% of diagnosis's with very low psa exhibited.

Anyone know the % of initial diagnosis of pca that exhibit little or no psa. Is it rare, medium or large? Thread started to give Billhorn and others more info for their decision making. Please, Kokua {help} even if I displease you.

Logo,
The only data that I know of is from Klotz on his AS studies. He said that 1.7% of patients showing no or low psa had a PC variant that resulted in death within 5 years regardless of treatment.

I believe what John T. is talking about is the neuroendocrine or small-cell prostate cancer, PSA is none or low, chemotherapy is effective more than HT. But there is also adenocarcinoma of the prostate which accounts for 95% of all prostate cancers. It also can give off a low PSA and be agressive, but not as agressive as the neuroendocrine kind. My father had psa of 7.5 and 2 bone mets, yet he is alive and well 3 years into this fight. He has adenocarcinoma (arises from epithelial tissue of prostate) and his PSA reacts to HT. LupronJim, JerryL also had low PSA and extensive disease, and I believe their cancer histology is also adenocarcinoma and they are keeping their disease in check. To answer your question, if there are several people just on this board, it cannot be rare. Low or medium low.

I have widespread mets and zero PSA. I'm five years post surgery. I think I still have a pulse. I'll check .. right after breakfast.

Very interesting, as I thought it would be rare. I hear you on the small cell. Oncas, to hone my point a bit finer, what was your psa pre biopsy. I am thinking of Bill horns case of doing a biopsy with .6 down to a .5 at age 63 , although with a positive dre. I know with treatment you can have mets{under control], I think, with low psa, as thats what you are looking for. Im thinking of the guy who has a really low psa, and is diagnosed with pca, prior to any treatment. Im still thinking that might be rare, don't really know. Again I appreciate all the input. Those with a relative low psa and bone mets ,untreated, interests me. I wonder if they are in a state of "remission" and left untreated say, would, when activated would start to produce a higher psa. In other words, does a stable,thug relatively higher psa, indicate a dormant stage or is it due to a varient. Speculation. My next life, I want to be a detective, pca is deadly but fascinating. Lousy wx here in paradise lately, rain, go downy to 56 at nite a week ago or so. folks for get we are not a tropical island but, semi-tropical. I know, tough life……. tanks again.

Logo - not at diagnosis...but my psa was .09 (not on hormone therapy) with mets

Hi Logo, - It depends on what is interpreted to be "low" PSA. Such general terms can mean different levels to different people, often depending on their relative situation.

The most often quoted statistic re low PSA appeared in a Study from 2005 that first identified the fact that 15% of its participants diagnosed with PCa, had a "normal" PSA reading, classified at that time as 4.0 ng/ml or less.

A more recent Study addressed "low" PSA results in relation to "high GRADE" disease. Such combinations are quite rare, as demonstrated in the following excerpt:

" Low PSA and Prostate Cancer: Study Results
Importantly, the study also found that only 2.3 percent of men in the study with PSA levels of 4 ng/ml or less had high-grade cancers. For men with a PSA of 2 or lower, the chance of having a high-grade cancer was even lower -- 1.4 percent.

Grade was measured by Gleason score, a system that ranks tumors from 2 to 10 based on their appearance under the microscope. High-grade tumors -- Gleason scores of 7 to 10 -- often grow more quickly and may be more likely to spread than lower-grade tumors.

Gleason scores of the highest grades -- 8 or 9 -- were found in only seven participants, or 0.2 percent of men in the study. Most of the men with prostate cancer, 349 of them (78 percent), had Gleason scores of 5 or 6."

Perhaps these are the kind of stats you were seeking. If not they are still enlightening. Best regards! - [email protected] (aka) az4peaks

I have learned over the years that my version on PC with its low psa and high gleason, mets, etc... isn't necessarily less or more aggressive than other Gleason 9s with high psa. Hope that made sense.

for those with a low PSA and one or more bone mets...are they always blastic or do you have some mixed and lytic ones too?

reading this has put my mind a little at ease as my dad's cancer is also a low psa/high gleason/with one possible bone met and the uro has us worried it's anaplastic. we will have the pathology report next week but in the meantime we are going a little sick with worry (though trying not to, as advice was given to me in another thread - this just causes anxiety and little else!)

Nomar, I inherited a 62 rambler wagon from my grandpa in the late 70's when I was a teen. Great car, I'd still be driving it had I not wrecked it.🙂

island time - thank you for the reassuring words! i also wonder the same, how frequent is low psa with metastatic disease and maybe more frequent than people usually think, esp with those with a 8-10 gleason

jack h - apologies as i didn't realise how old this thread was. still getting the hang of things on here and was trying to search for info similar to my dad's case. very sorry i've made a faux pas

plus this one and the dental thread seem to have risen like a phoenix...enjoyed by many...

hi dr. who. i'm so sorry to hear about them not catching your ductal variant sooner. i didn't realise PC could change from the "standard" variant to another variant. how is your treatment going so far? as for tracking it i think there are other mechanisms like levels of certain things in blood tests that can be used. i don't remember the specifics but i know that for some of the less common varieties of PC some other markers can be used.

with my dad, he was diagnosed in early 2010 with gleason 8, got an RP (which didn't push the PSA to 0) and then radiation and hormones. psa did go down to 0 but chemical recurrence began in jan 2016 and the uro didn't do any more tests as my dad wasn't showing symptoms and he thought PSA was too low to be worried. turns out he now has a singular mixed bone met on t6 on his spine, despite a PSA of 1 at the highest during recurrence (and down to 0.45 on its own at the time the met was detected). i'm scared this is going to be difficult to manage and wish the uro had been more vigilant in his treatment plan instead of waiting until pain showed up

i hope your treatment is going well and everything works out. it sounds encouraging that you were able to fight the cancer without treatment for so many years despite it being ductal. i wish you all the best in my thoughts and prayers!