12 years since surgery update 07/04/2018

Ok had the Robot 10/12/2006

2006 PSA after surgery .001
2007 0.02
2011 0.085
2012 0.15
2013 0.13
2014 0.20
2015 June 0.17
2015 Dec 0.23
2016 June 0.26
2016 Dec 0.25
2017 Dec 0.326 update 12/05/17 seeing doctor today for annual
2018 July 0.300 update 07/04/18


Anyway doctor say we might talk if it goes to 0.30 ok talk about what?

How do we know that these numbers actually mean CANCER? A healthy prostate puts out PSA right? Can these numbers reflect healthy prostate cells? How do you know they are cancer or not?

I check in here about once a year or so with my numbers. Everything else health wise is great far as I know heart, lungs, etc. I take no presriptions of any kind and everything works as it should for a 67 year old guy. Still this CREEPY PSA CREEP bothers me a bit.

Post Edited (56pontiac) : 7/4/2018 8:22:12 PM (GMT-6)

Hey 56.....sorry about the continual worry about it creeping up.

Given it's slow creep, I am very interested in knowing what your Gleason was post op. In my little mind, I am thinking it's the slow progressing type 3 cells that were left behind. They are the slow movers I believe.

The most widely accepted definition of a cancer recurrence after surgery is a PSA > 0.2 ng/mL which level you have seem to have passed in two measurements. You may benefit from secondary treatment like salvage radiation but that could also be over-treatment if it is a non aggressive recurrence. Waiting to 0.3 or more, considering that it was 10 years since surgery, sounds reasonable.

This could be a relevant study for when men with detectable PSA after RP can avoid the anxiety, toxicity and costs associated with additional treatment. Low Detectable Prostate Specific Antigen after Radical Prostatectomy—Treat or Watch?
It is written:
"Low detectable-stable PSA (greater than 0.03 and less than 0.2 ng/ml, no 2 subsequent increases and/or prostate specific antigen velocity less than 0.05 ng per year) do not often experience disease progression and can be followed safely."

56pontiac - unfortunately it looks like your numbers are worse than this definition.

I agree, ride it out. With such a long time to get to where you are at (10) years, SRT may or may not even work for you, and you would be at risk for radiation related side effects. If it's not broke, don't fix it.

However, if it continues to rise, steady for the next year or so, re-evaluate your situation. With such a slow doubling time, you will either live to be an old man, or something non-PC related will get you. Just my take, not a doctor

Thanks a lot guys. I am leaning to the ride it out and wait and see what the doctor says. I also don't believe there really is a "cure" for any cancer it seems to always be there.

Hello Pontiac,

Your post interests me very much. My sitch is very similar. Had DaVinci in August 2005. PSA 4.0, Gleason 3+4. Started out out at <.03 and crept up over the years. In December last year it hit .20. This month it went to .26. Doc has shortened PSA check intervals to 4 months so we'll see where we are in October.

Like you, I am 68, fit and in very good health with all systems functioning properly. The thought of potentially screwing things up with radiation side effects is not pleasant. With a family history of longevity I can expect another 25 years or so. It's a dilemma. I'll watch your story with interest.

You can assure us all day long...means nothing...you always leave out the determinant for the the OP...which is your saving "grace" ...as you have zero credentials for such...and you know this as sure as fresh falling snow is pure... I think you get the drift...As Walt Whitman said: "you think you know...and you don't". Hubris...a lousy breakfast..lunch and dinner especially when served to to someone else..."Paints what I see's" Gahan Wilson...

I have been here for nearly 8 years, no that doesn't make my experience special or any advice I have given any higher value - first to admit that. But I have also seen "experts" come and go over the years.

In the original concept here at HW, it was intended to be a patient to patient (peer based) exchange of experiences, a place to life a fellow PC brother up, or their spouse or S.O. And of course, sharing of credible medical information to assist others with difficult medical decisions ahead. But we also knew/know, that at our best, even the "experts' here, are in no form or shape - a replacement for sound medical advice. Personally, that's how it should still be and is for the most part.

I feel, and it may just be me, I speak for no one else, that a flood of stats, abstracts, findings, whatever name one care to give them - sometimes, just sometimes, can actually daze and confuse those new to the PC world, and just sometimes, can cause needless anxiety and fear, which is not the obvious intention of the poster of such information. I have seen folks here go negative on their doctor's advice based solely on what appeared to be more educated opinions from some regular posters. I find this to be a dangerous approach and trend.

From that very first ever PSA test, to that first biopsy (if needed), to surgical and radiation treatments, to HT and Chemo journeys, we have a wealth of first hand knowledge from real life PC patients to share - and for the biggest portion, these stories are helpful to those in need. There is very little related to PC and PC treatments, and yes, even PC tragedies - that hasn't been experienced and shared here.

I say (again, speaking only for myself), save the doctoring to the doctors, ands leave the true support level assistance to the HW PC community here. It has worked well for years.

The saddest part to my 8 years here, is the never ending line of new Men and Women that find us and end up being a part of HW PC. It would be nice if that were not the case, I really wished there wasn't a constant need. But that wouldn't be real world.

Perhaps its just me, but your use of the word anecdotes always comes across as demeaning and even condescending. But that's just me.

It's not all peaches and cream out there, and its not all hard cold academic facts either, there's a lot of suffering, a lot of pain, a lot of fear, and a lot of anxiety among our community - to those elements, I will never let down my level of care and heart felt empathy, despite my own woes. To truly understand suffering, you have to experienced suffering, same as pain and worry/anxiety. Those can't be learned from a study or abstract.

56 Pontiac

Your numbers would match any definition of recurrence, whether one uses the standard of .2 or the more current .03. This would be the accepted trigger point at any of the major cancer centers in the US. Established studies from the past 8 years show that waiting past .2 to begin a secondary treatment lowers your chance of a real cure or durable remission. Have you plugged your numbers into MSK SRT nonograms?
I had surgery in Oct 2007- GS 3+4 first PSA reading after surgery was .005. Finally I reached .06 in January 2015. Had SRT at MD Anderson and been stable at <.006 for 14 months. Both my urologist and RO said I needed SRT. After SRT, both said I had 80-85% chance of being finished with PC. So far so good. My doctors are at the very top of the elite PC specialists in the field. Thank you God. Tall Allen has given you a very accurate assessment of the most current protocols for your situation. What you do with that information will effect you the rest of your life. You are very young and healthy. I have had absolutely no problems with SRT. That is the case for a very high percentage of men who have secondary treatments. There are deaths from lightning strikes. I am sure there is someone who would advocate, as an authority, that you should dig a hole in the ground, line the walls, floor, and top with eight inch sheets of rubber and get in it to avoid the effects of being hit. You know that records show that one or two in a gazillion people have been hit. It is amazing that those two also have prostate cancer. Go figure. Here's the most important number: roughly 15 percent of men diagnosed with PC die from it. Pretty clear understanding? Stay in touch.

Post Edited (Octorobo) : 6/21/2016 4:50:15 AM (GMT-6)

56,
I would definitely watch things as you have. Taking on an intervention therapy may be a good idea and it may also be totally unnecessary. There may be a trial alternative out there for you to consider that would compare some of the novel new drugs as an early intervention after RP leaving great data behind for others. Perhaps the best advice is stay informed and stay vigilant. And keep playing that awesome music!

Bololidat said...
You can assure us all day long...means nothing...you always leave out the determinant for the the OP...which is your saving "grace" ...as you have zero credentials for such...and you know this as sure as fresh falling snow is pure... I think you get the drift...As Walt Whitman said: "you think you know...and you don't". Hubris...a lousy breakfast..lunch and dinner especially when served to to someone else..."Paints what I see's" Gahan Wilson...

Can you please translate this from BoloSpeak to plain English?

Tim-

I didn't see that post until you quoted it because I have that member blocked. I've given up trying to understand and translate Gibberish, especially mean-spirited (as far as I can tell) Gibberish. It's difficult enough when people try to communicate. To obfuscate intentionally of a site where people are looking for help is unconscionable to me.

- Allen