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Posted 11/22/2022 5:19 PM (GMT 0)
Hi Guys,
I was wondering if you had any advice. I just got my latest results and even though mathematically the number didn't rise much, psychologically it did by hitting "the next level".
My RP was 7 years ago in November 2015. Since then my psa tests were this:
PSA After <0.03 first 5 quarterly visits. Then switched to a more sensitive test and psa was found to be 0.020, 0.021, 0.027, .022, .028, 0.024, 0.027, 0.026, 0.029(2 years ago), 0.029 (1 year ago), 0.030 today.
So it was bouncing in the 0.02x area a few years, then the last 2 years was 0.029. Now I went to 0.030 and it does have me concerned. When it went from 0.022 to 0.028 a few years back, my surgeon wanted me to get follow up radiation. But then it dropped and stayed low for the next few so he had me hold off. Now that I am in tot 0.03 zone, it seems like something must be growing. Why else would it have gone from 0.02 to 0.03 in about 5 years?
So would you guys get the radiation at this point? I am 60 years old. My doctor explained a few years back that most would wait until 0.2, but he feels if it is growing, why wait. Knock it out now while it is small and easier treated. I am sure he will tell me this again when I see him next week.
Thanks very much,
Tom
Posted 11/22/2022 5:26 PM (GMT 0)
Tom, hopefully the science guys will chip in soon, but you have had a nice run on your tests, and I would focus on enjoying the holidays and not to worry about this last test.
Michael
Posted 11/22/2022 6:59 PM (GMT 0)
Thank you, Michael.
I hope you have a Happy Thanksgiving.
Tom
Posted 11/22/2022 8:31 PM (GMT 0)
Tom, you have earned an UN-radiated turkey. With your recent readings of 0.027, .022, .028, 0.024, 0.027, 0.026, 0.029, 0.029, 0.030, your PSA is stabile. The Labcorp uPSA test, as an example, can vary ±0.002 when the same blood sample is repeatedly tested. In addition the non-prostatic (healthy) tissues that produce minutes amount of PSA undoubtedly fluctuate in what they put out. Then there is equipment calibration and other sundry factors. (Notice the dip to 0.022 you had followed by 0028; it's the trend we watch.)

One study showed that a PSA of 0.030 or lower 2 years after surgery is a good prognosticator--you are that low after many more years.

Your PSA could reach 0.20--the official PSA for biochemical recurrence in a decade--or never. We have more sensitive tests, but the 0.20 definition has not been changed. Also, PSA can rise and then plateau. Folks with more serious situations after surgery may start salvage treatment at, say, 0.10, but I think your PSA is much too low for salvage therapy. But remember, we are not doctors.

See you next year smile

Djin
Posted 11/22/2022 8:48 PM (GMT 0)
Thank you for the input Djin.
That puts my mind at ease a lot!
Happy Thanksgiving!
Tom
Posted 11/22/2022 9:04 PM (GMT 0)
"My doctor explained a few years back that most would wait until 0.2"

i think that is lousy advice. but i also think your PSA is still in the stable range. if the day comes that BCR is confirmed i'd act immediately, and well before .2 which i think is late in the game
Posted 11/22/2022 9:09 PM (GMT 0)
Hello, TomC1962 ~

Diagnosed in 2013, my PSA has been checked every month up until recently, when we switched to every two months.

That being said, I have MANY PSA values on my chart.

Going in every four weeks gave me insight into the upticks and downticks ~ sometimes being inexplicable.

Through it all, when I get that worried look on my face, my oncologist tells me fluctuations are part of the deal.

Remember, at Mayo Clinic, they classify PSA values below 0.10 as "U-N-D-E-T-E-C-T-A-B-L-E."

You are in that range, rest assured.

Simply stay vigilant. Your medical team will watch for any worrisome trends, but you are experiencing the fluctuations that I have experienced ~ time and time again.

You are right on top of everything, rest assured!

CYCLONE ~ # Iowa State University
Posted 11/22/2022 9:25 PM (GMT 0)
Tom - Your signature does not highlight any risk factors other than the small positive margin and you are at G6 in both biopsy and surgery pathology. This says to me that jumping on the salvage radiation option is way premature.

Effectively, you have no PSA, just a bunch of test digits of extremely low magnitude. That being said, you should go about your business and get your tests at some appropriate schedule that suits your needs at this time. Give it some time and if you see a constant sustained rise then visit the RO and start the discussion. Happy Thanksgiving to you also.
Posted 11/22/2022 11:43 PM (GMT 0)
I cannot thank all of you enough! Your wisdom really helps me A LOT.
I try not to worry about it after going through is for 7 years, but then the test
results get me set off again. But thanks to all of you guys helping a "worrier"
I really do feel much better.
I wish all of you long healthy futures and Happy Thanksgiving this year and many more to come!
Thanks again more than I can say!
Tom
Posted 11/23/2022 10:42 PM (GMT 0)
For comparison sake, check out my history. When your numbers look like that, you actually have something to worry about ;)
Posted 11/23/2022 11:41 PM (GMT 0)
Stephen,
I guess I have a lot to be thankful for. Thanks for sharing and I will pray for your
numbers to start going lower and lower.
Tom
Posted 11/24/2022 12:22 AM (GMT 0)
Tom, my PSA became detectable after 2 years, and from that point it rose from .02 to .08 in about another 18 months. At .08 i pulled the trigger. But .08 is a long way off from your .03. And such a slow rise to .03 at the 7 year mark? I'd say you've got nothing to worry about, go out and enjoy life.
And FWIW, at .08, my surgeon was against Radiation, he recommended we wait until .2 and then do scans to try and locate the problem.

Obviously i didnt listen. But if it had taken me 7 years to get to .08, i might have.
So chill out you're doing great.
Posted 11/24/2022 12:56 AM (GMT 0)
Thank you Pratoman.
I think my main problem was seeing it go for .029 to .030.
If it went from .024 to .025 I would not have thought twice,
But seeing the "3" psychologically is my issue.
I guess another way to look at it is I went from .02 to .03 in 7 years.
Thanks again,
Tom
Posted 11/24/2022 8:00 AM (GMT 0)
Well I understand your anxiety. It took nearly 8 years for my uPSA to reach .06. My surgeon usually pulls the trigger at .03 but let me go a little longer until I reached .06. I had salvage radiation seven years ago. All tests have been<.006. Radiation oncologist says “You’re done”.
Hope you have peace.
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