Another 3 month PSA-update

[Guest guest]

Hi All,

I'm hoping some of you remember me. My husband before treatment had a PSA of 7.9

Gleason 9. Choose IMRT treatments and he had to be put on hormones for one year.

His PSA every three months: .2,.26,.47,.52 and now it's .53. It's slowly

climbing and scaring the hell out of me. I know they would put him back on

hormones and we both hated that. He didn't say anything and I told him it was

still within normal range. I'm so scared but all we can do is have it checked

every three months for now. We don't see the oncologist until March. Just

thought I'd check in vent, update and look for moral support. He recently had an

MRI on his spine and has many problems but thank heavens no cancer. We are

trying to stay right on top of it. Thank you for letting me vent.

Best to All,

Sheila

[Guest guest]

Sheila,

Feel free to vent all you want. We all feel that way sometimes. Since I had surgery and so have no idea what to expect after radiation, I have no advice or consolation to give, but you and your husband are in my prayers.

Mike

Subject: Another 3 month PSA-updateTo: ProstateCancerSupport Date: Friday, September 9, 2011, 9:34 PM

Hi All,I'm hoping some of you remember me. My husband before treatment had a PSA of 7.9 Gleason 9. Choose IMRT treatments and he had to be put on hormones for one year. His PSA every three months: .2,.26,.47,.52 and now it's .53. It's slowly climbing and scaring the hell out of me. I know they would put him back on hormones and we both hated that. He didn't say anything and I told him it was still within normal range. I'm so scared but all we can do is have it checked every three months for now. We don't see the oncologist until March. Just thought I'd check in vent, update and look for moral support. He recently had an MRI on his spine and has many problems but thank heavens no cancer. We are trying to stay right on top of it. Thank you for letting me vent. Best to All,Sheila------------------------------------There are just two rules for this group 1 No Spam 2 Be kind to

othersPlease recognise that Prostate Cancerhas different guises and needs different levels of treatment and in some cases no treatment at all. Some men even with all options offered chose radical options that you would not choose. We only ask that people be informed before choice is made, we cannot and should not tell other members what to do, other than look at other options. Try to delete old material that is no longer applying when clicking replyTry to change the title if the content requires it

[Guest guest]

It's experiences like this that make this group discussion so positive. Regards all, from one with five days left of proton beam therapy. T Poxon > Hi All,> I'm hoping some of you remember me. My husband before> treatment had a PSA of 7.9 Gleason 9. Choose IMRT treatments> and he had to be put on hormones for one year. His PSA every> three months: .2,.26,.47,.52 and now it's .53. It's> slowly climbing and scaring the hell out of me. I know they> would put him back on hormones and we both hated that. He> didn't say anything and I told him it was still within> normal range. I'm so scared but all we can do is have it> checked every three months for now. We don't see the> oncologist until March. Just thought I'd check in vent,> update and look for moral support. He recently had an MRI on> his spine and has many problems but thank heavens no cancer.> We are trying to stay right on top of it. Thank you for> letting me vent. > Best to All,> SheilaHello Sheila,The rising PSA can't help but scare you, but I'm thinking thereare some good signs in the numbers you posted.First of all, the rise has slowed considerably after the .26 -.47 transition. The rise to .52 was pretty small and thesubsequent rise to .53 was insignificant. If it continues torise at the rate of the last three months you might want tostart treatment sometime in oh, about 200 years.Secondly, the slow rise may not be caused by growing cancer.It is my understanding that radiation does not kill cancer cellsright away. The quantity of radiation needed to kill the cancerimmediately would be too dangerous. Instead, they give a dosedesigned to damage the DNA and other molecules in the cell enoughthat the cell has trouble surviving over time and is totallyincapable of dividing successfully. It can actually take someyears for all of the tumor cells to die. During that period, thetumor cells can still produce PSA and may actually produce morefrom time to time, for example under the stress of attempting todivide and failing. So the PSA doesn't necessarily decline in asmooth curve. It can go up and down.In my own case, my PSA went up and down for three years afterradiation, reaching a high of 1.8. Then it went steadily downand reached its low point of 0.08 five years after treatment.Also, the reading of .2 and .26 might still reflect the influenceof the ADT treatment. In theory, the Lupron treatment lasted forone year. In fact however, it is unlikely that your husband'stestosterone level returned to pre-treatment levels at the end ofthat year. It could easily have taken another 3, 6, or even moremonths. I was only treated for four months but it took another 3months after that before my testosterone was back topre-treatment levels.Furthermore, even when the testosterone returns to normal levels,it takes an even longer time before the prostate cells respond toit and produce as much PSA as they would have produced had therenever been any Lupron. In my own case, I believe that took atleast several more months. In your husband's case, with longerLupron treatment than I had, it could be more.I think that 0.53 is a pretty good number. It took about 2.5 years for me to get down to 0.5. So I'm thinking that, whileyour husband might still have cancer, there's a very decentchance that he doesn't.I'm not a doctor, but I think I would not leap into furthertreatment at this point. I'd keep watching the PSA. Even if thePSA rises to 1.0 or maybe even 2.0, if there is no other evidenceof cancer I'd question whether it's time to get further treatmentor to wait. It could still go down again, or just as good, neverrise any further.Finally, one last point. If it turns out that your husband stillhas cancer and does need further treatment, the PSA rise has beenslow enough that we can be very hopeful that treatment willtotally control it for many, many years. Also, although you andyour husband hated the Lupron treatment, there are other hormonetherapies that have different and possibly less drastic sideeffects. Lupron is probably the single most effective drug formost patients, but other treatments like estradiol, which I'mtold has very few side effects and no sexual side effects, mightbe all he needs.So don't let yourselves get too upset. The situation may not bebleak at all.Best of luck.Alan