PSA question

Got a question about post RP surgery 24/04/13, psa. My psa is as follows: 26/06/13= 2.79, 08/12/13=3.01, 29/07/14=4.30, 15/12/14=6.50, 12/02/15=9.25, 15/04/15=8.60, 14/12/15=8.71, 15/03/16=4.55, 15/06/16=2.80, 15/09/16=1.41, 02/12/16=1.75, 21/02/17=2.16, 12/06/17=1.20, 12/09/17=1.40.

My URO stated that he is stumped by these numbers as have his experienced colleagues. After surgery, have not taken any drugs or treatments except ciallis as required.

After psa of 9.25 in February/2015, my URO was thinking about putting me on ADT therapy but that has been put on hold, and instead of seeing me every 3 months he wants to see me every year. I have had a CT and BS every 2 years, all negative.

Any comments?

What country are you in? Several countries now have the Axumin PET scan, some have one of the PSMA PET scans. In Holland, you can get a Combidex MRI for lymph nodes. That could give you a clue as to where the cancer is and what can be done about it.

I live in BC, Canada and had a PET scan a few years ago with negative results. My URO thought if cancer showed up on the PET scan, it could be treated with specific radiation. I thought it strange that after surgery, my PSA was quite high. Assumed that prostate cancer cells were floating around. As PSA increased, as previously stated, my URO was prepared to start ADT therapy. Then PSA numbers started dropping and no sign of cancer after almost 5 years of negative CT or BS.

Pratoman, you are not missing anything. That is why I am here and why my URO is stumped.

slapshot-

I don't think your doctors are right to just shrug their shoulders and let it go. I think you should push for further investigation.

(1) A few years ago, they didn't have the same kind of PET scans they have now. In fact, the BC Cancer Agency is running a clinical trial of the best known PET scan (DCFPyL). I hope you can get in on this trial (contact info in the link):

/clinicaltrials.gov/ct2/show/NCT02899312

(2) Another possibility is that you have a "mixed type" of prostate cancer. It is possible that through 2015, a normal acinar type of prostate cancer dominated, but after 2016, another type took over. If so, they might be able to detect the new type using an FDG PET scan (which is normally not useful for PC).

(3) If they still have your prostate in a freezer somewhere (probably not, but you can ask), you can request a Decipher genomic test of your prostate tissue. If it's too late for that, ask if you can get a blood test for circulating tumor cells (CTC).

Tall Allen, garyi,

Will talk to my URO about the Pet scan clinical trial and Decipher test that you have mentioned. One question. Is it posible for the lymph glands to filter and kill PC cells? Is this why the my PSA count went down?

Thanks for your knowledge.

Tall Allen,

Neutrofils: 02/17= 2.1, 06/17= 3.4, 09/17= 4.1, 01/18= 2.4.

Got a question about post RP surgery 24/04/13, psa. My psa is as follows: 26/06/13= 2.79, 08/12/13=3.01, 29/07/14=4.30, 15/12/14=6.50, 12/02/15=9.25, 15/04/15=8.60, 14/12/15=8.71, 15/03/16=4.55, 15/06/16=2.80, 15/09/16=1.41, 02/12/16=1.75, 21/02/17=2.16, 12/06/17=1.20, 12/09/17=1.40, 01/17/18= 1.40, 03/02/18= 2.82

My URO stated that he is stumped by these numbers as have his experienced colleagues. After surgery, have not taken any drugs or treatments except ciallis as required.

After psa of 9.25 in February/2015, my URO was thinking about putting me on ADT therapy but that has been put on hold, and instead of seeing me every 3 months he wants to see me every year. I have had a CT and BS every 2 years, all negative.

Any comments?

Update: Saw Uro a few days ago because my PSA=2.82,03/02/18. We discussed options and he said that he doen't treat numbers, he treats symptoms IE;tumors so unless my PSA was approaching 20, there was not a concern which seems to be different to what this forum has shown.

Said I wanted to see a RO and MO for another opinion as my case seems to be different than most of his patients, so he requested a meeting with the RO and/or MO mid June as the soonest as we go away at this time right after ski season for 2 months of MTB, road riding and hiking in Utah, Arizona. There are clinical trials in Vancouver, BC with the PSMA Pet scan(thanks TA) which I will ask to be put on the list and if there are tumors in the soft tissue, possible a session with the SBRT radiation machine also in Vancouver, BC.

Comments? Thanks.

Post Edited (slapshot) : 3/16/2018 10:07:21 AM (GMT-6)

Wow Slap Shot we always talk about how everybody's cancer is unique to them and man are you an example of that!!! I like the other guys wonder why they didn't start you on ADT and SRT as soon as your healed from surgery but in your case sounds like maybe it's working for you so far! Keep it up and have fun biking!!

Larry