This forum is for the discussion of anything to do with Prostate Cancer. There are only four rules:
No fundraisers, no commercials (although it is OK to recommend choices of treatment or medical people based on your personal research; invitations to participate in third-party surveys are also acceptable, provided there is no compensation to YANA);
No harvesting e-mail addresses for Spam;
No insults or flaming - be polite and respectful at all times and understand that there may be a variety of points of view, all of which may have some validity;
Opinions are OK, but please provide as much factual evidence as possible for any assertions that you are making
Failure to abide by these simple rules will result in the immediate and permanent suspension of your posting privileges.
Since this is an International Forum, please specify your location in your post.
The consideration of "Active Surveillance" (formerly "watchful waiting") should be based on some indication that your cancer is not growing rapidly or about to escape the confines of your prostate gland and set up housekeeping someplace else. Unfortunately as imperfect as it is, the PSA test is the only means available to monitor POSSIBLE cancer growth. Since factors other than cancer growth can result in PSA increases, your should take precautions (such as you did in avoiding ejaculation) before each test to try to have the same conditions present in your body when the blood for the test is drawn. This may reduce the severity of the fluctuations exhibited in your last three PSA tests. Following is some old information you can use as a guide (the columns will line up if displayed in a unispaced font such as Courier):
Condition/Manipulation Effect on Persists
PSA Level Up To
Acute bacterial prostatitis 5-7 fold 6 weeks
Acute urinary retention 5-7 fold 6 weeks
Digital Rectal Exam (DRE) Variable 3 days
Exercise - bicycle 0-3 fold 1 week
Prostate biopsy Very Variable 6 weeks
Prostate massage Variable 6 weeks
Ejaculation Variable 3 days
TURP Very Variable 6 weeks
There can also be a great amount of variability in any individual's PSA from day to day, as discovered by Terry in an experiment he did many moons ago. You should always use the same lab and same assay. There exists no standardization between different "brands" of PSA tests and different essays will produce different results for the very same blood sample.
If future 3-month PSA tests do not show inordinate increases, then the continuing active surveillance track can be pursued. I do suggest that you get a Free PSA test done the next time, since the free vz. bound PSA ration can give an indication of the aggressiveness of your cancer.
Back in 1997 when I was first diagnosed, the velocity with which my PSA was increasing did not provide the luxury of AS (then "WW"). Use the time to keep investigating possible treatments, so that if and when the time comes, you will be able to make an informed decision.
Good luck! Believe it or not, I still recall the difficulty of making my treatment decision 13 years ago.
