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The things to look for in an ascending PSA is the velocity and doubling time. You also need to remember that advancing years equates with increasing psa values. So from 0.1 in 2018 to 0.5 in 2023 is only a modest increase Judy. But the 6 monthly checks are very much in order. In addition biochemical recurrence is only reached when the psa value increases from its NADA (0.1) in your husbands case to 2.01. So I suspect that will be many years down the track. Plus there are some other caveats as well. So get out there and enjoy yourselves, you are doing everything reasonable. Further questions just ask.
John, greatly appreciate your response. But I am still not clear as his
Urologist seems concerned, while the radiation oncologist is not. His last 4 PSA readings have been rising. Also this article on biochemical recurrence:
I think I am with your Radiologist on this one. Even with your worst scenario, biochemical recurrence (Nada plus 2.0), treatment in all likelihood would not be offered until PSA has reached 3.0. The reason? The tumour volume would be very small and amiable to further treatment if required. Judy there is no cure for prostate cancer. Given enough time, sometimes decades, it will surely return. But with todays pharmaceuticals even guys with advanced metastatic PCa (PSA in the hundreds< even a thousand or two) can still lead comfortable lives for many years. Most guys today die with prostate cancer not from it. You basically have two choices Judy, 1) continue your quest for not so nice answers or 2) focus on enjoying life with your husband. I hope you choose two!
John, thanks again for your response. I do really appreciate the information and your prospective. However, since I am limited in what I can write here do to
time constraints, what I have to consider is my own observations of those who acted too slow to PSA rising and are now, contrary to what you wrote, are living horrible lives. A former co-worker whose husbands PC spread due to his PC doctor not
ordering regular PSA tests and so being diagnosed at a later stage. This man, sadly,
on hormone therapy and is living a life where he and his wife are
not very happy to put it mildly. This treatment does not cure anything and
has horrible side effects. Now he is going off of it and will try a wider
radiation to his abdomen. (God only knows what that will do to his organs..) But
he feels it is worth the risk rather than to "live" the way he is. So that is
just one example of what can happen if you do not nip this horrific disease in
the bud. The concern we have is to get it while it is confined to the prostrate.
So if you wait till PSA 3.0 it may be already have metastasized. Anyway, I
know you mean well in your thoughtful responses and have been very helpful. But
we are enjoying our lives - just don't want to regret not having acted in time as
there is no way to undo that decision. Of course, the fact our highly experienced
urologist does seem concerned and he has treated many PC patients over the years, is something he needs to consider. I was looking to hear from other HDR PC patients to
learn what their experience has been over the years.