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jerryo

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Prostate Cancer
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Posted 11/9/2018 6:27 PM (GMT 0)
Have my appointment with a new urologist on this nest Wednesday, as you can read from my posts I was 0.01 for 7 years, and my last test came back at 2.04. I believe that this Dr. will order a Bone Scan and a ct scan, Just wondering what other questions I should ask while I'm with the Urologist, I know that no decisions will be made until the tests come back, but I am interested in future treatment options, any help from my brothers would be greatly appreciated.
Posted 11/9/2018 6:46 PM (GMT 0)
Are these your annual PSA test results for the last seven years (sorry, you signature details were a little unclear, so I interpreted your written comments to be this):
    1. <0.1 ng/mL
    2. <0.1
    3. <0.1
    4. <0.1
    5. <0.1
    6. <0.1
    7. 2.04 ng/mL


That's a significant jump and an unexpected result. Yeah, you might want to have bone scan, but any "unexpected" PSA test result should always be re-tested. Discuss this point with doc.
Posted 11/9/2018 6:52 PM (GMT 0)
I have the same comment as Blackjack...to go from undetectable to 2.04 strikes me as unlikely. Are we reading this correctly? If so, how much time elapsed between the last <0.1 and the last PSA? I'd also want to see about a PSA re-test.
Posted 11/9/2018 6:52 PM (GMT 0)
If you haven't had SRT, that with ADT would be the next treatment steps.

At your PSA scans might not be conclusive, but you should get them. Have you had a PSA test to confirm the 2.04? If the PC is still in the prostate bed, RT could be effective. If there are mets, you move right to ADT.

The question is, "is this really true?" and "What's next?"

After you get the scans, you may want to get an opinion from a MO who specializes in PC. If you are at BCR, you're moving beyond just needing a URO. A consult with a RO will be in your future too.

Sorry to hear you still have to deal with this.
Andrew
Posted 11/9/2018 7:28 PM (GMT 0)
Yes my psa tests were all at the one year point, and always came back at 0.01, I asked my Primary physician to retest as the jump in one year from 0.01 to 2.04 seemed a little unreal, he stated that the tests are rarely inaccurate and to just have my new Urologist retest. The problem with your Primary Physican is that they really have no idea how much anxiety this causes. Thanks for the input, you fellows know how much it is appreciated..
Posted 11/9/2018 7:31 PM (GMT 0)
I don't know how often the tests are wrong, but I've read stories of inaccurate tests here at HW. I seem to recall a few folks that refuse to use Quest as a result of some inaccuracies.
Posted 11/9/2018 7:36 PM (GMT 0)
Jerry, sorry you have to deal with this. I agree with the others that say re-test. If that comes back similar to the last one you have probably outgrown any urologist and should make an appointment with an experienced RO ASAP.

Jim
Posted 11/9/2018 9:17 PM (GMT 0)
jerryo, this is minor in the context of the most recent reading and doesn't change anything about what I said earlier, but you also seem to be making a very common mistake on the number of decimals...0.1 or 0.01? You are reporting both; look, too, at your signature.

Again, the "rule of thumb" applies either way: retest after an unexpected result.
Posted 11/9/2018 11:06 PM (GMT 0)
Jerry make sure to retest BEFORE you start doing any scans. It should go without saying, but just to be clear. If it was lab error, then scans are unnecessary.
BTW I’m one of the guys that had a big lab error at Quest...from <.02 to 3.8, in 4 months
Posted 11/9/2018 11:44 PM (GMT 0)
lab errors can and do happen.
more often than pros are willing to admit to.
Posted 11/10/2018 1:20 AM (GMT 0)
I’m just very shocked that they let you go for a yearly PSA with a G9 and PT3b. But that’s over and you can’t do much about it.

Could you go back and check your last year PSA to see if it’s 0.01 or 0.1 ( if you or uro missed a decimal )

I also vote for a retest.
Posted 11/10/2018 6:15 PM (GMT 0)
For the first 5 years after the removal of the prostate I was being checked every 6 months, after five years the URO went to once a year, all this time until this test in October the results were 0.01 then this last test the nurse called and said it had came back at 2.04 and to contact my urologist. I have an appointment this Wednesday and I am sure he will recheck the numbers and order a new draw.
Posted 11/10/2018 6:48 PM (GMT 0)
I agree that you definitely should have a PSA retest, but continue forward with a bone & CT Scan.

If nothing is found on those scans you can either assume cancer is still in the pelvic area and proceed with ADT & SRT to the whole pelvic area or have one of the newer PET Scans, 68 Gallium or Axumin, to see where the cancer is to make a more informed decision.

If cancer is outside the pelvic area ADT would probably be the next step.

Bobby Mac
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