HealingWell
Search Close Search
☰

PSA

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 8/11/2010 8:47 PM (GMT 0)
Deliberating on whether to have surgery this month due to my job.  I may have to wait until January, so I thought I would monitor my PSA to see if it rises.

My initial PSA was 1.5 - 2008

                             3.0 - Jan- 2010

                             3.7 - May 2010

Does any one know if your PSA can fluctuate depending on different factors? such as sex, riding a bike etc.... I am just wondering if I am taking a big risk by waiting until January....... How do you know how quickly the cancer is spreading? Is there a way to tell?  Should I have another biopsy?  Would that help? 

 

Posted 8/11/2010 8:59 PM (GMT 0)
Only a doctor can tell you whether to have another biopsy. But my guess is the doctor will not recomend a second biopsy. Yes, PSA can vary depending on certain pre-blood-draw activities, such as ejaculation, maybe intense bike or horse riding, or manipulation of the prostate, such as from a DRE. There is also some normal variation day to day. PSA test results can also vary dependng on which assay is used for testing. This variance is more substantial than most people would think. So you should use the same lab, and the same assay, for each test.
Posted 8/11/2010 9:07 PM (GMT 0)
Diagnosed in April of this year probably won't require a re-biopsy until April of next year...based on that most folks on Active Surveillance have annual biopsies.
We have been told that PCa is a slow growing cancer, so I doubt that waiting another 4 months would be a very big deal. But always ask your doctor, he is the one in the best position to make a definitive advise. Take mine with a grain of salt.
Posted 8/11/2010 9:40 PM (GMT 0)
I monitored my PSA without really knowing why for about 18 years. It slowly rose from 0.9 to 2.98, then jumped to 4.6 in a year. That triggered the biopsy, which came back 3+3=6, T1c, which triggered treatment. The urologist was really impressed with my records, which made his job easy. So, based on my experience and some very recent literature, I'd recommend periodic PSA tests starting at age 50, biopsy on sudden rise, or PSA above 6, and Gleason score of over 6, T1c or T2a. PCa can be a very slow growing cancer -- they say that all men will die _with_ PCa, but most will not die _of_ it -- but OTOH, it can grow aggressively under some conditions. If I saw a rise from, say, 3.0 to 3.7 in 4 or 5 months, with Gleason grade 6, Stage T2b (Tumor involves more than half of a lobe, but not both lobes) in a small (19cc) prostate, I would be scheduling treatment now. I would at least want another PSA, and probably a biopsy, in 3 or 4 months. Note: I am not a doctor, nor do I pretend to be one on TV.
Posted 8/12/2010 12:06 AM (GMT 0)
Some docs will even say take casodex or flutamide drug to control or halt PCa while you are looking, analyzing and deciding. The only down side is it could make removal of gland a little more difficult(shrinkage and related), of course if you go other than surgery, no problems. The gleason score and volumes you have are typical of low rate of growth PCa, towards but not identical to the new definition of indolent PCa. (google indolent PCa John Hopkins- Brady Urology and read such). Best to your decisions.
Posted 8/12/2010 1:28 AM (GMT 0)
You already know you have PC..Now you know it might be getting worse more quickly than is tolerable. You are only 58, not 75..With cancer, outcomes don't improve by waiting longer...You could do another PSA in 30 days just to be sure, then get your treatment started if it bumps up again...
Posted 8/12/2010 1:39 AM (GMT 0)

Minn, 

My thought for my own case was to have treatment sooner than later.  My wife's preference was for me too have treatment even sooner than that.  After seeing the pathology results of the post-surgery biopsy I'm happy with the decision to have had the surgery even sooner.  The tumor was right up to the edge of the prostate capsule wall but not into it or through it.  My wife works in the cancer screening field and we are aware of the importance of having negative margins.  You can see from my signature that I had fairly low psa with some velocity. Original biopsy gleason was 3+3, changed to 3+4 final.

Take the time to make the best decision for your treatment.  Please don't panic, I don't mean to add any more stress to your situation either.  There are no easy answers.

Best wishes for successful treatment whenever it is,

Dan

 

Posted 8/12/2010 10:00 AM (GMT 0)
You will never be younger and the tumor will never be smaller than right now.
You already had a biopsy and it showed 3 out of 5 with tumor in both lobes.

Before you decide to wait, set an internal threshold for action and then follow through. For example "I will do something when my PSA hits x.x".

Good luck,
Jeff
✚ New Topic ✚ Reply