On_A_Journey's journey

On_A_Journey

https://csn.cancer.org/discussion/comment/1707202#Comment_1707202

Thanks, Old Salt.

Thinking about it more, what you said makes sense. The 'normal' testosterone range is a very broad thing, perhaps amongst other reasons to cater for potential intra-day variability. Perhaps I have been reading too much into my results.

I wonder if my PSA result would have been different if I got my blood test done a few hours earlier or later?

Old Salt

AFAIK, the PSA test is not subject to hourly variations. But one often reads not to engage in sexual activities or bike riding (basically activities that 'massage' the prostate) in the days prior to the test.

On_A_Journey

And in the blink of an eye, another three pages have been turned on the calendar. Where did all the time go?

Something weird has happened. My PSA only increased 0.01 since last time. My readings have stabilized, and I have no idea why! Calculated doubling time based on the five most recent results is now out to 50.1 months! Testosterone is still low-ish but within normal range.

Recap since late last year:

Dec 2022 – PSA = 0.48, T 17.9 nmol/l (516 ng/dL equiv.)

Feb 2023 – PSA = 0.57, T 18.6 nmol/l (537 ng/dL equiv.)

Feb 2023 – PSMA PET Scan, all clear

Apr 2023 – PSA = 0.51, T 18.3 nmol/l (528 ng/dL equiv.)

Jul 2023 – PSA = 0.57, T 15.0 nmol/l (433 ng/dL equiv.)

Oct 2023 – PSA = 0.58, T 15.5 nmol/l (447 ng/dL equiv.).

PSA nadir was 0.04 in May 2018.

Old Salt

I guess, we can conclude that even though we don't know where the cancer is hiding, it isn't 'multiplying' to a significant extent. A VERY good thing! I hope that that will remain the case for many more months.

On_A_Journey

Thank you, so do I!

I guess if nothing else I'm just kicking the can down the road so to speak, but I'll take it! 😉

On_A_Journey

This is getting ridiculous.

It is now some time since I passed by the biochemical recurrence checkpoint. After that, during 2022, my PSA went from 0.33 to 0.57, a significant but not a dangerously rapid overall result. My latest result shows a PSA reading of 0.59, which for all intents and purposes means negligible change over the last 12 months! And I still have no idea why! Maybe my last PSMA PET Scan is still having an effect, I don't know. I'm still on 3-monthly follow-ups for now, so as per usual, the next result will be important to provide guidance.

Testosterone was up a bit compared to last time, but still in the lower half of normal range, at 18.1 nmol/l (522 ng/dL equiv.).

This follow-up was also the first one with my new oncologist. My previous one, who I saw for almost 6 years, has left for greener pastures. I'm always interested in what comes next and my new guy seems to be in the camp of delayed rather than early treatment with ADT and mentioned that in the absence of confirmed evidence of metastasis down the track, he would wait until my PSA got to 10! I don't agree with that, but I do understand that it's something that I am unlikely to face for quite a while yet, either way. In fact, at the current rate, I'm probably a couple of years away from my next scan! He did agree with me that waiting until my PSA reached 1.0, as long as I didn't experience a sudden spike in PSA in the meantime, was a worthwhile trigger for one.

On_A_Journey

Strange goings on.

Had my 3-monthly follow-up today and it revealed a PSA reading of 0.54 which is a small decrease. In fact, my six most recent results have all been between 0.51 and 0.59 which is pretty stable.

I had no idea that cancerous cells can just sit there and not multiply.

Recap since this time last year:

Apr 2023 – PSA = 0.51, T 18.3 nmol/l (528 ng/dL equiv.)

Jul 2023 – PSA = 0.57, T 15.0 nmol/l (433 ng/dL equiv.)

Oct 2023 – PSA = 0.58, T 15.5 nmol/l (447 ng/dL equiv.)

Jan 2024 – PSA = 0.59, T 18.1 nmol/l (522 ng/dL equiv.)

Apr 2024 – PSA = 0.54, T 19.4 nmol/l (560 ng/dL equiv.)

Using those five most recent results, my calculated PSA doubling time according to a nomogram that I consistently use is a ridiculous 141.8 months!

PSA nadir after RP in June 2015 and SRT in Jan 2016 was 0.04 in May 2018.

I am no longer seeing the correlation between T and PSA that I noticed between mid-2022 and mid-2023, but I have noticed that there is a correlation between T and the seasons! It seems to be higher through our warmer months here (Australia), no doubt due to a higher amount of physical outdoors activity and the general level of fitness that goes with it. Even so, it is a relatively minor variation in readings, and the readings have always been within normal range for this 61yo.

Today, my oncologist offered 6-monthly follow-up consultations while still maintaining 3-monthly blood tests, but it's only a 10-minute drive for me and it costs me nothing to attend, so I will see him again in July.