re: PSA anxiety

[Guest guest]

The posts about 'PSA anxiety' from those who have had treatment are interesting.

A number of posts on the various prostate lists by those who could have considered Active Surveillance (AS)(based on biopsy results indicating probable 'low risk' cancer-- Gleason sum 6, PSA less than 10, no more than 3 positive cores, no core more than 50% involved) but instead chose immediate treatment indicated that they did not want to live with the 'uncertainty' of AS.

Yet the posts about post-treatment 'PSA anxiety' seems to indicate that many who decided on treatment are living with continued uncertainty,

I'm entering my 4th year of AS, and part of my monitoring protocol is to have PSA tests every 3-4 months, including %free annually. I can honestly say that I do not await the results with any anxiety.

Why? Because I've been following my PSA kinetics long enough (since 1994) to know that, pretreatment, a change in one reading of PSA of as much as 25% is meaningless. My PSA trends have frequent ups and downs due to inflammation. The graph (semi-log) of PSA vs time is a sawtooth pattern with as many as 3 to 4 readings showing an increasing trend, then dropping back to an average of 5.6 to 6.0 and a doubling time of more than 15 years. So I don't start to worry about my PSA results until there is a series of at least three increases in a row. And thus far every time that has occurred, the subsequent tests dropped back to the long-term trend.

So, for those meeting the criteria for AS, but are worried about AS 'anxiety', consider how seriously those who have been treated await their PSA results with concern about increases in tenths or hundredths of units.

For anyone with our disease, there is no guarantee of a 'cure' after treatment.

For those of us on AS, there is no guarantee that we can avoid treatment forever.

However, there is increasing evidence that some of our cancers are 'lambs' that will never be life threatening. And, there are significant available clues to watch to catch the cancers that might turn into the 'lions'.

In all cases, it behooves us to seek consults on treatment options from reputable practioners of different treatments, including serious consideration of AS if one's diagnostics suggest that option.

And, once a decision is made, continue living so as to maximize the benefits of being alive!

The Best to You and Yours!

Jon in Nevada