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Re: Rising PSA

Hi Joe, sorry to hear your j/bump. worrying about it will probably only exacerbate the problem. wishing you the best chris nz

Re: Rising PSA

Joe 67,

I know you had RT but have you been on ADT too? Everything I've read about RT said not to worry about a small bump in PSA 12 to 18 months after so I don't think I'd worry about it. Of course I know that's easy for me to say and hard for you to do :-)

On another note. I've seen more than once where a Doctor said that patients worry way too much about small changes in PSA, and even IF IT IS progression often the increase is very slow and never becomes a problem. So keep the faith !!!

The Stranger

Re: Re: Rising PSA

Aloha Stranger,
Was on ADT June 07 to June 08, Lupron Depot 3 mth shots to hips, they still hurt.
Joe

Re: Re: Re: Rising PSA

Joe 67,

I remember now, you talked about your hips hurting after the injections, sorry I forgot.

The reason I asked about ADT is I thought you must have been on it for the PSA to go down that low after RT. So this information makes me think you shouldn't worry about the increase since this blip is from getting off the ADT. In fact it might go higher since the ADT is wearing off now. I seem to remember for RT guys reading several times that .2 to .4 is the point where a Doctor starts to be concerned, and then only after a steady increase. So for now I'd do my best not to worry about it.

The Stranger

Re: Rising PSA

Sorry to hear about your worries, Joe. My last PSA (last month) was 0.1, up from 0.01 a couple of months ago. I know how you feel. I'm apprehensive too. My next test is in February and I'm worried as well.

Keep a good thought,

Paul A. RI, USA

Re: Rising PSA

Hi Joe. We are all suffering from PSA (Prostate Specific Anxiety)and it's only natural that you will worry about your reading. But from what I read I think The Stranger is right to say that bumps can still be expected this far out from your radiation treatment. (You are still only 15 months out I think).

I just had my PSA at 17 months post robotic (similar story to Paul A - the robot left a bit of my prostate behind). My PSA chart is as follows: 1.58 at 6 weeks post; 1.62 at 12 weeks post; 0.67 at 6 months; 0.76 at 7 months; 0.76 at 10 months; 0.81 at 13 months; and now - at 17 months out - PSA down to 0.42.

I found Terry's PSA 101 stuff of the greatest help. The measure of PSA seems to show huge variations and I don't think you should decide anything without a clear evidence of progression. Also you have to weigh any progression with the pathology you have of your prostate before treatment (and in my case after "removal").

FWIW I found that the greatest comfort for me was to make a plan and stick to it. Since the partial failure (or partial success?) of my op I resolved to avoid all further intervention until the odds dictated it. That includes not having a template biopsy yet. I am 63 and decided after a TURP and then a prostatectomy all since 2006, I would let myself settle down.

I have had a further TRUS scan and enhanced MRI and they say they show nothing that looks bad. So every 3 or 4 months I have the PSA tested and if tracks up clearly and beyond normal variations of around 10 to 5 per cent, then I shall let them do the biopsy of my 6 grams.

If I eventually have a biopsy and they find more cancer I will still have to decide how to act. If I think it is as insignificant as I am now told what they removed was I may well leave it anyway.

Sorry to write a lot about me here, Joe, but what I'm getting at is how to avoid Prostate Specific Anxiety and I can only deal with that by telling you what I do. I think you need to make a calm and clear plan of monitoring yourself over time. Otherwise we spend so much time worrying about tomorrow that we no longer enjoy today.

Ted from England
PS I just read a really interesting thing about "Sully" the airline pilot who saved all those people by the way he ditched in the Hudson. It seems that guys like him feel the same fear as we all do, but what stops them panicking and running crazy from the cockpit, is that although they are able to *feel* the fear, they overwhelm it by being absolutely rational and following all the plans they make in their training. It seems to be a very advanced example of mind over matter. These guys of course train, and train again, in a simulator. We on the other hand have no PC simulator. We live with the C word and it's very easy for the anxiety to build up and take over.

Re: Rising PSA

Sorry guys, typo, I said "and beyond normal variations of around 10 to 5 per cent," but I should have said 10 to 15 per cent.

Ted

Re: Rising PSA

Hi Joe,
You are about 4 months ahead of me since end of radiation treatment. Like you I also had hormones although mine were neo adjuvant (before radation). But of course the effects of the hormones will linger on for about six months or more after your last shot. I note that you have your last shot in April 2008. So we could expect your PSA and testosterone levels to rise by say about December January. Your January PSA came in at 0.12, approximately double the 0.05 that was the reported low in your treatment chart that I read.

OK now we both still have our prostates unlike the surgery guys. So our PSA levels are never going to be zeros.
Mine is currently 0.1ng/ml and I am very happy with that Joe. You also may care to read my treatment chart as well.

Now papers that I have read suggest that after external beam radiation, PSA can decrease over 1 to 2 years to a mean value (nadir) of less than 1.0ng/ml, which is indicative recurrence free survival. Note that figure Joe, 1.0. Now you are currently at 0.12ng/ml, which is looking ok in my opinion. It is far to early to speculate just yet Joe. And I know after reading your treatment charts that you have had issues to deal with. So Joe, relax smell the flowers and enjoy each day as it comes. Who knows, perhaps several years down the track we may both look back and wonder what all that PSA anxiety was all about, LOL.

Cheers John

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