PSA after 10yrs goes from non-detectable to 0.70,

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Ag1964
Ag1964 Member Posts: 3

25 Oct 2004: Prostatectomy

PSA=5.4, Gleason=6, cancer close to margin but not in margin

21 Oct 2014: (PSA undetectable until today!)

Annual exam today showed PSA=0.70

Now extremely concerned!

QUESTIONs:

1) Should I expect PSA to continue to rise?

2) What is the praobility that it won't continue to increase?

Thanks,

Very Shook!

 

 

 

Comments

  • VascodaGama
    VascodaGama Member Posts: 3,689 Member
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    Could the last result be erroneous?

    I suggest you recheck the last PSA results in another reliable laboratory. Errors are an evident probability.

    I wonder if you know what level represents the PSA "undetectable threshold” used by your doctor.

    Some doctors use cut-off levels of PSA=>1.00 (ng/ml), to report real values, and some others got thresholds of 0.5, and still some consider values under 0.1 (ng/ml).
    In other words, 0.7 is lower than 1.0 so you should have previous values to validate any possibility in increases. Undetectable means nothing in diagnosis but it got a meaning to your doctor.

    After prostatectomies, doctors consider RP success when the PSA gets into remission. This value also varies among physicians but almost all of them use the bracket of PSA=< 0.03 to 0.05 (ng/ml). Any increase thereafter is named biochemical failure and surely of concern. A number of doctors do not trust PSA results with values lower than 0.2.
    The AUA classifies levels above 0.2 as recurrence. They recommend salvage treatments when the chronology of tests shows constant increases, reaching the 0.4 (ng/ml) threshold mark.

    I think you should verify the veracity of the last results and try gathering the values of previous tests along your ten years of survivorship.

    Best wishes and peace of mind.

    VGama

  • Old-timer
    Old-timer Member Posts: 196
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    My record might be interesting to you

    July 1991, at age 65: PSA 4.0, biopsy Gleason 3+4 = 7.0.

    September 1991: radical prostatectomy.

    December 1991 through 2003: PSA .0.

    Early 2004:  PSA 0.2. Then at 3-month intervals my PSA rose: 0.39, 0.61, 1.11.

    Feb.-Mar. 2004. Radiation sessions (35).

    July 2004: PSA 1.20. (Informed that radiation was not successful.)

    October 2004 to June 2008. PSA see-sawed a bit while gradually rising to 20.4.

    June 2008. Began hormone therapy.

    September 2008 to October 2014. PSA undetectable <0.1.

    I am 88, feeling good, remaining relatively active, and enjoying life.

    I recognize that no two cases are the same. Hope this record helps keep your spirits high.

    Best of luck to you.

    Jerry (Old-timer)

  • Ag1964
    Ag1964 Member Posts: 3
    Options

    Could the last result be erroneous?

    I suggest you recheck the last PSA results in another reliable laboratory. Errors are an evident probability.

    I wonder if you know what level represents the PSA "undetectable threshold” used by your doctor.

    Some doctors use cut-off levels of PSA=>1.00 (ng/ml), to report real values, and some others got thresholds of 0.5, and still some consider values under 0.1 (ng/ml).
    In other words, 0.7 is lower than 1.0 so you should have previous values to validate any possibility in increases. Undetectable means nothing in diagnosis but it got a meaning to your doctor.

    After prostatectomies, doctors consider RP success when the PSA gets into remission. This value also varies among physicians but almost all of them use the bracket of PSA=< 0.03 to 0.05 (ng/ml). Any increase thereafter is named biochemical failure and surely of concern. A number of doctors do not trust PSA results with values lower than 0.2.
    The AUA classifies levels above 0.2 as recurrence. They recommend salvage treatments when the chronology of tests shows constant increases, reaching the 0.4 (ng/ml) threshold mark.

    I think you should verify the veracity of the last results and try gathering the values of previous tests along your ten years of survivorship.

    Best wishes and peace of mind.

    VGama

    VGama, thank you so much for

    VGama, thank you so much for your reply & suggestion.

    Only 3 days after my PSA was 0.70 I went to a different lab and the PSA reading was <0.1 (N). Does the (N) mean non-detectable? Thank you.

  • Ag1964
    Ag1964 Member Posts: 3
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    Old-timer said:

    My record might be interesting to you

    July 1991, at age 65: PSA 4.0, biopsy Gleason 3+4 = 7.0.

    September 1991: radical prostatectomy.

    December 1991 through 2003: PSA .0.

    Early 2004:  PSA 0.2. Then at 3-month intervals my PSA rose: 0.39, 0.61, 1.11.

    Feb.-Mar. 2004. Radiation sessions (35).

    July 2004: PSA 1.20. (Informed that radiation was not successful.)

    October 2004 to June 2008. PSA see-sawed a bit while gradually rising to 20.4.

    June 2008. Began hormone therapy.

    September 2008 to October 2014. PSA undetectable <0.1.

    I am 88, feeling good, remaining relatively active, and enjoying life.

    I recognize that no two cases are the same. Hope this record helps keep your spirits high.

    Best of luck to you.

    Jerry (Old-timer)

    Jerry, I really appreciate

    Jerry, I really appreciate your responce. So glad to hear that you are cancer free and enjoying life. Your story is inspiring & uplifting to me.

  • VascodaGama
    VascodaGama Member Posts: 3,689 Member
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    Ag1964 said:

    Jerry, I really appreciate

    Jerry, I really appreciate your responce. So glad to hear that you are cancer free and enjoying life. Your story is inspiring & uplifting to me.

    Zero PSA

    Congratulations for the PSA results. What a relief you may be experiencing.

    This result (less than 0.1 ng/ml) from the second laboratory is the low limit detection (LLD) level of the assay they use. Surely that is enough but I think that in your future followup you should move into ultra sensitive type of assays that provide two decimal places (0.0X ng/ml), because you have no prostate gland. The PSA should be read very low.

    Best wishes for continuing ZEROS.

    VG    

  • Old Salt
    Old Salt Member Posts: 1,403 Member
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    Zero PSA

    Congratulations for the PSA results. What a relief you may be experiencing.

    This result (less than 0.1 ng/ml) from the second laboratory is the low limit detection (LLD) level of the assay they use. Surely that is enough but I think that in your future followup you should move into ultra sensitive type of assays that provide two decimal places (0.0X ng/ml), because you have no prostate gland. The PSA should be read very low.

    Best wishes for continuing ZEROS.

    VG    

    Anxiety?

    Please note that those ultrasensitive PSA assays may generate a lot of anxiety without clinical benefit.

    PS: Here's a link to a thread focussed on just this topic.

    http://www.cancerforums.net/threads/10111-Regular-PSA-vs.-Ultra-Sensitive?s=f0454011ad58ee0be2b531dc418009df