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hello, i am a 51 year old husband and father, in june of 1999 was dx wth pc.. gleason was 6, psa was 9,,T2b
nodes were negitive, seminal vessicals were negitive.
did a rad prostectomy in july of 1999, since then psa
has been 0, lifes good, until last psa which was .2
doc says probably lab error but wants another in 6 months instead of 1 year. any thoughts? doc says recurrence after 9 years is unlikly, althoiugh not impossibe, should i be worried? i'm a bit worried, but not like in 1999. what do you think?
Before discussing the concept of ‘failure’, I think it is important to understand that there are over 200 definitions of ‘failure’ and most of them depend on the interpretation of the PSA tests which are, of course, notoriously unreliable. It is important not to fall into the trap of assuming that a marginal increase in PSA is a forerunner of mortality.
First the ‘bad’ news – I have to say that all of the current treatments can fail. As your doctors says, it is unusual for failure to occur at nine years but we have to be honest and say that although the time frame is usually shorter rather than longer, there have been reports of failure as, long as 20 years after surgery. These long term failures are usually controllable by secondary treatment such as ADT (Androgen Deprivation Therapy) and are unlikely to be fatal, at least in the short term.
So what ‘good news’ is there?
In the first place, again, as your doctor says, there is a chance of lab error or a change in the test being used. I had correspondence recently with a man who was thinking of getting a biopsy because had some odd PSA results – some up some down. I suggested he get copies of all the tests to ensure, as a first step, that they were all from the same manufacturer’s machinery. He was reluctant to do this because they were all from the same lab, but it turned out that the lab had changed suppliers twice in the period – and the three most worrying tests were from differing protocols.
So, I’d make the same suggestion to you – do you have copies of all the relevant tests so you can check this aspect.
Secondly there may well be some condition other than PCa that has caused this blip – after all there are many glands in the body that create what is identified as PSA – it is NOT prostate gland specific or prostate cancer specific.
Thirdly, even the best run labs occasionally get specimens mixed – so this may not be your result anyway. I gave my path slides to a leading US institution as part of my investigations when I was first diagnosed. They sent the slides back to me at my request, but the slides they sent were labeled with a different name! They never found my slides.
Good luck – and don’t worry too much if that’s possible! But if it's not possible, why not get another PSA test now - ensuring if possible that it's done in the same method as the previous ones.
terry, thanks for the prompt reply, i'm not going to worry too much about it, but i probably will get another psa test sooner rather than later.
also, just wanted to let you know that sharing your knowlage on this subject is a wonderful service to guys who are shocked and many times very scared.
i'm sure i'll post again, and in meantime will be praying for all who have to indure this issue.
