Djin thank you very much for your reply.
1. The readings were taken the same day with two different blood samples in two different laboratories. I'm trying not to make a big deal out of one unusual PSA reading so we will go ahead with the scheduled PSA test in January and not retest until then. No point on having extra anxiety over such low values. Let's hope and pray it's just a fluke or it is stabilising.
As far as his oncological status he is doing good. There was no EPE in his pathological report.
Diagnostic summary in English
Adenocarcinoma of the prostate, Gleason 4+3=7, tertiary pattern 5 (Gleason 4: 50%, Gleason 3: 48%, Gleason 5: 2%) with involvement of both sides of the prostate. Maximum tumor diameter 24 mm. Focal perineural invasion. No extraprostatic tumor extension. Tumor contact with resection margin in one block2. As far as supplementation goes his doctors mentioned only green tea as when it comes to cancer nutrition and supplementation doctors in Europe fall a bit behind. I'm going to do what you suggested and drop the pomi-T and add the broccoli extract.
DjinTonic said...
Hi Aliel and Welcome to the Forum! Here is my two cents:
1. When you get an unexpectedly high PSA, I would wait a bit (perhaps 30 days) or wait until the next scheduled test) and repeat it at the same laboratory. A true rising trend will always reveal itself. It is hard to compare values from another lab for several reasons I won't go into. Were those readings taken the same day? With the same blood sample? Also, it's hard to compare a 2-decimal test with a 3-decimal. A 0.02 could, for example, be a rounded 0.015, which would essentially the same as the 0.014. I see that his previous back-up lab readings have differed from the main lab 's. (My 3-decimal PSA over 3 years has been essentially stable, but the values do fluctuate up and down a bit.) There is always uncertainty in the right-most decimal place of any lab test. Finally, his PSA has been .02 post-RT several times before only to then come down. As to you other PSA question, yes, low values can go up and then stabilize. I would not worry at this point.
Your dad seems to be doing well as far as his oncological status. In terms of risk prediction, I would only note that--in addition to the positive margin you mention--if he was pT3a post-op, then there was extracapsular extension (or perhaps some bladder-neck invasion). A G7 (4+3) with tertiary pattern 5 is considered on a par with G8 (4+4) as far as risk prediction.
2. Make sure your dad's doc(s) know about his supplements and don't exceed recommended dosages unless you have a doc's approval. I, too, take some of the same supplements. I suggest dropping the Pomi-T, since (a) he is already taking 3 of its 4 ingredients (you can add broccoli extract if you want the 4th Pomi-T ingredient); (b) it's more expensive than buying the individual ingredients; and (c) it doesn't have that much of any one of its ingredients, even if you take 3 capsules/day, which raises its cost even more. At 2 capsules/day you are getting only about 1/4 of the amounts you would get from 2 caps of each ingredient. (I used to take Pomi-T, but replaced it with capsules of its individual ingredients.)
I'll let others give you opinions on the B-12 because I don't know enough about it. I would certainly first OK it with his docs.
All the best,
Djin