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So what is an undtectable PSA

Steve1961
Posts: 301
Joined: Dec 2017

In a few weeks I will 1.5 years done with combo radiation treatment ..anxiety is starting to build ..3 months back PSA was 2.0 ..this is why I'm seeing the surgeon /urologist.he is a specialist.i know the radiologist won't be concerned if it is still dropping even if it drops to 1.5 ..but the surgeon will be more concerned ...i so regret doing this ..no where can I read thst radiation works by killing cancer cells and making it impossible for them to multiply ..it says makes it harder for them to grow or slows down the growth ....anyone who is thinking about doing the criiminal radition treatment as primary choice please thinkkkk hard about not doing it ....it is extremely nerve racking ..believe me ..especially in younger men like me only 57 at the time ..I have read that other procedures should be done if possible ..THAT tells me there should be some kind of regulation prohibiting this radition therapy as long as the patient is healthy enough for surgery ..any other cancer you need surgery to remove the tumor period .just because the tumor is inside a gland that we may not need doesn't mean it shouldn't be removed ..this is my thought and it's a good one ..the side effects of surgery even leaking terribly or total incontinance no erection at all me is a small price to pay for KNOWING the cancer is Gone and not taking the chance  of giving yourself another cancer ,,just think I put poisen in my body to kill a poisen  ..that  poison may not kill the other poison and may give me another cancer later on in life ...sucks 

Georges Calvez
Posts: 463
Joined: Sep 2018

Hi Steve,

Your PSA is never going to fall to undetectable levels for the simple reason that you still have a prostate in place.
What you are aiming for is a low stable PSA over time.
Laboratories battle to offer the PSA test offering the lowest detectable limit and urologist and biochemists fight over the significance of the tests.
Some men post RP will go below 0.05 ng/L, maybe as low as below 0.003 ng/L.
There are men that have been treated for bladder cancer by having the whole bladder, prostate, etc removed and they still have a PSA of around 0.1 ng/L
PSA tests are not that reliable and PSA levels in men with a prostate moves around a bit even in healthy men.
I know this sounds hard but you have to take things as they come.

Best wishes,

Georges

ASAdvocate
Posts: 139
Joined: Apr 2017

The overall recurrence rate after surgery (all risk levels) is 35 percent. So, your point about "KNOWING the cancer is Gone" with RP is not factual. You have been complaining about your RT here, and on other boards, since you did it. Would you have been happy with surgery???

Your post-RT PSA will bounce around for up to three years, or more. Please try to get your mind off of the worst outcomes. You are just making yourself anxious.

Georges Calvez
Posts: 463
Joined: Sep 2018

Hi there,

Steve had a low PSA, Gleason Grade and staging so his chance of recurrence would have been very low, certainly much less than the all patients recurrence rate of 35%.
Given his age and staging he would have been a good candidate for bilateral nerve sparing so he would have had about a two in three chance of regaining reasonable potency and only about a ten percent chance of serious incontinence.
Not bad odds but it could have all gone seriously wrong for him.

Best wishes,

Georges

Clevelandguy
Posts: 590
Joined: Jun 2015

Hi all,

Need to look at the numbers ASA posted in comparison.  According to one of ASA's sources sited in another recent post yes the reocurance rate for all types of Pca treated with surgery was 34%, but 25% of those cases had cancer outside the gland.  Factor that out and the percentage drops to around 25%.  Another source he sited says that various types of radiation treatments range from 7-32% reoccurrence . I know I would never have surgery if my cancer had spread to adjacent organs or tissue.  You need to really study the data to see what the sources are talking about.  The whole cancer treatment radition vs surgery is a crap shoot as to re-occreance.  Surgery is a good choice IF the cancer is contained as is radiation.  In my opinion radiation is better to control or eliminate the cancer if it has spread to other areas outside the Prostate. Surgery can have short term or lasting ED or leakage problems.  Radiation can have bowel & bladder short & long term side effects also.  So which is the best? There is not a best or perfect treatment except the one you pick based on your circumstance.

Dave 3+4

Clevelandguy
Posts: 590
Joined: Jun 2015

Hi Steve,

Diddo to what Georges said, you need to chill and not let this consume you. I know that's easier said than done but maybe seeing a professional might help.  Just remember there are always people worse off than you. The guy living in the house behind me has Pancreatic cancer, just think what he is going through, mental & physical!! I hope you are cancer free and live a productive long life, start planning for the future(projects, vacations, ect.) and try to not dwell on the past so much.  Good luck Steve, control what you can but not what you can't.

Dave 3+4

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