HealingWell
Search Close Search
☰

PSA Up After 7.5 years.Reason For Concern?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 1/4/2019 4:50 PM (GMT 0)
While still undetectable and barely going up, it's only natural I guess for me to be a little concerned. While being <0.03 for 6.5 years, 7 years went 0.04 and then the recent 7.5 test was 0.05. My Dr said that it may just be a few benign glands around the uretha neck and still low risk for any significant recurrence. Nonetheless, he wants me to go in every 6 months and if it keeps going up, maybe we can at least start talking about salvage radiation. Anyone with a similar situation?
Posted 1/4/2019 5:25 PM (GMT 0)
Sadly that happens. Monitoring every six months is prudent. That's still not much PSA, but an increasing trend isn't what you want.

If you get a test or two above .05, it might be time to get an opinion from an RO.

Whether or not you'll need more treatment is a question for months/years from now. At the moment you have some wacky readings.

Go live life and come back for a recheck in six months.

Andrew
Posted 1/5/2019 4:52 AM (GMT 0)
Lot’s ‘a people. It’s not uncommon. Do what ya gotta do to keep it in the back seat. Live and learn. You come to terms..
Posted 1/5/2019 2:42 PM (GMT 0)
Of course you should be concerned. That is smart and healthy and means you will approach the increase appropriately.

If the PSA is increasing and you lose the < sign it means it is no longer undetectable. After RP the main reason it will increase is due to some PCa. I question why it would take seven years for benign glandular tissue to express PSA.

You now have to watch for a trend. If you stay level it is good. If the PSA continues to increase then you may have to consider additional treatment. You had a good amount of G4 and that is what can cause problems.

Personally I would be having a quarterly PSA test.
Posted 1/5/2019 11:19 PM (GMT 0)
JNF, I thought anything below .2 was undetectable.
Posted 1/6/2019 12:05 AM (GMT 0)
What counts as "undetectable" depends on the type of test used. Some docs use a less sensitive test that can't detect PSA below .02. Others use a ultra-sensitive test that can detect as low as .008. There is a disagreement among doctors about the value of the ultra-sensitive test. Some think it detects too much natural fluctuation and thus causes unnecessary worry. If the test result comes back with a "<" sign in front of the number, it is undetectable.
Posted 1/6/2019 12:29 AM (GMT 0)
For a long time, 0.2 was the conventional cutoff for biochemical recurrence. (It's sometimes referred to in the literature as "cBCR," conventional biochemical recurrence.) Many surgeons still hold to that. But there's no longer a medical consensus on the cutoff point. Most ROs now seem to favor pulling the trigger on salvage radiation therapy at 0.1, and some would start as soon as 0.05.

"Undetectable" is feel-good term that doesn't mean a heck of a lot anymore. It says that your PSA is below the sensitivity threshold of the assay that the laboratory used. When the consensus was no BCR until PSA reached 0.2, running a standard assay with a threshold of 0.1 was more than sufficient -- you could gleefully report you were "undetectable" and it was understood to mean you were cancer-free. But with no real consensus on the cutoff for BCR and ultrasensitive PSAs that can report as low as 0.02, its value in terms of reporting the status of one's disease is negligible.
Posted 1/6/2019 5:48 PM (GMT 0)

Saipan Paradise said...
For a long time, 0.2 was the conventional cutoff for biochemical recurrence......Most ROs now seem to favor pulling the trigger on salvage radiation therapy at 0.1, and some would start as soon as 0.05.

The lower the definition of BCR, which IMO is just fog sculpting to begin with, the more 'trigger pulling' work for RO's. Could they be playing on our innermost cancer survival fears?
Posted 1/7/2019 2:10 PM (GMT 0)
Thanks guys for the input! I will get tested again in 3 months.
✚ New Topic ✚ Reply