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Psa 0.04 after 4 and a half y after RP

Internship41
Posts: 6
Joined: Mar 2018

Hello,

My dad had rp at age 57 in 2013 Sept, pt3a I think and I think Gleason 7 (dont know if 3+4 or 4+3). Dont know the details, but there are no seminal vesicles and node lymph involved...
Psa has been for the first one or two years below 0.02, after that 0.02, then in Autumn 2017 0.04. three months after that 0.02, then two weeks ago 0.04. all were from the same lab (beckman coulter access 2 machine i think).
Now i am worried sick about my dad. How long will he live (he is 61 atm)? Will salvage RT at some point save his life? Can he live until at least 75 or does he has ončy 5 y or so? I so scared for him and dont know what to think anymore, we thought he would be cured after rp but now i fear for the worst...
Some kind of encouraging news would be much appreciated.
P.s. sorry for my english it is not my native tongue

hopeful and opt...
Posts: 2224
Joined: Apr 2009

Please clarify. Is that two tenth of a percent, or two hundreds of a percent?

Internship41
Posts: 6
Joined: Mar 2018

Hello,

 

I dont understand the question... The psa reads 0.04 ng/ml

Clevelandguy
Posts: 441
Joined: Jun 2015

Hi Intern,

Work with your doctors and after they get a few more PSA readings on the graph they can determine a trend.  There are a lot of salvage radiation treaments + hormone reduction drugs if his cancer has returned.  You might want to get the pathology report they did after your Dad's surgery to see the extent of the cancer and it's location.  I would not worry too much at this point, but if the PSA does start to increase other courses of action as I stated above will need to be looked into.  Keep us posted on his progress, a lot of good people here with lot's of experience.

Dave 3+4

contento
Posts: 76
Joined: Jul 2017

Intern, I take a .04  psa  4 years after RP with a pt3a stage as excellent news.. I would not worry about this level at all if I were you. Yes your dad needs to be on top of his check ups and not let them lapse but otherwise I would not worry. Where on earth are you getting this 5 yrs survival thing ?? If I was assessing myself with your information I would be thinking I have decades to live, definately not 5 years. Relax and take a chill pill...

contento....

VascodaGama's picture
VascodaGama
Posts: 2988
Joined: Nov 2010

Intern,

PSA=0.04 ng/ml is still in remission levels. A portion of the urethra also produces PSA serum which could count for the extra 0.02. The assays LLD (low limit of detection) can easily provide a higher value (noise of the equipment) too. I think it better for your dad to continue the periodical test as he has been doing along the past 4 years.

By norm, recurrence is declared when the PSA follows a pattern of continuous increases reaching the level of 0.20 ng/ml. At a level of 0.40 doctors recommend a salvage therapy.

I wonder about you. How old are you? Sons and daughters with parents that have contracted prostate or breast cancer have higher risk for contracting the disease too. You should start checking your PSA (if male) at the age of 40. Does the 41 of the acronym mean your age?

Best wishes,

VG   

Internship41
Posts: 6
Joined: Mar 2018

Thank you all for the replies.

I am a little relieved by now. I really do want my dad at least lives until 75 , i love him so much.

Vascodagama

Thank you again for the reply. Im 30y old, and surprisingly do not care much about myself as i care for my family members...(i know thats not ok, but it is how i feel atm)

Grinder
Posts: 438
Joined: Mar 2017

"A portion of the urethra also produces PSA serum which could count for the extra 0.02. The assays LLD (low limit of detection) can easily provide a higher value (noise of the equipment) too"

Did not know that about the urethra, though it makes sense. After all I've read deep into the archives of this forum, I did not know that.

Every time I think I needn't bother reading all the posts anymore, I learn something new.

When research was done back in the 70s, it was sitting in a stuffy library going through indexes for related subjects and plowing through pages and pages of journal entries.

What a phenomenal difference computers and the internet have made. If you think about it, the cumulative knowledge of VdG would have been impossible in the days of hard copy journalism, without devoting an entire lifetime to intense journal study. I think that is why I am stunned that he knows so much without being a professional with a PhD. And probably why this forum admin is a bit off guard. Who could have foreseen  a day when a layman with his computer and the internet would accumulate more knowledge on a particular subject than an academic who devoted his life to journal researching the same subject. I certainly didn't. To quote a 70s expression, it blows my mind, and takes some getting used to.

And In41... What VdG said goes for your family members too.

Internship41
Posts: 6
Joined: Mar 2018

My good people.

I have obtained my dads pathologic report, or brief summary of discharge letter to be exact and have found out the correct data regarding the ilness.

It says (in brief): pT3a, no lymph node involvement, no seminal vesicles involvement, pre-OP PSA 5.6 , Gleason score of 7 (3+4).

But it says something i fear is not good, and i cant get to translate it from my language so the raw english version should be something like: apically right margin positive.

Does this means the surgical margin is positive?

If so, is it dangerous regarding my dads situation? Is it something i should fear more than anything?

Please tell me it is not something horrible...

VascodaGama's picture
VascodaGama
Posts: 2988
Joined: Nov 2010

Intern,

You worry too much and the wordings you use to describe your feelings are exaggerated. I wonder your language and the country you are from. The translation of "dangerous", "fear", "horrible", etc, may have another meaning in your language but it is too drastic in English when judging the contents in the pathological report you share above.

Apically right margin positive means that they identified a possible route for extraprostatic extensions. It could be the reason for the classification as pT3a. Surely, doctors will consider such fact as a cause for any failed surgery and the area (apex) would make part of a salvage therapy if recurrence ever becomes apparent. In any case, for the moment the slight increase of the PSA is still very low to consider any thing.
The other data in the report is good. Can you tell us the type of the surgery, was it open or robot? Do you have any report on image exams?

You doing well in being vigilant but you need not to worry to the extremes. PCa takes many years to spread and is slower in development when comparing it with other cancers. We need to treat any advancement of the disease but should do it considering the quality of life. We survivors including your dad may die from other causes than prostate cancer.

Best wishes,

VG  

Internship41
Posts: 6
Joined: Mar 2018

VascodaGama

thank you for the reply.

Yes, our language now when i think about it really does use in raw translation such overstated words, which in english i think sound harsh... i think.

Regarding the surgery, i think it was open surgery, because it would write somewhere that it was robotic i think.

The more i research the less i know so to say, and thats why everytime i read something/hear something new (like those margins) i freak out, its just how i function.

i know it is wrong, but i always about everything fear the worst, i guess everyone battles their problems as individuals...

Kind regards,

Intern

Internship41
Posts: 6
Joined: Mar 2018

Hello everyone,
just wanted to report the latest PSA results for my dad, and its back to 0.02 woooohoooo

Have praying for that, and am so relieved and I wish all of you here the very best!

contento
Posts: 76
Joined: Jul 2017

Internship great news !  One of the disadvantages to the ultra sensitive psa test is the frequent flucuations of the psa at those low levels causing a scare. The same exact thing happened to a freind of mine where his psa went from .03 ng/ml to .05 ng/ml and he was in a panic . On a retest it was .04 ng/ml and that was several years ago. His psa is still between .03-.05. Maybe someone could explain the value in the ultra sensitive test . It's widely used but I don't think even those institutions take any action until a psa level of about .2 ng/ml which the standard test can read ( doesn't read values below .1 ng/ml )

Probably some of the guys could explain the value.

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