PSA rising after RRP
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From: otto on 25 Jan 2006 17:53 Hello to all, I am 51 yrs old and had RRP in January 2005. I found this group after my surgery while recovering and have just been lurking until now. I was diagnosed with PC Nov. 2004, PSA 8.2, Gleason 4+3=7, stage T2c. Post-op pathology showed neg margins, clear lymph nodes and vessals. Tumor was within 0 .1mm of inked margins. Incontinance is still a problem, although it is still improving very slowly. ED is just now becoming a non issue with ED pills. It's been a long tough year. Post-op psa tests have been at 3 month intervals and have all come back undetectable until yesterday. That test showed that my psa is now 0.25, which to me seems like quite a jump in just 3 months. The uro sent my blood sample to another lab in hope that maybe his machine didn't work properly. I can call him tomorrow for the other lab's results. He said he will retest me in 2 months and if it's still reading, he will refer me to a radiation oncologist. My question is, if there is a psa reading now, why wait another 2 months? Wouldn't I be better off getting treatment sooner than later? I know that there are people in the group that have been down this road and I would appreciate any advice or experiences they could offer. Thanks, Otto Does anyone know of a good radiation oncoligist in the Syracuse, NY area?
From: c palmer on 25 Jan 2006 18:55 From: otto(a)bearswamp.net (otto) I am 51 yrs old and had RRP in January 2005. I found this group after my surgery while recovering and have just been lurking until now. I was diagnosed with PC Nov. 2004, PSA 8.2, Gleason 4+3=7, stage T2c. Post-op pathology showed neg margins, clear lymph nodes and vessals. Tumor was within 0 .1mm of inked margins. Incontinance is still a problem, although it is still improving very slowly. ED is just now becoming a non issue with ED pills. It's been a long tough year. Post-op psa tests have been at 3 month intervals and have all come back undetectable until yesterday. That test showed that my psa is now 0.25, which to me seems like quite a jump in just 3 months. The uro sent my blood sample to another lab in hope that maybe his machine didn't work properly. I can call him tomorrow for the other lab's results. He said he will retest me in 2 months and if it's still reading, he will refer me to a radiation oncologist. My question is, if there is a psa reading now, why wait another 2 months? Wouldn't I be better off getting treatment sooner than later? I know that there are people in the group that have been down this road and I would appreciate any advice or experiences they could offer. Thanks, Otto Does anyone know of a good radiation oncoligist in the Syracuse, NY area? ========= hi otto - been there, done that. there seems to be two schools of thought. one - is the wait and see if the psa still continues to rise, then act on it. two, is a more active SR treatment and not wait. my surgeon leaned toward early intervention when my psa became "detectable" i was schedule for a 90 day psa test and those 90 days does make you wonder and doubt. but the test came back "undetectable" again. when i ask about it, i was told that tests can "misfire" and this was at a VA hospital. that sure makes you wonder. the psa test was not sent to some testing place, but is done at the hospital lab. you have to wait for time to past to find out just what is going on inside your body. it is hard for the surgeon to get ALL the prostate tissue. they do not want to admit to this. most of the time, this is not a problem, and that is why the psa test is so important - to detect any prostate cells producing psa. but the tissue left behind could be regular prostate cells, BPH cells, or pca cells. this is why the time period on waiting. so, what you have right now is the waiting period before making a decision. ok, making the decision - what you have to understand that if you decide to have radiation therapy, then you have used the second chance for a cure. you can't keep getting more radiation if the psa were to rise again later in life. these are one shot treatments because radiation damage adds up and the damage to other organs and tissue can cause quality of life issues. and the incontinence issue - it took 11 months to get to 99% dry. coming up on 3 years, it hasn't changed any, but i can live is the dampness. final comments - your stats look good going in before treatment and the end results of the path report is normal to be assigned T2c. you stand a real good chance that the psa rest will come back undetectable as i see it, but of course, the waiting sucks. ~ curtis knowledge is power - growing old is mandatory - growing wise is optional "Many more men die with prostate cancer than of it. Growing old is invariably fatal. Prostate cancer is only sometimes so." http://community.webtv.net/PALMER_ENT/doc
From: GregL on 25 Jan 2006 19:19 G'day Otto I had a similar experience. My PSA was around 8.0 and biopsy was positive (4 of 6 positive). Had RP surgery in 1995 aged 43. After three months my PSA was <0.1, three months later it was 0.3. My doctor immediately advised radium based on this result. He wasn't interested in a retest so I got it done myself with another lab and the result was <0.1. After telling the doctor the results of this retest he still advised radium so I had 6 weeks of radium. Not sure who was right but last PSA done in June last year was <0.01. Cheers and good luck greg "otto" <otto(a)bearswamp.net> wrote in message news:jgsft115pob307d0634r8ml42gldccfs7f(a)4ax.com... > Hello to all, > > I am 51 yrs old and had RRP in January 2005. I found this > group after my surgery while recovering and have just been lurking > until now. I was diagnosed with PC Nov. 2004, PSA 8.2, Gleason 4+3=7, > stage T2c. Post-op pathology showed neg margins, clear lymph nodes and > vessals. Tumor was within 0 .1mm of inked margins. Incontinance is > still a problem, although it is still improving very slowly. ED is > just now becoming a non issue with ED pills. It's been a long tough > year. Post-op psa tests have been at 3 month intervals and have all > come back undetectable until yesterday. That test showed that my psa > is now 0.25, which to me seems like quite a jump in just 3 months. The > uro sent my blood sample to another lab in hope that maybe his machine > didn't work properly. I can call him tomorrow for the other lab's > results. He said he will retest me in 2 months and if it's still > reading, he will refer me to a radiation oncologist. My question is, > if there is a psa reading now, why wait another 2 months? Wouldn't I > be better off getting treatment sooner than later? I know that there > are people in the group that have been down this road and I would > appreciate any advice or experiences they could offer. > > Thanks, > Otto > > Does anyone know of a good radiation oncoligist in the Syracuse, NY > area? >
From: Steve Jordan on 25 Jan 2006 19:29 On January 25, otto wrote, in pertinent part: (snip) > Post-op psa tests have been at 3 month intervals and have all > come back undetectable until yesterday. That test showed that my psa > is now 0.25, which to me seems like quite a jump in just 3 months. The > uro sent my blood sample to another lab in hope that maybe his machine > didn't work properly. I can call him tomorrow for the other lab's > results. I would counsel Otto to wait overnight for the new result. Caveat: one serious problem with changing labs used for PSA tests is that there is little or no consistency from one lab to another. In other words, tomorrow's result may or may not be meaningful when compared with the previous result. The uro should know that, but apparently does not. And who knows whether the uro's "machine" is properly maintained and calibrated? My experience, which may or may not be relevant to Otto's, is this: after eight months of <0.01 PSAs I tested 4.85. Scared the hell out of me. My onc recommended starting chemo. I had the test redone within a week. Result: 0.01. The lab had made a mistake. It happens. > He said he will retest me in 2 months and if it's still > reading, he will refer me to a radiation oncologist. My question is, > if there is a psa reading now, why wait another 2 months? Wouldn't I > be better off getting treatment sooner than later? I believe that what is needed at this point is the ultra-sensitive PSA test, such as the DPC Third Generation ICMA method. Refer to the website of the Prostate Cancer Research Institute at: http://prostate-cancer.org/index.html And also what is needed is a reference that covers a reasonable period of time. A snapshot -- one test -- means little. I recommend ultrasensitive tests on a *monthly *schedule. Any trend will quickly become evident. And the ultrasensitive tests give the patient early warning of trends. If the RP has failed to cure, I have to say that this happens fairly frequently. The problem seems to lie in the fact that it is virtually impossible to be sure whether the PCa has expanded to anatomical structures other than the prostate. When the uro moos "we got it all!" watch out; in truth, he doesn't really know. The lower the test results, the more likely is this to be the case. But the uncertainty increases with each increase in the results of the staging tests. And, of course, a full course of staging tests is quite rare, which is IMO a scandal. (snip) > Does anyone know of a good radiation oncoligist in the Syracuse, NY > area? > Check this page of the PCRI website. It is not comprehensive, but is a good start: http://prostate-cancer.org/resource/special.html#radiation_oncology Regards, Steve J "Flagrantly, we docs ignore the declaration of biology. We do this out of ignorance, greed or both. The prime directive of the physician, the real physician, is patient outcome, & not physician income (or ego). -- Stephen B. Strum, MD
From: Steve Kramer on 25 Jan 2006 21:01
"otto" <otto(a)bearswamp.net> wrote in message news:jgsft115pob307d0634r8ml42gldccfs7f(a)4ax.com... > Hello to all, > Post-op psa tests have been at 3 month intervals and have all > come back undetectable until yesterday. That test showed that my psa > is now 0.25, which to me seems like quite a jump in just 3 months. > He said he will retest me in 2 months and if it's still > reading, he will refer me to a radiation oncologist. My question is, > if there is a psa reading now, why wait another 2 months? Wouldn't I > be better off getting treatment sooner than later? I know that there > are people in the group that have been down this road and I would > appreciate any advice or experiences they could offer. I've been down the road that you think you're on. Three quarterly tests, then a 0.27. Pissed me off. But, it was the next one, the 0.37 that cinched it. You need three consecutive tests to show a real cancer trend. Be patient. If radiation is to be, you have plenty of time. -- PSA 16 10/17/2000 @ 46 Biopsy 11/01/2000 G7 (3+4), T2c RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins PSA .1 .1 .1 .27 .37 .75 EBRT 05-07/2002 @ 47 PSA .34 .22 .15 .21 .32 Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05 PSA .07 .05 .06 .05 .08 Non Illegitimi Carborundum |