What to make of it? Recurrence, benign tissue, or both?

I have been reading postings at this site for some time with particular interest in benign tissue, diet, and further treatment options. I appreciate very much the information and support offered in this forum. Since the return of a detectable psa I have modified my diet and returned to a vigorous exercise routine. I have read recent postings by Trimix, KickintheButt, and TaurusBull with particular interest. Piano, I would be interested in your thoughts on ground flax seed.

 

68roadrunner

     I suppose a small number of cancer cells remained in the area,  had gotten out of the area, new cells had gone bad, and/or there is benign tissue growth. If you discuss with your oncologist I would be interested in his/her answer.

excityboy

Your sig does not mention lymph node biopsy, seminal vesicle involvement, or perineural invasion. All possible areas where PC could have escaped.

Your case is an argument for ultra sensitive PSA testing in my opinion. You could have had a steady increase from .01 to .09 over the last several years, but you don't suspect any problem until it hits .1.

I too have been watching a slight increase in PSA over the last 3 years. I have chosen .05 as an action point because of my Gleason 9.

Good luck. Will be interested in what continues to happen in your PSA progression, if that is the case.

goodlife

     I asked my oncologist for additional information during last visit. I then forgot to remind him at end of visit. I'm going to call and ask that info be sent. Thanks for your suggestion.

     I think I understand you approach and rationale. Looking forward to your psa remaining less than 0.05.

XCB

EXB,

Actually, I was hoping if it was benign tissue that it would have flattened out by now (lol).

I believe one of the notes in the MSK online nomogram mentions that the most significant PSADT to observe is that taken from the last 12 months of PSA readings, as this gives a better indication of what is going on presently (i.e. PSADT can change). My PSADT over the last 12 months comes out to a rate of about 21 months using the nomogram. However, with PSA recurrence after RP, any PSADT over 12 to 15 months is very favorable and begs the question whether SRT, if effective, would even prolong your life. This, of course, is dependent upon other factors including your post surgery Gleason, etc. Also, the doubling time should be calculated starting with readings that are greater than 0.1, hence the >0.1 qualifier underneath the box where you input the PSA readings.

TB

PS. The information above is from MSK website, Dr. Myers v-blogs and my personal medical and radiation oncologists. I am not a doctor, nor a medical professional by any stretch of the imagination.

XCB,

You definitely need a third data point to validate your PSADT using the MSK nomogram. I agree that ones present health and age are major considerations and should factor into the decision of when to start SRT. Somewhere on the forum in another thread, someone mentioned that it takes 40 doublings after PSA recurrence for PCa to become lethal. That seems a bit too optimistic to me. For example, if you calculate 40 doublings from a BCR of 0.2, the PSA comes out to some astronomical number like 2.19 X 10^11 ng/ml. I think you'd be dead long before that happened. There is also the question of what is considered a lethal PSA reading? No one knows because it varies from one individual to the next. BTW, I am presently in good health too, which is one of the reasons I am somewhat fearful of SRT. I am afraid SRT may change that (due to the SEs), and I still need at least another 10 good years to work before I can retire. It's a tough decision...I almost wish I had a positive margin at surgery, because the SRT decision would have been a no-brainer.

Best of luck to you on your next PSA reading.

TB

Jeff

Thanks for the input. Your psa history is an example of why it's so hard to judge what it means. Your's flattened for a while where you could have thought it was benign tissue but later took off again. Keep putting up those .05's.

XCB

Does anyone know of cases where the psas stayed between .1 and .2 or .3 for many years post prostatectomy? It seems every case I see, it eventually rises.

I updated my situation in another thread, but will post it here as well. After approximately 3 months on Avodart, my PSA has declined slightly from 0.38 in January to 0.31 in April. I will remain on the Avodart for another 3 months and see what July brings.

TB