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PSA rising slowly

Steveun21
Posts: 3
Joined: Jan 2011

Hi I am new here, had a radical in 08 PSA stayed a 0 form 9 months then went to .01 stayed there for 6 months then went to .02 last test in 1/11 was .08. Dr. said he is not overly concerned. Should I be?

Steve

califvader's picture
califvader
Posts: 108
Joined: Aug 2010

you and i have similar experiences. i had a radical in 03. over the last 7 years my psa has risen very slowly. started out just like yours and now it is 5.8. i would say that eventually you'll have to make a decision on futher treatment. like i am now. all i can say is don't rush into anything and do your research. you'll find the members here very heplful and making you aware of questions that you can ask your urologist. my urologist is suggesting lupron treatment now for me. i haven't made my final decision yet.

Steveun21
Posts: 3
Joined: Jan 2011

Thanks for your respnse I have been reading through the previous postings.

VascodaGama's picture
VascodaGama
Posts: 3406
Joined: Nov 2010

Your doctor may be right for not being overly concerned, but something is causing the increase in PSA and that is of concern. Particularly because the PSADT (doubling time) is lower than 6 months.
Without any justifiable reason for the increase, your case is at chemical failure. Recurrence is usually declared when PSA gets to 0.2, which may be your doctors threshold to become “concerned”.

I would suggest you to do some researches on the causes for the increase as well as on any possible treatment you may have to undertake.
Here is a site where you can find information about the PSA significance;
http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines/main-reports/psa09.pdf

Wishing you the best.
VGama

Kongo's picture
Kongo
Posts: 1166
Joined: Mar 2010

Hi, Steveun and welcome to the forum and I'm sorry that you're having some PSA anxiety over this. As Vasco suggests, SOMETHING is going on. Whether or not it's a recurrence may be too early to tell. One question for you: Is the doctor your referenced your general practitioner or your urologist? If it's your GP, I would strongly urge you to schedule an appointment with a oncologist that specializes in prostate cancer or a urologist that you are comfortable with. It may be something as simple as your doctor changed labs or the lab is using a different procedure to run the PSA test. If that's the case you simply need to readjust your baseline and continue to monitor your readings. If nothing unusual is going on with the labs then you will want your urologist to rule out some other cause for a growing PSA such as a urinary tract infection or something else that may not be giving you any symptoms.

Following RP, most urologists subscribe to the notion that a PSA score greater than 0.2 ng/ml and increasing is a sign of biochemical recurrence of your PCa. While you're not technically there yet, something is causing your PSA to rise and you and your medical team should be looking for some answers that make sense. You should be aware that there are perhaps a dozen working definitions of recurrence floating around out there in various studies and scientific papers but the consensus seems to be that the 0.2 ng/ml level is critical for men who have had their prostates removed.

Regardless of which initial treatment we choose, all of us are faced with the potential of a recurrence at some point in our lives. Prostate cancer is a lifetime relationship. Sometimes it's smooth sailing, sometimes it's bumpy. While it's too early to know for sure what your future looks like it's never too early to educate yourself about potential treatment options in future years should you and your medical team decide more treatment is necessary.

Best of luck to you.

K

lshick's picture
lshick
Posts: 62
Joined: Apr 2009

One of the elements of accepted wisdom about PCa is that more guys die "with" it than "of" it. Your prostatectomy (and mine) have knocked the cancer back in the pack, and increased the chances of "with" rather than "of."

One measure of post-recurrence aggressiveness that some researchers like is called "PSA doubling time," i.e. how many months does it take for the PSA number to double? Big doubling time means low aggressiveness, higher odds for "with" rather than "of," and less reason to intervene with things that will do bad stuff to your quality of life.

Google "PSA doubling time" for more information. Good luck.

tarhoosier
Posts: 195
Joined: Aug 2006

Steve:
Before you can have a meaningful discussion here or with your doctor(s) you must obtain, read, and fully understand the pathology report from your surgeon. This is packed with all of the information necessary to understand where you were at that point and in what direction you may be going. Decide nothing until this has occurred.
You can return here and receive worthwhile anecdotal information once you and we understand your precise medical status. Without that information anyone is just shooting into the dark.

Steveun21
Posts: 3
Joined: Jan 2011

Thanks for all the responses I have the pathology report it I have the pathology report I will read it over again. The doctor my urologist did go over it with me but that was along time ago. Thanks Steve

YTW's picture
YTW
Posts: 67
Joined: Apr 2010

Welcome to the group. Alot of honest & good information here. I agree with Kongo. It is important that you have your PSA test done at the same lab. I had my treatment (CK) done at
the University Hospitals here. My radiation oncologist (RO) advised me to continue to have my PSA work done at the same lab (not theirs)that had been doing it for years. The reason being that there can be variations in the test results due to testing procedures. Also, thumbs up on Tarhoosier's post. Best of luck................................................

Jimmy/Cleveland

subu1970
Posts: 13
Joined: Jan 2011

I am having a similar problem (please see the back pages). It is bothersome, but you know
worrying about it is the last thing you want to do. Be concerned but keep your life busy -
this will take your mind off of it. Do keep in regular touch with your doctors as I am
sure you are.
Welcome to the discussion board and we all wish you the very best.
Cheers.

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