PSA not acurate predictor

PSA may not be an accurate predictor of lethal PCa.

http://www.sciencedaily.com/releases/2007/04/070403161946.htm

PSA may not be an accurate predictor of lethal PCa-> Pretty sure we've always known this. The PSA test is a tool to "help" determine if other steps are needed.

So, in summary, even though I was a G-9, PSA hovering around 33 before surgery. Then undetectable 12 weeks after surgery,  followed by ART 3 months post surgery, there is a chance, because of the aggressive nature of my PCa, that it is still alive and well in my body (key word is well).  I am not naïve enough to think I am cured. However, I would like to think it has been blasted into some sort of  long term remission.

Maybe the radiation oncologist was right when he said “PSA is not that great of an indicator.”  I wrote his remark off as hogwash.  Guess it wasn’t.  Should have done my homework a little better.

My post-op Gleason was 4+5, pre-op PSA was 7.4 (only one done - nothing to use for history).

I try to always emphasize that a PSA test is just one potential indicator. Done without a DRE, it can be just another blood test, but when done together, the tests are important.

It is always important to remember that you can have a low PSA and have PCa, or a high PSA and no PCa. The level of PSA is just that, the amount you have, not an explanation of the reason.

Insp.,

I see that a lot at screening events I volunteer at. Where we can only offer PSA testing, and advise the men to see their urologist for a DRE, most seem to ignore the suggestion with an "I feel great, why bother". I have seen men at free events leave after getting a PSA even when a DRE is offered, just because they don't like the idea of getting one. Excuses are offered, but you know they are invented.

Somewhere I've seen it said (in a Western, I think) that you don't get old by being stupid. I think of that often while working at a screening event.

 

mr bill,

My T level is at the low end of normal these days, but it had never been tested before, so I have no comparison. My GP would normally have me try to raise it a bit, but my uro said absolutely not, since I have a rising PSA and am likely headed to the dreaded HT decision point.

hangin-in said...
Just wondering... Is it also a poor indicator after RP? Mine has been .01 range for 3 years since surgery. Do I still need yearly DREs?

After RP the PSA test is an indicator of whether or not any prostate tissue is still in the body. This tissue can be cancer or not cancerous but will produce some detectable PSA numbers. I have been told by others that many URO's after RP still do the DRE just to see what is going on in the old  prostate bed and to feel if any growths of tissue or tumors are taking place.

Terry

"PSA may not be an accurate predictor of lethal PCa."

I can certainly relate to that...

My PSA was 3.8 at the time of DX and my Gleason was 8.

Mal,

My GP didn't even attempt the DRE, saying he wasn't the right one to do that - referred me straight to a uro. Makes sense now, knowing what I didn't know then.

PSA seems to be not the end all for PCa screening. Look at my PSA over the last few years, towards rock bottom. Luckily my family doctor is proactive and very observant when getting a yearly physical. A DRE is definetely required as part of the exam with your GP or seeing a Urologist. Even then if the nodule is behind your prostate nothing may be felt. Since learning I have PCa I have tried to be diligent to discuss getting screened with all of my family, friends and co-workers. I have found others that have gone through diagnoses and treatment are also more than willing to share their experiences and knowledge. Hopefully in the future there are better testing methods that can be completed.  

Putt -- are you doing any supplements or dietary changes?  your PSA is moving alot slower then i would have thought.  best to luck to you.

ed