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My PSA trajectory…interesting experiment

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Posted 7/21/2023 10:44 PM (GMT 0)
I have my six month AS checkup next week, and I also had my annual physical two weeks ago. In prep for the physical I had the standard blood test, including PSA. The value was 1.0, which sounds great, but it is up from 0.4 following my HoLEP a year ago. A 0.6/year rate of increase was what I had before the HoLEP, telling me the PCa is likely chugging along.

Because I had an order for the test from my uro in the works, I got another PSA test yesterday. Value is 0.87, which still shows increase, of course.

I couldn’t really think of anything I did that would lead to the difference. The 1.0 value was at 0730 as I had to fast prior for the other tests. Yesterdays was at 1600.

Just sharing an interesting data point in statistical dispersion. Interested to see what the uro recommends.
Posted 7/21/2023 10:59 PM (GMT 0)
I'm curious why your PSA went down after the HoLEP, if none of the tissue removed was cancerous.
Posted 7/22/2023 12:31 AM (GMT 0)
Having done my reading, for just your normal BPH prostate, a HoLEP removes about 2/3rd of the prostate, cores it out and leaves only the peripheral zone, Drops the PSA down 80% or so. Typically in the 0.6 - 1.0 range. I was amazed by how low mine went. Kind of bummed it is crawling back up. A typical HoLEP will see about a 0.1/year increase. Mine is in the PCa indicating range.
Posted 7/22/2023 11:40 AM (GMT 0)
At least part of the difference is the test that was run. Your first reading of 1.0 looks like it was the standard accuracy test, and the second looks like the high sensitivity test. You're skating within the +/- values of each test. Let's say the standard test has a limit of +/- 0.1, and the high sensitivity test has a limit of +/- 0.05. Lo and behold, 1.0 and 0.87 are statistically the same!

Oh, and within 48 hours before either test did you have a sexual release?
Posted 7/22/2023 3:55 PM (GMT 0)
Dude, My initial impression is the differences in PSA values maybe statistically insignificant. I did find an interesting article from the Sperling Prostate Center site discussing “Prostate Zone Anatomy, Prostate Cancer & Imaging”. It suggests that 80% of PCa is found in the peripheral zone while the transition zone surrounds the urethra and is responsible for most of the BPH and only 20% of BPH. Seems probable that the HoLEP would focus on the transition zone and not the peripheral zone. I hope the HoLEP provided significant relief from the BPH. Terry
Posted 7/22/2023 7:57 PM (GMT 0)

halbert said...
At least part of the difference is the test that was run. Your first reading of 1.0 looks like it was the standard accuracy test, and the second looks like the high sensitivity test….
Oh, and within 48 hours before either test did you have a sexual release?


Exact same testing lab and procedure, I took care to ensure that. I honestly can’t remember about the first one. Yes to the second (lower) one.

Somebody said...
did find an interesting article from the Sperling Prostate Center site discussing “Prostate Zone Anatomy, Prostate Cancer & Imaging”. It suggests that 80% of PCa is found in the peripheral zone while the transition zone surrounds the urethra and is responsible for most of the BPH and only 20% of BPH. Seems probable that the HoLEP would focus on the transition zone and not the peripheral zone. I hope the HoLEP provided significant relief from the BPH. Terry


From the biopsy I knew it was in the peripheral zone, at least what they found. Glad there wasn’t any in the rest…I guess? If it had been there, then it’d have been removed. I’d seen where the cancer typically was in the PZ too.

Also, typically really large prostates don’t have bad cancers. It’s the smaller ones that get angry.

My urinary track is absolutely firing on all cylinders now, wish I had done this sooner. Although it results in dry orgasms.
Posted 7/22/2023 10:37 PM (GMT 0)
Bottom line is that small variations over a few days or week or so are expected, and do not define a trend.
Posted 1/1/2024 2:49 AM (GMT 0)
So flash forward six months, and my test yesterday was 0.86, which is essentially the same as my 0.87 from six months ago, and definitely down from my 1.0 that was also taken six months ago. This, after a hard hike and sex. Pleasantly surprised!
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