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psa up after 2.5 years what is considered a recurrence

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Posted 11/24/2010 6:03 PM (GMT 0)
just  had a psa done today and the psa numbers were as follows    1/20/10 0.00    5/25/10 <0.05     11/22/10  0.10   any feed back on this would be greatly appriciated   thank you ,,,dirt
Posted 11/24/2010 6:08 PM (GMT 0)
it would help to see your stats before answering, can't remember your situation. normally, if you are post surgery, and I am assuming that, then they usually want to see 3 rises at or above .10. You got your first one, so in 3 months, if it is at .10 or higher, then you got your 2nd, then 3 months later, if your third is .10 or higher, most doctors would consider that evidence recurrance. Different doctors use different standards of course, this is how it was determined in my case.

david in sc
Posted 11/24/2010 6:27 PM (GMT 0)
thanks ill attach stats
Posted 11/24/2010 7:21 PM (GMT 0)
David:

I've been wondering about that.

My next PSA will be done on 12/30 or 12/31 and I'll get my results on about 1/3.

I then have my appointment with the Ford team on 1/7.

As you may recall my 3-month PSA's are: 0.01, 0.02, 0.06

Suppose my next one is above 0.10 (say 0.13).

Would they wait 3 months to do another one, or maybe wait 1 month, or just deem it a BCR and advise me to go to the next step of SRT? Any thoughts?

Mel

Posted 11/24/2010 8:52 PM (GMT 0)
mel,

depends how itchy you are to move forward, and how itchy your doctor is. mine, had me wait a full 3 months before the 2nd rise above .1, then another 3 months for another reading to confirm. this helps to eliminate tests spikes and glitches. it would also depend how much of a rise you had at each test point.

as usual, too many answers from too many doctors. each has their own way.

david
Posted 11/24/2010 10:05 PM (GMT 0)
Thanks David.

I suspect there is no one answer, so we shall see.

Believe me, I am not itchy at all to move forward. But the studies seem to suggest that sooner rather than later is the ticket!

If my PSA goes to say 0.14 and the doctors suggest waiting for another reading, I would follow their advice. (I also suspect the next reading would be a month later, rather than 3 months)

Mel

Posted 11/24/2010 10:15 PM (GMT 0)
You need to retest to rule out lab error. You had a clean pathology...Try again next week.
Posted 11/24/2010 10:25 PM (GMT 0)
well, mel, different doctors deal with what you ask in different ways, but had already said that. since we share personal experiences, we usually base that on our own experiences in our own local areas. There is no right or wrong here. You and your doctors will have to decide, if you ever have BCR, based on what they tell you and what you want to do.
Posted 11/24/2010 11:23 PM (GMT 0)

Dirtmover said...
just  had a psa done today and the psa numbers were as follows    1/20/10 0.00    5/25/10 <0.05     11/22/10  0.10   any feed back on this would be greatly appriciated   thank you ,,,dirt

Hi Dirtmover,

You had surgery and are being treated by a urologist, and so the American Urological Association (AUA) is the governing body which publishes the PSA-related medical standards of interest to you.  The AUA has an easily-readible, free online document which would be of direct interest to your thread title "psa up after 2.5 years what is considered a recurrence."  The document is titled:  "Prostate Specific Antigen BEST PRACTICE STATEMENT:  2009 Update", and I will give you the hyperlink below.

The first part of the document deals with pre-treatment PSA information, and the second part deals with post-treatment (after surgery, in your case).  Starting on page 37 is the section titled, "The Use of PSA in the Post-treatment Management of Prostate Cancer"...this is, of course, the section for you.

You undoubtedly realize that after treatment, the PSA test is the overall best-available means of detecting prostate cancer recurrence...the specific term is Bio-Chemical Recurrence, or BCR.  Different definitions of BCR exist after surgery and radiation, but the AUA defines post-surgery BCR in this way:

The AUA defines biochemical recurrence as an initial PSA value ≥0.2 ng/mL followed by a subsequent confirmatory PSA value ≥0.2 ng/mL.  (page 38)

The document goes on to very clearly state that "This cut-point [≥0.2 ng/mL] was selected as a means of reporting outcomes [of BCR], however, rather than as a threshold for initiation of treatment."  In other words, the threshold for "official" BCR and the threshold for action are not necessarily the same, depending on each case's specific details.  If your post-surgery PSA starts rising (it appears that it might be headed in that direction for you), then your doctor might start you thinking about/planning for SRT (Salvage Radiation Therapy) even before you reach BCR.

I hope that this information adds value...

Here's the link to the AUA document, and I recommend reading the entire second half about post-treatment management of PSA; you will learn more about BCR, plus other important information:

http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf

 

Posted 11/25/2010 9:11 AM (GMT 0)
Sorry you've left the zero club.
Question is: is it temporary?
The only way to find out is to wait and see, and this raises the old spectre of PSA anxiety, but there's no other way to find out more other than the passage of time.

It could be a blip of some sort so that you end up with a lower PSA score.
It could be a small rise following the existing pattern so that you get a 0.13 or a 0.15, or
it could be a bigger rise to say 0.2 or 0.3
The PSA velocity/doubling time will thus be the main factor in deciding what to do next and how soon to do it.

Not an easy time and you have my sympathy for this development. When my own PSA jumped from 0.1 to 0.4 having never made it to the zero club, I was strangely relived, as there was little room for doubt about whether there was or was not something wrong, so that it was at least easy to make the decision to go for SRT.

Alf
Posted 11/25/2010 10:12 AM (GMT 0)
Hi Dirt As Alf says above in time you will know where the PSA stands. Anxiety is the worse way to take. Your next test will give you peace of mind. Hope that the rise in PSA is due to other things than recurrence.   Whishing you the best, Baptista Post Edited (Baptista) : 11/25/2010 6:01:55 AM (GMT-7)
Posted 11/25/2010 3:54 PM (GMT 0)
I think the <.05 result just means .05 is as low as the equipment could test and you were beneath that number.  Either the lab or the testing equipment changed from your first test result of 0.00. 

So, that would mean the <.05 is not indicative of any increase in your PSA whatsoever.

In regard to the recent 0.10 result, did you see the lab report yourself?  If not, it's possible that there is a < before the number, and whoever is giving you the result omitted it from what they told you.  I had that happen when the nurse left a message with my wife.  I called back and was told the same thing, "0.10" until I specifically questioned the result and was told, oh yeah, there is a < before the number.  Big difference.

So, if the 0.10 is really <0.10, again, that's as low as that equipment can test.  That's a zero.

Finally, if there isn't a < in the lab report, it's only one test.  It could be lab error.

Posted 11/26/2010 12:11 AM (GMT 0)
I can speak from my standpoint. My PSA this year has gone from .16 to .71 in three months. I still opted not to do anything. Even though I am a gleason 9 I do not want to get trigger happy. My plan is to keep exercising diligently and when the PSA reaches probably 2 or higher I will consider doing something.
Keep in mind this is just me.

peace to all
Dale
Posted 11/26/2010 1:22 AM (GMT 0)
Dave7 is exactly right. If you don't have a copy of the lab results get one. The exact same thing happened to me. The nurse on the phone said my result was .03. When I got my copy it said <0.03
Posted 11/26/2010 4:25 PM (GMT 0)
the copy of the report or the docs printout said .10   with no< in front of it  ?
Posted 11/26/2010 4:35 PM (GMT 0)
Dirtmover--I agree with ChrisR that you should get retested to r/o lab error, especially with your uncomplicated PCa history. In any event, the standard cutoff before doing anything is 0.2. All the best!
Posted 11/27/2010 1:29 PM (GMT 0)
Dirt, I was thinking about you last week and hoping you are doing well. Sorry about the PSA but agree with Dave above. Make sure the you have used the same lab. The < means it is as low as the machine will go. Follow-up wiht the doctor on the .1. Also, did the doctor say anything when the PSA was .1 or say come back in 6 months?
Posted 11/27/2010 9:28 PM (GMT 0)
the doc was a general whom really didnt know much of anything. so im gonna follow up with a new test , with a uro, and go from there , i used the same lab, but htere could be a chance, ther was an error, let hopr for the best , thank to all for your input ,, dirt
Posted 3/4/2011 9:05 PM (GMT 0)
Dirt,

Did you ever follow-up with this? What is going on with you?

Chris
Posted 3/4/2011 11:21 PM (GMT 0)
Dirt

If you have two more rises above .10, my doctors would consider that early evidence of BCR.
Posted 3/5/2011 2:16 AM (GMT 0)
OR maybe study up on your specific condition and then decide. PAACT has helped recently talking to a Mr. Ptofit. You may try that for some DD.

http://www.paactusa.org/

 

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