Recently diagnosed with Gleason score of 9

SV said:

Still <0.1</b>
Hi guys. I just received results from my third PSA test and it continues to be a <0.1. Although my sex life is nearly returned to normal, about three months ago I experienced a regression in erection firmness. That temporary mysterious step backwards has ended along with nearly zero dribbling, even when lifting free weights and motorcycle riding for long periods.

To be safe, we've also remained on a healthy diet of fresh organic vegetables, organic chicken and wild caught cold-water fish. We're still zero sugar but do use very small doses of honey or agave on our organic oatmeal. Dairy is mostly off the table too except once in awhile on a cheese pizza.

With all of the pros and cons about Pom juice, just for the heck of it I take a few swigs a day along with lots of fresh organic berries and two aspirin. If I had to guess, I'd bet that I'll be on vitamin V for life but at age 59 that is not so unusual, with or without prostate problems.

And most of all, I want to thank all of you who contribute such valuable information and encouragement to all of my fellow cancer warriors. The debate will likely go on about the best treatments and so forth, just remember that after you've adequately researched all options that relate to your case, believe, believe, believe. It's the power of positive thought that will always give us the vital edge that can save our lives.</p>

SV said:

Still pulling those zeros
I am happy and relieved to report that my sixth 90-day, post-surgery PSA test is still <0.1
Although my sex life has mostly returned to normal thanks to Vitamin V, when lifting heavy items at awkward positions I occasionally continue to squirt a drop or two. As confident and positive as ever, for some odd reason the day of PSA testing, and especially the day after when I go to pick up my results, my stress level rises dramatically. Even after the nurse hands me the results I believe will reveal <0.1, I am so shook up I have to sit down for a few minutes and catch my breath. What's up with that?</p>

SV said:

Bad PSA test?

It's been eight years of post surgical bliss with the ability to have a normal sex life and very sporadic urine leakage if lifting something at an awkward angle. All of my blood tests over the years  have come back perfect until today. It's been a year since my last test can anyone tell me what the next step is?

Roche ECLIA methodology. According to the American Urological Association, Serum PSA should decrease and remain at undetectable levels after radical prostatectomy. The AUA defines biochemical recurrence as an initial PSA value 0.2 ng/mL or greater followed by a subsequent confirmatory PSA value 0.2 ng/mL or greater. Values obtained with different assay methods or kits cannot be used interchangeably. Results cannot be interpreted as absolute evidence of the presence or absence of malignant disease.
PSA, Free	0.04 ng/mL	N/A ng/mL
Roche ECLIA methodology.
Free PSA/PSA Ratio	10.0 %	%
The table below lists the probability of prostate cancer for men with non-suspicious DRE results and total PSA between 4 and 10 ng/mL, by patient age (Catalona et al, JAMA 1998, 279:1542). % Free PSA 50-64 yr 65-75 yr 0.00-10.00% 56% 55% 10.01-15.00% 24% 35% 15.01-20.00% 17% 23% 20.01-25.00% 10% 20% >25.00% 5% 9% Please note: Catalona et al did not make specific recommendations regarding the use of percent free PSA for any other population of men.

 

SV,

I may be quite wrong on this, but I do not think that mainstream recurrence criteria pertains to the Free PSA form of PSA testing. I know that is certainly not what most doctors use in the US.  My Urology Group (around 15 surgeons) virtually never uses Free PSA testing at all, even in the initial diagnostic process. I do not see any Total PSA Result in your post above, only a free PSA result (that is how it is labeled).

I have always viewed the free PSA process as a form of hand-wringing for pre-confirmed PCa patients; a way to worry more about interpreting results instead of just getting a biopsy, which is the only authoratative way for determining PCa anyway.

The Probability Chart you show also includes DRE data, which suggests to me that it is not intended for post-RP patients.  (A guy with a bad DRE following R.P. has way bad problems one would suspect.)

SV

PSA=2.0 ng/ml means recurrence. You need to think in a salvage treatment. Typically it involves radiation therapy with or without hormonal drugs. You can visit the same hospital that treat you in 2010 or a radiology clinic closer to you. Everything starts with a consultation but you should get an image exam to try locating the bandit's hideaway. PET scan is the best in recurrences from surgery.

I recommend you to do some research on salvage therapies before the consultation so that you will be prepared to question the physician.

Best wishes and luck in your continuing journey.

VGama

Hi,

There have been little advances regarding salvage therapies. Newer radiopharmaceuticals are now used in systemic cases and some treatments using mabs have passed clinical trials phase 3, however the real revolution regards imaginology with PET scans. CT and MRI search for volumes whether PET looks at celular level. Google PET-PSMA for details.

In regards to good hospitals, I recommend you to procure one close to your home because radiation is administered in several sections (about 35) everyday except on Sunday, taking about 20 minutes each time. The facilities should be modern with the latest equipment.

It will save you travel time.

Best

VG