Lets have some fun with the PSA Over-Under Numbers

Tomorrow morning I am going to MD Anderson Orlando for a blood workup in preparation for my trip to UCLA for nodal SBRT radiation. They need specifically creatinine levels (for the C11 Scan) and we are going to draw for PSA (to establish a pre SBRT baseline) and I told them to throw in a Testosterone level as well.

I was going through my records and here is kind of a history of my PSA and corresponding testosterone numbers, just for giggles and grins.

11/05 PSA 1.9

8/07 Testosterone 465
8/07 PSA 3.0

5/09 PSA 6.2
Surgery 9/23/09
10/23/09 PSA .4
11/6/09 PSA .53
11/19/09 PSA .64
11/30/09 Radiation Therapy

2/10 PSA 1.0
5/10 PSA 1.3
May 2010 Radiation for suspected met-left femoral head
9/10 Testosterone 760.3
9/10 PSA 2.2

1/11 PSA 3.9
May 2011 Testosterone 689.50
7/11 PSA 5.6
8/11 PSA 7.2
September 2011 entered NCI/NIH diagnostic clinical trial for F18 Sodium Fluoride PET Scans - received 4 scan in the course of 12 months. None of the scans showed any evidence of bone mets. In fact lead doc said she did not think that the suspected met that was radiated in May 2010 was a met.
October 2011 Testosterone 558.20
10/11 PSA 9.0

2/12 PSA 13.33
10/12 PSA 34.6 LAST PSA TEST
October 2012 Ct scans showed 2 lymph node abnormalities for the first time.

May 2013 CT scans showed very little change.
October 2013 CT scans showed change and growth about 6-8%. Just the same two nodes and nothing new.

It is obvious that I need the PSA test just to see if the SBRT has an effect on my Pca and resulting PSA. As I have stated many times over, it is not the number I am treating but rather the activity of the cancer in my body.

So there are the numbers, have some fun and somebody come up with a winner as to what the new PSA will be. I will have the results about 3pm on Tuesday 11/19 (tomorrow).

And Dagnabbitt, "Every Day is Still A Bonus in MY World,"

Sonny

OK, My guess is 42, which would not suggest an aggressive pattern, ????

We'll see.

PSA - 54, but hope I am wrong

david

If you draw a line through 10/11 and 10/12 and project the line out you get somewhere around 63, or at least I do. People are guessing low to be nice. That leaves me the entire range of linear growth and exponential growth open. I'll go with 65. I'd love to be high but even if I am not it just gives you more room for the SBRT to rack up big numbers.

OK, Sonny. PSA tests are not that expensive relative to everything else you are spending on this trip, so take the test.

Not as scientifically as Casey I will go with a 7 month PSADT which would make your Dec 2013 PSA 138.4.

All the more amazing to have virtually undetectable scans.

If the recent rate had anything to do with your pre-treatment doubling time of 20 months, that would have made this 14 month extrapolation about 70, but seems the recent experience in 2011-2012 would be more pertinent than pre-2010.

Edit - I guess I should have read your first post a little closer as I presumed your PSA was being measured in LA next month, but just a crap shoot anyway.

Sept 2010 2.2 was about 4 times greater @ 9.0 (vs 8.80 in Oct 2011 then not quite 4 times as large a year later at 34.6 (vs. 36). So guessing Casey's 6 month PSADT is pretty accurate and last month would have been yet another 4 times greater at 138.4 which is my guess.

LupronJim

I am posting from my phone while watching a little league ball game. So this ones going to be brief. Got the test results today and the current PSA is 82.5. More later when I get to my computer.

Sonny

Well, that bottle of whisky was something to strive for, and it was a great day.

Wish my # had been closer to reality.

82.5, yeah there is something called "Imperial Drops" made by some monks in northern Italy that beat that. If I drive to GFMPH, I'll bring some.

I'm happy that you beat the pessimists, but I guess it is what it is.

But you're here to talk about it, so the day was a bonus!

GO TEAM!

Ed you missed the post just above. Short post as I was reporting from my cell phone at a little league game.

PSA test today was 82.5

Folks that is certainly not a number I would want, but I was actually thinking that somewhere north of 70-75 was in the realm of possibility.

But I now have a pre SBRT baseline and gauging the efficacy of Lymph Node Radiation should be fairly easy. I don't think for a minute that all of my PSA is the result of these two nasty nodes, but then again there is nothing about this crap that surprises me anymore.

Yes my PSA is 82.5, but I have had 6 or 7 of some of the best bones scans you can buy and they have yet to find a honest to goodness bone met. There was one that was found but even that one was not definitive and we radiated that one just to be safe.

But I continue to monitor and address this as it warrants, so I am off to UCLA in 12 days for the next step. Once there I will detail the whole procedure for others that will/may find this valuable down the road.

No doubt I am in uncharted waters here, but as with any voyage, someone has to go first.

Sonny

Jim, my GL was 3+4=7 going into surgery and 4+3=7 from the path report. The selection of surgery had many variables that went into it.

The 34.6 result was from testing done at the NCI/NIH last October when I received the last scan of my clinical trial. When I returned to MDA, we ran another PSA and the result was 34.2. I tend to believe that the NCI result was probably more accurate.

Peter, nice win. Your prize can be picked up in March at the GFMPH FL gathering.

Sonny

Sonny,
I was not going to vote, just wanted to wish a M-2 .50 cal ",river boat gunner" all the best.
Bill

Lupron Jim,

Your basic math is correct on the doubling time. But there is a lot of difference in the quantity of cancer if you are talking about 40.x, or 80.x, as opposed someone that just went from .40 to .80, for example. Yes, the doubling time is the same, but the 80 represents a heck of a lot more cancer than say .80.

From what my oncologists has told me, when you are in these situations (such as Sonny's and mine) the actual doubling time doesn't mean as much in the normal sense. If these high readings are the results of multiple micro-mets, then the higher numbers are a cumulative total of cancer present, coming from any number of sites, that add up to the high numbers. And until any one(s) of these micro-mets are large enough to be picked up on a scan, then the PSA total number will continue to accumulate.

My doctor said he has had a handful of patients in this scenario, with PSA's of 100 or more, with no evidence of mets, again, because no one site, is large enough to pick up on a scan. But eventually, given enough time, they will show their ugly face.

David