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Currently on AS - Update on PSA- Concern?

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Posted 1/21/2018 4:51 PM (GMT 0)
My 2nd PSA reading came back at 2.81. My visit with Uro is next Friday for already scheduled exam. One of my questions will be to remind me what a worrisome PSA will be in the absence of any other concerning upcoming tests such as DRE; follow up biopsy, follow up MRI. Anything else I may be missing? My wife seems to be more concerned with starting intervention when PSA doubles which I guess would be 4-5 using my case instead of the AUA guideline of 10. Trying to find a middle ground. If I use 1.9 as my base, I think my doubling time is 11 months if I’m using the MSK tool correctly.
Posted 1/21/2018 7:26 PM (GMT 0)
You are misusing PSADT. It as no relevance to your situation. No one uses PSA kinetics to determine whether treatment should begin - it's been shown to be useless for that.
Posted 1/21/2018 10:12 PM (GMT 0)
Thanks. It seems PSADT is more relevant for either advanced or reoccurring but not so much for prior to any treatment.
Posted 1/22/2018 1:07 AM (GMT 0)
PSA kinetics were used at some point historically to determine whether to stay on AS, but it has been stopped as the sole reason to start treatment. Today, PSADT of say, less than 3 months might be used as a reason for closer scrutiny. That scrutiny would be repeat biopsies and multi parametric MRI to determine whether or not to stop AS.
Posted 1/22/2018 1:45 AM (GMT 0)
I agree with all the above comments. You are far from needing to be concerned about leaving AS.

The one outlying data point that Johns Hopkins pays attention to is PSAD (psa density), which is .15 by their alert level.

But, I don't see anything else that would concern me, and that one item would not make me change my course, if I were you.
Posted 1/22/2018 2:55 AM (GMT 0)
Thanks. I wasn’t thinking drastically but this has made me read up on PSADT and I’m good.
Posted 1/22/2018 1:51 PM (GMT 0)

ejc61 said...
Thanks. I wasn’t thinking drastically but this has made me read up on PSADT and I’m good.

Yes, you are.

Congratulations on being able to remain on AS. The rest of us wish we could have joined you!
Posted 1/22/2018 2:20 PM (GMT 0)
This is a humbling journey. I think of everyone on this board. I’ve had my share of stuff like mitral valve surgery, endocarditis and an emergency arterial thrombectomy with 3 compartment fasciotomy much of it in the last 3 years. I’m not one to gloat. I’ll temper my thoughts going forward.
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