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I'm interested in experiences others may have had with fluctuations in PSA values below the standard assay detectable range >0.1. I elected the adjuvant I am a G9 post RALP, 9months Lupron and 35 IMRT. I elected to have the adjuvant therapy on the advice of Mayo medical and radiation oncologists to effect a "cure". PSA 3 months post surgery (pT3aNOMO) came in at 1.5. Prior to commencing ADT two subsequent PSA's came in at 0.22 and then<0.1?
Ultrasensitive PSA's during and after completion of treatments Mar2015 remained <1.015 until Jan2016 at0.092. One month follow-up back to <0.015. 3 months later 0.073, one month follow-up <0.015. Earlier this month 0.065. Curious if others have had similar results. I have read the article on site regarding other possible sources for PSA following surgical removal.
Larry; I am going to be no help here for you but would like to comment anyway. My understanding is that there are some other minor normal sources of PSA in the body and these very sensitive tests may pick up those readings. I have read that even women can have some PSA reading if tested so go figure. Also, as with any super sensitive testing etc. Very small variances can look magnified in these circumstances. It could be a situation where too much information is detrimental if all the variants aren't fully understood. Also, I don't know how much human input there is in interpreting these test results so that may be another variable. I know that we all would like to see a ZERO on our test results. I think we are all on the same page there. I think you are as close to that ZERO as can be hoped for under the circumstances and the ultra sensitive tests may be causing you more worry than you deserve. Remember - this is all just my layman's opinion. Jon R.
Thanks for your response. Very kind of you to take the time. You may be certain that I am blessed to have such minor issues. I continue with my exercise and moderation in diet and drinking, and keeping a watchful eye.
It is unusual to have no trend with PSA like that at this point in your treatment. I have heard of this happening 5 to 10 years after treatment. My guess is that the PSA is coming from the dying prostate cancer cells. I suspect that a trend will develop in the next few years (good or bad) but you are down to low PSA values now so that is good and it was a very good decision to get the adjuvant treatment. The other sites for PSA do not really produce any significant PSA even with the ultra-sensitive test.
Thank you for your response. My PSA history continues to be confusing, but I take comfort in the trends both prior to adjuvant therapy and now. I find myself wishing there were more extensive nationwide and worldwide data bases tracking more detailed analysis of PCa to address these issues.
One new trend that will help you in the future is the "liquid biopsy" which is a blood sample that is tested for stray DNA strands in your blood from cancer cells that have recently died. ( this is actually being done now in at least one cancer center I know of) They can test the PC DNA and determine how aggressive it is, any drugs that are effective against it and if the PC is likely to be lethal.