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PSA up!. Should I worry.?

tonybuxton
Posts: 76
Joined: May 2012

My PSA yesterday was 0.752, up from 0.24 3 months ago. I had a testosterone test done at the same time and it was up to 268 which is normal for my age. (81) It is 8 months since I finished IMRT and 9 months since my first and only 3 month Hormone injection. So with my testosterone levels back to normal the HT should no longer be effecting my PSA. So I can now assume that my last PSA is a correct marker in my battle against recurrence. Is this last reading OK in spite of it tripling in 3 months?. I believe that the usual criteria is nadir + 2.00. Any comments will be much appreciated

VascodaGama's picture
VascodaGama
Posts: 1515
Joined: Nov 2010

Tony

If you got still the prostate then 0.752 may be a natural level. However, without a gland the PSA should be lower (<0.05) to be in remission.
Again, the theoretical rule applied to judge recurrence after Radiation Treatment differs. In SRT cases recurrence is taken on the third continuous rise post nadir. In RT as prime therapy cases with tumours producing typical levels of serum initially, nadir + 2.0 ng/ml threshold stands; but in cases of tumours (types) that produce low levels of serum, judgement with the "third rise" may be proper.

What's your case?

Try finding info on bounce PSA: http://www.ncbi.nlm.nih.gov/pubmed/12705989

Best
VG

tonybuxton
Posts: 76
Joined: May 2012

Thanks VGa
I have not had surgery just MRT with 3 months RT. I understand nadir +2.00 is the PSA that would indicate recurrence.
How do I get my nadir? Because of HT my PSA readings would not be useful in ascertaining my nadir. So only now with the effects of the HT gone the last test at 0.75 reading would be the first one to consider? I guess I will just have to wait it out until my next test in 3 months time. However would this last test be about the right figure for successful treatment?
Incidentally my PSA after RT & HT was <0.1
Perhaps I am worrying unnecessary because of my younger brother died of colon cancer which spread very quickly to his liver. At 81 I am not looking for any long term survival just some kind of assurance that I will not suffer from metastases and be incapacitated within the next year or two. I would hope only to see out my 85th birthday in 3 1/2 years time. I need this time to look after my wife who needs me because she is ill. Her sister will retire soon and then she can look after her. If it was not for my wife I would be quite happy to "call it a day" because I have had a wonderful life.
Hope all is going well with you. I really miss Portugal, the friendly people and the wonderful fish and wine! But I am too old to travel long distances any more. I think my parents were lucky to have spent their last days there at Praia da Rocha in the Algarve.

VascodaGama's picture
VascodaGama
Posts: 1515
Joined: Nov 2010

Tony

I forgot about your previous PSA tests (before treatment). In any case your nadir should be the 0.24 which was the first lowest after treatment (RT+HT). You are still far from the 2.0 threshold.
I sense anxiety in your post. I cannot understand what would prohibit you from being a live 3 more years. Is there any particular symptom or metastases found in image studies, or did your doctor tell you anything negatively, or have you other illness that could drive you down, etc ??

PSA=0.75 is a very little fraction of serum. Relax and let time lead the things. Be vigilant with the lipids and do everything coordinately with no rush. Enjoy the moments the best you can with your family.
Travelling has been good to me at times of despair.

Hope for the best.
VG

tonybuxton
Posts: 76
Joined: May 2012

Thanks again VGa for your kind concern.
I had severe BPH and had TURP. Unfortunately I did not take my PSA after TURP, But it was 42 before. But how much PSA was due to BHP is difficult to ascertain. Because three years previously my PSA was 27 and biopsy showed no cancer. TURP removed 30grms tissue which was diagnosed with a Gleason score of 3+4 with 70% involvement.
I am in excellent health internally and take no medicine, so perhaps the only thing that could kill me is the PCa. However physically old age has caught up with me because the three months HT treatment nearly killed and added 5 years to my life. I am just recovering but I have very little strength. I can not do anything I like doing. I Have a lovely tropical beach 150 yards from my house but I can not walk or swim there. If I fall over I can not get up as the beach is deserted apart from weekends So I just walk around the house for 30 minutes a day. I can't fish, ride, hunt, climb mountains, dive, ski or travel. I am an out doors man. I don't watch TV because I never had it when young. I can't socialize anymore because I have outlived most of my friends and relatives. I find life very boring compared to what it was. So I just want a few more years disease free to look after my wife until her sister retires and can look after her. She is 15 years younger than me but not well at all. I do love to travel. I do have a few friends in various parts of the world, who I would love to see. (last year we went to Burma) But now my wife is not well enough to travel and I can not leave her alone.
I am not complaining, I am just stating what my situation is. I am lucky to have come in contact with people like you and others on this forum and I have nothing but admiration how you are coping. Most of you are probably in much worse condition than I am.
All the best to you
Tony

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