this it? Is that it? What

should I do now?

If you haven't done so already, and if your biopsy slides are

still available, it's probably a good idea to get a second

opinion on them. If it comes back Gleason 7, then maybe you

should accelerate your decision.

Best of luck.

Alan

[Guest guest]

> Since the subject of stress and cancer has come up, the following

> from http://tinyurl.com/5snxzx.

>

> *STRESS*…Stress because of concern regarding one’s condition can

> lead to depression, and may also have an effect on cancer cell

> growth. I have included below the results of a lab study at Ohio

> University on cancer cells from a head and neck cancer. It

> validates findings in ovarian cancer and _may apply generally_.

> Interestingly, a beta-blocker slowed progression of the stress

> hormone stimulated cells. This study supports the importance of

> avoiding stress and depression

Reviewing what has gone before, I suspect that we're wandering

off-topic.

Seems to me that the " stress " that is the subject of this thread

actually is (literally) physical stress. Frex, in materials

science, the stress upon a rope that, increased, eventually leads

to its failure.

Mental stress is an entirely different matter.

Regards,

Steve J