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Sharing the 15 month PSA # and a question

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Posted 3/11/2019 11:39 PM (GMT 0)
Just had my 15 month PSA test at one of my two labs. Each 3 month Post SBRT is 2.03---2.20---1.03---0.64--- and today 0.28
I am of course very happy. Lab#2 will be next week.

Just FMI: Are various Nadir points different. I mean a fellow reaching and maintain a nadir of 0.1 and another fellow reaching and maintaining a nadir of 1.5 after RT. Are these numbers equally as good or is the lower number more indicative of better long term outcomes?

It seems from what I have read that any nadir number that is maintained means the cancer is either gone or is fully in remission at that time. Right or Wrong???????

I realize of course that we are dealing with a decade or two to be really comfortable.

May all beings be well.

Roger
Posted 3/12/2019 12:23 AM (GMT 0)
Correct, you should stabilize at a nadir and it's different for everyone. You have nothing to worry about until it moves +2 from nadir.

I continued to drop PSA for about 4 years.
Posted 3/12/2019 12:52 AM (GMT 0)
Thx Andrew.
From looking at your signature, then do you consider your nadir to be 0.3 until/if it goes lower?
Posted 3/12/2019 1:02 AM (GMT 0)
The nadir is the lowest point you ever reach. You may not be there yet.

Expect some bouncing in the 18-36 month range. Inherent with radiation therapy as an initial primary therapy.

Studies show the best long term results occur when PSA reaches levels under 0.50. However this is not necessary.

You appear to be doing well and with a great trend. Remember this is a marathon and the objective is that something other than PCa delivers us to the next life.
Posted 3/12/2019 2:06 AM (GMT 0)
Roger looks like your heading in the right direction. keep it up!
Posted 3/12/2019 3:48 AM (GMT 0)

three 5's and a jack said...
Thx Andrew.
From looking at your signature, then do you consider your nadir to be 0.3 until/if it goes lower?

Exactly. Nadir is always the lowest reading recorded.
Posted 3/12/2019 3:17 PM (GMT 0)
Why two labs, Roger? I assume one is uPSA and the other is from the VA.

Your PSA pattern is wonderful, and you haven't hit your nadir yet!
Posted 3/12/2019 3:57 PM (GMT 0)
Thx guys for the comments.
Garyi: I get my primary care through the choice program from an outside provider. I still have my Uro at the VA though and so I get a PSA at the VA for the Uro and outside for the PCP. They both run the same system but of course I keep those numbers separate even though they run pretty similar.

I moved my PCP away from the VA after the PCP I had had for 10 years missed the PCa.
Understand that PCa was off my radar screen back then. I really didn't understand the risks or anything about it to include what PSA was.

This PCP had tested for 6 years with the numbers rising. 1.0---1.3---1.7---2.0---2.1---2.2
Then she skipped a year with no test and then tested 3.3.
She never once discussed anything with me concerning why she tested, why she didn't and what the numbers could mean. We did a yearly (mostly) dre which was always "it's large but ok".
Even after the 3.3 she didn't discuss and didn't test the next 2 years.
I was lucky in that I started having BPH issues and she sent me to the Uro who immediately tested and it came back 6.57

So I just couldn't trust her anymore and of course was somewhat pissed. So I went outside the system and now have a GREAT provider.
Posted 3/12/2019 4:20 PM (GMT 0)

three 5's and a jack said...

.....I moved my PCP away from the VA after the PCP I had had for 10 years missed the PCa.
Understand that PCa was off my radar screen back then. I really didn't understand the risks or anything about it to include what PSA was.

I was lucky in that I started having BPH issues...

So I just couldn't trust her anymore and of course was somewhat pissed. So I went outside the system and now have a GREAT provider.

I had almost the exact same experience Roger, and unfortunately it included my 110 year old VA urologist. Be very wary of some, on-the-job, retired VA docs, my brothers!
Posted 3/12/2019 4:39 PM (GMT 0)
My VA Uro is a great guy I really like him but I wouldn't let him treat me for PCa. I will let him prescribe my Flowmax or Finesteride when needed though.
Posted 3/12/2019 8:50 PM (GMT 0)
Roger - It looks like you're having a smoother trip down than I have been, but you are definitely going in the right direction. As the others have said, my RO tells me that any PSA is acceptable after RT (in our case, SBRT), as long as the trend is downward to a nadir, then relatively flat. The only thing we don't want to see is a reversal of trend and rising PSA.

The published literature does say that those patients whose nadir is below 0.5 do better over the long term, but it also says that those who experience bounces also do better. Who is to say what befalls any individual patient? I say "There's nothing wrong until there's something wrong!"

Congratulations, once again, brother!
Posted 3/12/2019 9:12 PM (GMT 0)
Roger, your understanding seems to be correct and your trend is great. As Paxton says there may be a slight advantage to nadirs below .5 but I wouldn't worry too much about that. Each of us has a little residual prostate tissue that puts out a little (hopefully only a little) PSA. There is a good chance you are not yet at nadir. It took me 6 years to reach .1. I actually may be below that but have never bothered to have a uPSA test and probably never will.

Lookin' good, bro!

Jim
Posted 3/12/2019 9:39 PM (GMT 0)
your numbers are good. look at how mine went and remember that's over 7-8 years!
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