PSA goes back up after RP 6 yrs. ago

Da Wizzard said:

MAY 2014 PSA results-confused - again

Summary:

6 yrs. after RP , psa was ( <0.1)

Dec. 2013 ...................(   .1 ) regular PSA Test

Jan. 2014.....................( .103 ) ultra sensetive PSA Test

Mar. 2014....................(  .122) ultra sensitive PSA Test

May 2014....................(   .091) ultra sensitive PSA Test........it went down........I'm Happy.....but confused......

Going to the Dr. in 3 days..........if it went up again I was considering doing IMRT.......why wait......let attack this CA the sooner the better is

my feeling and belief.......why let it get bigger and spread.......attack it sooner.......the Dr. was wait and see as it did not get to (.2)

and thus is not technically considered a recurrance of Ca...........is this going down just a margin of (+ or --) error in the PSA test.....

Did Ca cells if they returned die off on their own.........does that happen.......just confused............any advise for me to ask the Dr. in 3 dys will

be great as now I don't know where I stand.......also, thank you all so much for past advice and sharing.....Da Wizzard.....PEACE

 

 

I had Prostate Cancer and had the robotic surgery in 2008.  My PSA had been 12.9 and was going up at about 1 PSA per month.  The ultra-sensitive PSA was about 0.01 ng after the operation but then within 18 months it went up to 0.19 ng and continued to rise until 2010 at 0.40 ng.  So obviously the cancer had returned in less than two years.

 I had a positive margin when the prostate was removed, so definitely I was concerned and spend countless hours researching a cure.  According to what I have learned is that one wants to take some kind of action prior to the PSA achieving a 0.40- 0.50 ng reading.  So it appears that since you have had good luck for 6 years that it has only gone up very slightly, then you have adequate time to try different therapies to see if they will stop or slow down the increase, if there is any.

I went to the University of California Medical Center in San Diego, where I had my prostate removed initially and had IRMT radiation done in 2010 at cost of about $120,000.  The cancer cells were in my prostate bed area, most likely since I had a positive margin but they could have leaked out via the nerve roots also, before I even had the surgery.

 I researched Proton therapy and all sorts of therapy and decided that the IRMT was a bit better than other or maybe the same.  One needs to have the small shotgun effect to irradiate the prostate bed because that is probably where they (the evil cancer cells) are living if there are any if ones PSA continutes to go up.  If the radiation had no change in the PSA reading about 2 months after the radiation, then one would have to look elsewhere but how would that work or help to cure the disease?

A good scientific approach to a difficult subject is what you have endeavored upon.  I think you are doing the correct approach in just monitoring your PSA and keeping track of it.

Remember that a mosquito weighs about 2500 ng, so the measurements that they do to test for PSA are maybe not exactly correct but over a period of years it will give you a velocity/ slope of the line, increase if there is one, providing one is using the same laboratory for the PSA testing. 

Any radiation of any kind is not to be taken lightly. Since there is real no way to determine where  cancer cells are located at present, which will show a definitive location that one can home-in-on with any precision.  Since ones internal parts are moving around constantly then it would be difficult to have an external source to identify and surgically strike just those particular offending cells.  The Proton radiation won’t do any better at this now than anything else since one cannot find the bloody bastards lurking in the pelvis with today’s technology and then eradicate them. 

Why men get prostate cancer is a question that needs to be answer but unfortunately we have none yet.  But the body might help in this killing off of the cancer cells or stop them in their tracks from any more propagation.  They started to grow for some reason, so logically one might find a way to stop them from performing their goal to replicate. 

 There are no good side effects of radiation.  The job of radiation is just to kill off the fragile cancer cells, which have problems replicating after radiation but the damage to the bladder and rectum are not going to make you a happy camper most likely either. 

After the robotic surgery I was able to get a somewhat erection but the ~74 gray of IMRT radiation makes it very difficult since the object was to kill off the cancer cells in the prostate bed  but this is where the nerves of the penis also reside.  Now I have more problems with urination and not sufficient control during periods of heavy lifting or sneezing where the urine will leak out, which is a minor inconvenience at my age of 66.  The rectum was very uncomfortable at about half way through the IMRT radiation, sort of felt like trying to pass sandpaper or ground glass.  Now I have a very fast transit time for defecation when I eat lots of fiber containing foods and not much control over the stopping of the defecation but again an inconvenience at most.

After the radiation my PSA was back to the 0.010 ng level and I was concerned that it didn’t drop to zero.  I have come to the possible conclusion that maybe there were some native prostate cells still attached to the bladder or in the prostate bed area, which would not be destroyed by the radiation and they are just sitting there.  My PSA 4 years after the radiation is now 0.015 ng, so why did it go up a tiny bit?  Who knows, maybe the native prostate cells are dividing?

I tell my friends that I want to live as long as possible and in the best of health during those years and I thought if would help me,” I would eat a dry dog turd”.  So I decided to become a Vegan and exercise every other day and meditate about 2 years ago.  All the aforementioned items can’t do any harm and maybe might stop the propagation of prostate and other cancers and maybe also heart disease, which is a more likely  to kill us.  So I suggest you try these changes in your life, if you don’t do so now and continue to monitor your PSA every 3-6 months.

One has to be proactive in things that affect the most important items we have, our health and life.  I am sure everyone would agree on that.  There is no one solution that fits everyone since we all have different genes that get up and down regulated (turned on and off) at various times in our life.

Good articles/videos to read/watch and resources to look at can be found at the below links or subjects:

http://nutritionfacts.org/

Just put “Prostate cancer” in the search and there are a slug of videos that cover the disease.  Is he right or wrong I don’t know for sure but it can’t hurt to try plant based foods and stop eating any animal products, then see what happens, can it?

http://www.forksoverknives.com/

I don’t like their new website but as I am sure that the webmaster needed to make sure he would keep his or her job so they made it more modern, just difficult to find anything.  Just order the video called Forks Over Knives or view it on the Netflix, I think they have it.  They also have good newsletters that might have some information.

http://emedicine.medscape.com/article/453191-overview?src=wnl_edit_specol&uac=182507DY

Medscape, Prostate Cancer and Nutrition, Sep 24, 2014, good and fairly new article.

http://www.cancerquest.org/cancer-biology-animations.html#

If one is not really familiar with the cancer process then this video is excellent.

http://www.cell.com/cell-metabolism/abstract/S1550-4131(14)00062-X

One can download the PDF article for free here, might have something that is interesting to people.

http://ucsd.tv/search-moreresults.aspx?keyword=Prostate+cancer&x=2&y=7

There are also some videos on prostate cancer here that one can download or watch that are informative.

I need to get on to more pressing issues of finding a cure for roof moss in my life time and also diminishing the deleterious effects on teeth, of eating too many corn nuts.  J

So good luck, may the Tofu be with you.

Steve

Da Wizzard said:

MAY 2014 PSA results-confused - again

Summary:

6 yrs. after RP , psa was ( <0.1)

Dec. 2013 ...................(   .1 ) regular PSA Test

Jan. 2014.....................( .103 ) ultra sensetive PSA Test

Mar. 2014....................(  .122) ultra sensitive PSA Test

May 2014....................(   .091) ultra sensitive PSA Test........it went down........I'm Happy.....but confused......

Going to the Dr. in 3 days..........if it went up again I was considering doing IMRT.......why wait......let attack this CA the sooner the better is

my feeling and belief.......why let it get bigger and spread.......attack it sooner.......the Dr. was wait and see as it did not get to (.2)

and thus is not technically considered a recurrance of Ca...........is this going down just a margin of (+ or --) error in the PSA test.....

Did Ca cells if they returned die off on their own.........does that happen.......just confused............any advise for me to ask the Dr. in 3 dys will

be great as now I don't know where I stand.......also, thank you all so much for past advice and sharing.....Da Wizzard.....PEACE

 

 

I will join the chorus and tell you not to worry about these tiny changes in your PSA assays.

As a former research biologist, I can tell you that assays, especially ones done on different days, will show some variation. The instrument may drift due to aging, the standard run to calibrate the instrument may not be quite right. The technician responsible for the instrument may have changed and the new one may do things just a hair differently, even when sticking to the protocol.

And listen to your specialist who recommends a 'wait and see' approach. Enjoy life while you can; it won't go on forever...

Da Wizzard said:

Dr. visit March 21, 2014

First of all , Thank you all for the comments and Kongo, your last comment was spot on...I went to the urologist that's been on my csae since thr RP ,DaVince method, back in Oct, 25, 2007...He's has actually become , sort of a friend, but he is honest by telling any good news and bad news, he is very up front which to me is a plus.

 

I went to him yesterday, Friday 3-21-14, and he said :

A.) Psa is (now) .122.......was .103 (Dec. 2013)....was August 2013... <0.1 (for 6 yrs.)......he said to forget about the last two digits of the Ultra -sensitive PSA test.....look at the .1 in Dec and Jan. and now March....to him it has not changed...

but the Ultr-sensitive  PSA test might be signialing a very slight upward trend.....103 to .122......his recommendation was to keep an eye on this trend and lets not do anything as long as it is below POINT TWO, (.2 ).....he noted that if it does not reach .2 then protocol does not even consider it a recurrance.....I agree with him as to this .2 concept as per things I have read ( mostly from John Hopkins Hospital )....but something has happened....< 0.1 for 6 yrs......

B.) I read that the most common pathology was T1c...I did not know mine so I asked...he told me that T1c is for PRE-OP and that mine is now a Post surgery pathology that is : P3 No Mo....I found out that Seminal Vesicle and Lymph Nodals were Negative.... Great news as per what I have been reading on web-sites.

C.) I asked what would be the recommended possible plan if the PSA trends up over the .2 treshold...I have been reading about three types of first step options: IMRT....PROTON THERAPY....something at UCLA, I think it's CYBER-KNIFE or RADIO -something........anyway, the Dr. explained all three to me....he noted that Proton Therapy is exact but we don't know exactly where the cells are ?.....he said Cyber Knife is similar as it will cover where the prostate was, sort of a rectangle area ......IGRT / IMRT would be what he is leaning to as a recommendation as it covers a scattered area that will include the prostate bed and the sourounding area....he felt if I were to consider what to do if the PSA goes above .2 it would be IGRT / IMRT....but all three therapies are available not far from his office...I would note that his group of Drs.that work together owns a new facility that does only IGRT / IMRT...but as per my readings, IMRT is usually the way to go at this stage if needed......the Dr. ruled out any HT at this time , as he felt the IMRT would do the trick because my Gleason 7 just reached the margin area and was not full blown outside the prostate. Thus, only IMRT should work.

 

D.) additionally, he spoke of the doubling time as an key element to any further treatment. He noted that he has a patient that had RP and then the PSA went to .2....he said this patient opted to still wait for another rise and that was 10 years ago...wow, lucky guy, to stay at .2 for 10 yrs.

finally, he asked me when I want to get another PSA test and office visit...offer was 2 mo., 3 mo. 6 mo....he told me that he knew I was conservative and wanted to stay on top of this.....he was right, I selected 2 months, for another Ultra-sensitive PSA test and office visit. Friends and wife have kidded me that I would go daily if it had any beneficial aspects.

Well, thank you all and lets hope modern medical science can keep us alive and healthy.....Da Wizzard 

 

 

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