Bummer

I just got my PSA result. I almost made it to my 5th year since SRT with one 0.00 after another. Then in October I had a 0.02. I've been waiting for my January test to see if the .02 was a fluke -- or was at least holding steady. I got the result this afternoon -- 0.05. Don't Pass Go. Don't collect $200. It looks like my cancer-free days are coming to an end again.

I'm meeting with my RO week after next. Anxious to hear see what he has to say. I'll have another PSA test and see my Uro in April.

However, in light of all of the recent SRT, ART discussion on this forum, I note that I've had a pretty good run. If I hadn't done the SRT 5 years ago, I'm sure I'd have been on hormone therapy long ago. And even now maybe I've got a couple of years before I have to go there... maybe.

Jim

Sorry to read about your increased PSA. We're here to support you.

Stay firm on april before deciding please!!

Thanks all for your support. I have no plans to do anything about ADT at these low levels. My uro mentioned in Oct that if I hit 0.5 he might want me on Casodex. But even then I was thinking I might hold out until 2 or greater and take a trip to Mayo for a Choline scan before signing up for ADT. I'm curious to see what my RO will say when I see him in two weeks. He's less prone to guild the lily than my uro. For these last few years our annual visits have consisted of him saying he's pleased but surprised that I'm doing so well and then we segue into a chat about life, art, and the universe.

Jim

Jim,

Also consider the 18F-DCFBC PET/CT clinical trial that Jim (wampuscats) and Sonny got in on. It is even more specific to PC and may detect it at even lower PSAs than the C-11 PETs. It looked very promising in pilot trials at Johns Hopkins, and they cover all expenses, so you have nothing to lose.

- Allen

A brief update. I met with my RO and he agrees that the PCa is back, and at this point it is treatable but I need to give up any expectation of curable. No problem there, my eyes have been wide open for a dozen years now and I never had much expectation of cure given my initial pathology report.

The good news is so far this has moved really slowly. My question is that given that this thing has been lying doggo for nearly 5 years now since my SRT - truly undetectable at 0.00 -- and has now gone from 0.00 to 0.02 to 0.05 in 6 months--does this mean it has finally figured out how to beat my immune system and will now come on strong. The answer is it's too soon to know. I knew that. My RO confirmed that. The next test or two should tell if it is now newly aggressive or has just returned as its lazy old self. But for now, my plan and my RO's advice is to wait for later rather than sooner before beginning any further treatment.

Sorry Purg, but you and I have to agree to disagree on this one. I've been down this road before and then had SRT. Since SRT I have been 0.00 for nearly 5 years. Now I once again have detectible and rising PSA. These ultra-sensitive tests are real -- as pointed out in several posts recently by another respected poster on this site. Simply put .05 is not zero. Maybe it was when tests could only measure to .1. What matters is the trend and the momentum. Six months ago it was 0.00, three months ago it was 0.02, today is is 0.05. It will take a few more tests to assess the (as yet uncertain) momentum. But having previously had a large melanoma that my immune system held at bay (the path report showed "extensive regression"), and having now had PCa for a dozen years that my immune system has done a pretty good job of slowing down, my legitimate concern is that it may now have finally evolved in such a way that it has found its way past my natural defenses. And that it will once again, as it did 6 years ago, accelerate. And unlike then, this time any hope, however slim, of "cure" is in the rear-view mirror.

Confused on one minor point, for 6 plus years, I've been taught there is no such animal as a .00, or .000, simply can't exist. One can have a .01 or a .02, certainly, but there's always going to be noise or a +/- variance to any test. Anyone feel free to correct me if I were taught wrong on this one point.

Do you still agree that it takes .10 for an remaining PC to be considered viable? That is the normal standard. Of course, if that .05 quickly becomes .10, then .15, etc., would definitely be firm evidence of true recurrence.

Since you have "grown" to .05, the prudent thing (and you already indicated this) is to watch it closely the next couple of testing cycles.

I agree, since both of us had failed surgery, and failed SRT in my case (perhaps you too), the "cure" word or possibility of "cured" is no longer possible in the normal sense.

In my case, my SRT was considered failed by May of 2011, so I am approaching 4 full years past failed SRT, with no other treatment, other than watchful waiting with my oncologist.

Not suggesting that you or anyone else follow my path, circumstances are too varied. At one point, post SRT, my PSA was above 80, now after one unexplained huge drop, its on the rise again, in the high 40's, yet no physical evidence of mets, at least not large enough to pick up on scans.

I always have the option of HT, if that is what I want, or if my oncologist was recommending it, and he still isn't nearly 4 years later. Until there is scan evidence, I intend to stay the course, I have, as you know, enough very serious QOL issues going on in my life and body, and don't intend to make it any worse on myself.

If you are fortunate, you might still ,be able to buy additional years post SRT without the need of subjecting yourself and your body to any more invasive treatments. Of course, that is your choice, under the advisement of your doctors to make. I would support any path that you chose to do, or not to do.

David

Purg, Logo -- not looking for a p***ing contest. I like and respect both of you -- Purg for your long and difficult battle, with the disease, botched treatment, and the VA -- Logo for your abstract musings--something I'm prone to myself, having wasted what might otherwise have been an education reading French existential novels, the Pentagon Papers, and labor history when I should have just joined a fraternity and watched football and ended up with a normal life.

But the fact is that based on the equipment available at a major medical center, I have tested consistently 0.00 for nearly 5 years. That is simply a fact. We can wonder what the results would be with a yet more sensitive test -- I know there are others here who report tests to 3 decimals. That isn't the point. I am sure at some decimal place there is a measurement. I suspect that my years of 0.00 were probably 0.002, 0.004, or whatever, were they to be measured with a yet more sensitive assay. But the point is that the test and the lab I have used consistently has been unable to detect anything above 0.00 and now it has registered a 0.02 and three months later it has registered a 0.05. Maybe for the first time in five years someone remembered to wash the test tube or calibrate the equipment, but I doubt it.

As for future treatment the key point of concern -- more than any absolute number, is the rate of acceleration or hopefully, lack of acceleration. That will be the measure of aggressiveness both of the returning angry cells, and aggressiveness of how I and my doctors will plan our response. If this were, or is to be, the best of all possible Panglossian worlds, any rise will be slow and steady, in which case I will gladly wait a long, long, time before subjecting myself to the known downsides of the treatments that remain to me at this point. But if the rise is fast--that is the way the disease will to tell me that it has finally figured a way around an immune system that has done a way-better-than-expected job of kicking it back into its hidey-hole for a number of years now.

This is just basic risk analysis, and at this point there are just a few and scattered bits of information -- a previous BCR, a very long period of undetectability following SRT, and now two measurements three months apart that show the days of 0.00 (yes there is a 0.00, though I can't say there is a 0.000 because I've had no tests that can measure that far) have now given way to 0.02, and 0.05. These are real numbers that demonstrate a real change. Sorry if you don't see it that way.

Bohemond, Roger that, as I was finishing up the post I realized and posted it was a silly point for me to even discuss, so we are on the same page. Lord no, football yes Frats a resounding no…. was never, I mean never into reindeer games. Normal life??….I refer you to the Hunter S Thompson quote that was posted a little while back…forget by who… never heard it before but loved it.