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Posted 12/10/2017 5:37 PM (GMT 0)
Hi,
I have a question on PSA readings. I recently posted about my PSA rising. My first 5 visits after RP were undetectable at less that 0.03. Then my doctor switched to an even more sensitive test and it came back at 0.020 3 visits ago, 0.021 2 visits ago and 0.027 last week. I had an open margin of less than 1mm, Gleason 6 before and after. But he feels I should prepare for radiation treatment if it rises again on my next visit in 4 months, even though it is still low, because of the rises.
I want to avoid radiation because it scares me more than the surgery did. But if it has to happen, so be it. However I am trying as much natural alternatives to lower my PSA. I have read about supplements and certain healthy foods that can possibly do this. Not trying any wacky ideas, just things like ground flax seed, curcumin, etc. Overall, since my original diagnosis I do eat healthy.
So my question (finally) is this, and I hope its not too dumb of a thing to ask. Lets say I go back in 4 months and the PSA is 0.022. He will tell me to lets just monitor it. But does this mean the cancer that is still in me has shrunk, or just that the foods I am eating have lowered the PSA, but the cancer can still be in there growing? I dont want to falsely lower the PSA reading and miss out early more curable treatment.
Thanks,
Tom
Posted 12/10/2017 11:25 PM (GMT 0)
That is the problem with ultra-sensitive PSA test. The classic definition for zero PSA is technically, less than 0.1 nanograms per milliliter. So from that point you are good. Having a positive margin seems like a bad thing, but if PSA is creeping up you will hope it is from the positive margin and not a distant metastases. Additionally it increases your change for a long cure according to the radiation nomogram.

Having GS6 margins you should have a long time (possibly years) before having to make a decision. So I wouldn't jump the gun yet.

I was in the same boat, and waited until PSA hit the infamous 0.2 ng/ml threshold. My oncology urologist told me that there isn't any reason to rush into radiotherapy until I hit that 0.2 threshold.

As for radiation, it was a non-event for me. I had 39 treatments, 70.2 grays (IGRT/IMRT) with zero side effects I didn't change my diet or habits, and stopped by the radiation center on the way home from work every day.
Posted 12/11/2017 12:37 AM (GMT 0)
Thanks lapilot.
I was told on this board that my psa would be a lot higher than 0.027 if it was distant metasteses, and that Gleason 6 doesnt metastasize. Hope that is correct.
I am real glad to hear your radiation treatment was a "non event" and it all went well.
Thanks again
Tom
Posted 12/11/2017 8:32 AM (GMT 0)
Some say that if the PSA reaches .03 you should initiate early salvage radiation. When mine got to .05 I pulled the trigger. An advantage of such early SRT is that the docs don't recommend using ADT in conjunction, which was a big plus for me. The radiation treatment was no big deal in my case, and I had virtually no SEs. It was just a lot of visits to the radiation center and the nuisance of having to have a full bladder -- but not too full! -- at the right moment each day.
Posted 12/11/2017 2:20 PM (GMT 0)
Thanks fiddlecanoe. Glad to hear another successful case without side effects!
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