3 Years after surgery and PSA

Congratulations!
My most recent test was also <0.04ng/mL. Very low.
(Despite ethical protestations, some urology offices have invested in radiation equipment, either on-site or at a nearby site that they own...is this the case with your urologist?)
On the other hand, your protein in urine issue sounds like it needs follow-up...best wishes on that.

Tom,
If I subscribed to the 0.03 threshold, my personal choice if I were in your shoes, would be to wait for an additional 3 month PSA before making a final decision.

If you are still concerned with the protein thang...your gp can give you a small amount of lisynoprill which counteracts the protein...I have been taking 5 mg of same for blood pressure for years even tho my BP is normal just to soothe my gp...stupid yes...dumb yes...what?me worry! ...oh the protein still rises and falls based on my cardio activity...My previous GP who moved out of state 3 or 4 years ago never gave me a test for protein in urine as he was up on how longtime endurance atheletes are plagued by it...( he also knew I was on 10 mg of lisonoprill which he imself prescribed …. my now GP describes my hi bp at the office as white coat BP...Im fine with that tho I know it is not white coat...it is pissed off at template doctors and nurses who do not even know how to give bp readings...yak yak...keep u waiting...wake u from a snooze.in waiting then rush you to take their pitiful bp test syndrome...I now do "combat breathing" when I go to doctors...and it is normal...I also never respond to the nurses "stop and chats"( as they are taking my bp) when they could care less about dis n dats My BP is up as we speak just thinking about it...breathe..logo...breathe..not going to edit any typos et al...I got to go eat some oatmeal

Your PSA numbers don't look like a trend to me. The pattern is up down up down. Two increases in a row taking you over .03 would be a trend.

Tom-- The PSA result you have is likely background noise and any variations at this ultralow level have no significance. A little proteinuria can be normal.

As a aside, I started reading Barbara Ehrenreich's book Natural Causes about the medicalization of old age in order to gain some balanced perspective regarding my real and imagined medical issues. The placebo effect works. Sometimes.

Thank you very much guys. As always, you put me at ease again.
Especially about that 3rd digit being "noise". One time when I went the
doc that was filling in for my regular urologist told me the same thing about it
being noise, but my regular urologist seems a lot more cautious and concerned
about minor things. I am hoping maybe its leftover prostate tissue? I read that could be
the case at times, and it can be non cancerous. But in my head, I am thinking NO radiation
until (and hopefully it never gets there) I get an 0.2 or higher. I read most docs dont consider radiation
until it reaches .4, so I think .2 would still be safe. And again, hopefully I wont see that since I am 10 times lower than that 3 years out. The proteinuria situation is more concerning, but I have gone from 7 grams, to 6 grams, and now to 2 1/2 grams per day. So its trending right. I think stress is a major cause of it so I am trying to deal with that too.
THANK YOU ALL very much!
Tom

Take a look at my PSA. I just walked in from my urologist and he says worrying is gonna kill me before any PCa will. I've spoken with two RO's. One says treat. (he's conservative). One says "probably at some point, but no reason to today" (he's my kinda guy).

Pick who you wanna believe and just do that.

The protein I had lots of as well. Seemed to worry the docs (and, therefore...me). Today all was normal. That protein thing I had all kinds of tests run on. Found a stone...blasted it. Found cysts. No problem. Found another little tiny thing....then somebody yelled "fire". Had a CT. Don't remember anything coming of it. Today they did an ultra sound of my kidneys....found nothing.

Had a cyst in my pancreas. Doc said "follow up". Had it checked out. It turns out to be some little cyst in something. John's Hopkins says "Protocol....check it every 5 years"

Now I got a place in my mouth that hurts. Chewed tobacco for 40 years. Quit a year ago.


I've decided.....it's always gonna be somethin'.....and that's just the name of this game. called life.

My urologist's departing words to me were...."There's nothing I can see that's gonna kill ya. As far as I'm concerned....you look healthy....you are healthy....might as well act healthy".

OH! I remember what he said.....he said...."You might not be doing anybody any good (and I don't know that any of us are)….but you ain't doin' anybody any harm". lol

Tom,

Posting my uPSA history and results below for you to review. These were my own LabCorp testing since my uro only uses the standard PSA that goes down to .100 reading. At last December's (yearly) visit with uro, I finally discussed these readings with him. He seemed a little perturbed that I was using the uPSA -- thinks it just causes patient anxiety. He said I was way below the level he would refer anyone for radiation. Also later discussed with my primary, whom I trust because he originally caught my PCa and is sensitive to it because his own dad died of PCa. He said don't worry about this uPSA, stating "in your case, you just aren't going to die from prostate cancer".

Of course, I am still getting my own tests about every two months, and if I saw it jump to .04, then .06, then .08, I would self-refer myself to MDA or somewhere, regardless of my other docs.

Our uPSA may be coming from a small amt of benign tissue left over, or from the cancerous margin tissue -- yours and my margins were gleason 6 and supposedly this does not do mets. Or maybe some uPSA fluctuations due to heavy exercise or something.

If you read the LabCorp specs on their uPSA, they advise to refrain from biotin supplements for 72 hrs before. Do you do that? Many common multi vit/mins have biotin. Makes me wonder what else could affect this uPSA that we don't even realize. I always try to get my blood draw when in a "normal" level of hydration, i.e., manage my heavy cardio and fluid intake accordingly so that when I get blood draw, my urine output is pretty clear and pretty "normal". Do you do this? I would guess that a test like uPSA, measuring down to billionths of a gram, would be affected by hydration level.

Or, in my case, as you can see, possibly some T injection effect, since when I purposefully backed off my T shots for a few months, my uPSA trended down.

Robert



2013/05/04: uPSA < .006 (not on any TRT until 2014)

2014/03 -- started on Androgel

2014/11/14 tested T while off Androgel 3 weeks due to
insurance foul-up
total T = 321 ( below LabCorp range ) free T = 8.73

2015/12/08: uPSA < .015 (was on Androgel at the time)

2016/02 -- switched from Androgel to T-cyp injections

2017/02/03: uPSA = .024
(the first detectable PSA in the ~ 5 years since surgery
gave results copy to uro's front office - no response)

2017/02/17: uPSA = .025

2017/03/10: uPSA = .027



----------------------------------------------------------------

mid-Mar. -- stopped testosterone shots on my own accord


2017/04/10: uPSA = .021
2017/04/24: uPSA = .027
2017/05/24: uPSA = .025
2017/06/21: uPSA = .018
2017/07/19: uPSA = .018
2017/08/16: uPSA = .017

2017/08/21 tested T before restarting testosterone shots
total T = 406 free T = 6.2 ( below LabCorp range )

2017/09/15: uPSA = .018

mid-Sept -- restarted T shots (150mg/.75mL every other Fri.)
QOL much better now: energy, focus, motivation, physical effects

-------------------------------------------------------------------



2017/10/18: uPSA = .024

2017/11/17: uPSA = .020


2017/12/08 T reading at uro's was 908 at mid-point in 14-day injection cycle
Uro said little higher than the 750 he likes to shoot for with his guys
but we'll just let it go for now

2018/01/12: uPSA = .026

2018/03/05: uPSA = .032

2018/04/04: uPSA = .028

2018/06/15: uPSA = .029

2018/08/22: uPSA = .030

have you had your vit-D level checked? PC and low vit-D is common.

WOW...I rest my case on the telephone schtick...that last observation is wrong in too many ways to count....TomC ...you are fine...its a forum no more...no less...not a panacea to solve or make worse your situation...this type of forum will do both...if you let it...

Tom,

To follow up and clarify on a few things:

Benign tissue? -- no, never had a doc say that to me, just my uneducated opinion that no surgery is perfect, and since the apex has very little surrounding tissue anyway, a surgical margin (positive or not) may have gone unnoticed somewhere.

Positive margin tissue? -- well, by definition, that's tissue that could be pumping out uPSA, unless it dies off sometime after surgery/pathology were done, right? But many guys under active surveillance (AS) with G6 tissue on biopsy just live with it their whole lives and have neither surgery nor radiation. My feeling is that if my 3 mm positive margin, that Epstein determined was G6, wants to just sit there and pump out a little PSA and do no other harm until I die of something else, so be it. The key to this approach is to get uPSA tested regularly, under similar blood draw circumstances (hydration, time of day, avoiding things that might interfere), and watch for a rising trend that seems to be getting high enough to worry about. If it never gets that high, then ok, so be it -- I've got other things to worry about. Age 69, not gonna live forever anyway. At least, that's my view.

btw, this LabCorp doc discusses some things that can affect the test (see "Limitations" and "Special Instructions"):

https://www.labcorp.com/test-menu/33776/prostate-specific-antigen-psa-ultrasensitive#


On your kidney function, just wanted to mention my wife recently got a worrisome GFR kidney test, then retested and it was close to normal. She has a little incontinence, so often lets herself get a little dehydrated to avoid bathroom duty so often. Maybe hydration caused her conflicting test results? A family friend (doctor) told her hydration to get clear or slightly yellow urine is good, esp. as we age. Have you seen these young guys at the gym toting around two liter/gallon bottles of water? Pretty funny to me, but I guess it's for a reason.

***Wanted to ask a locksmith. I have a garage service door with normal doorknob/spring latch and, six inches above that, a separate deadlock bolt lock. Only go out that door, never in. The deadlock is fine. The knob/spring started falling apart and I even had to hacksaw off the latch as it was jamming so bad could not even get door open. Both locks are keyed but we have lost the keys over time. We want to have a locksmith come by and replace the knob/spring lock. Can he fix that key to match the rest of house keys (they all match)? Can he also rekey the deadbolt lock same way? It would be nice if all our locks were keyed same. Thanks in advance.

Robert