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Medical Forum / Diseases and Disorders / Prostate Cancer / December 2005

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Great news -- PSA Reversal

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jhhtexas@ieee.org - 08 Dec 2005 04:14 GMT
I posted last year with a concern that my PSA after RRP was creeping
up:

3 months - 0.03
9 months - 0.07

At that time, C. Palmer had also expressed a concern about his PSA
going to 0.05.

My 1 year reading was 0.08 which looked like it was starting to level
off.

I just got my 18 month reading and it has reversed down to 0.05.

This is great news, I was starting to worry about a gradual upward
trend. I know I still have to make it to the 10 year mark at below 0.2
to be relatively secure.

My Uro said he was never worried with a PSA of 6.6, Gleason 6 and PCa
totally contained at post-RRP pathology report. Some people have a
small residual PSA reading after PSA that never rises.
Glassman - 08 Dec 2005 05:20 GMT
> I posted last year with a concern that my PSA after RRP was creeping
> up:
[quoted text clipped - 13 lines]
> trend. I know I still have to make it to the 10 year mark at below 0.2
> to be relatively secure.

 I think I told you at the time that those readings were so minute, that
they were more likely in the statistical range of undetectable anyway.
Congrats!

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richk - 09 Dec 2005 00:51 GMT
There are a couple of articles that say ultrasensitive PSA above .02 after
RP is a bad prognasticator.  Witherspoon and Doherty are the authors of
the articles and Dr. Strum cites these articles often.
I am 3 years post RRP and my ultrasensitive PSA's have ranged from .035 to
.070.  My pathology post-surgery was cancer contained and clear margins.
My preop PSA was 5 and Gleeson 6.  
Not getting to less than .02 has been a concern but my doc says there are
alot of post surgery patients with my numbers.
Steve Kramer - 08 Dec 2005 10:54 GMT
>I posted last year with a concern that my PSA after RRP was creeping
> up:
[quoted text clipped - 9 lines]
>
> I just got my 18 month reading and it has reversed down to 0.05.

That is fantastic!  When I had my RRP (almost 5 years ago), they were still
speaking in terms of <0.1.  You have always been undetectible by that
standard.  Considering how mine has fluctuated under 0.1, (.07, .05, .06,
.05, .08) I wonder if that shouldn't still be the standard.

Signature

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

Buttercup's Dad - 08 Dec 2005 12:33 GMT
They do not do the ultra sensitive tests where I get mine done.  Of course,
where I get mine done they also will not give me the results unless I come
in the office to get it!  Blame "HIPPA".  Cannot give out patient
information over the telephone they tell me.  Not secure.  I wonder how
secure my medical record is sitting on some desk somewhere.  How did I get
off on that?

What I meant to say is that I wonder if they are really doing us a
disservice by reporting the numbers under 0.10?  How much of the fluctuation
is due to other factors, e.g., the batch of reagents used in the test
processing, the machine calibration, the temperature, and so forth?  I
detect a lot of tension in some of the posts here when a result goes up .01
point.   Does that really indicate anything of significance?

> I posted last year with a concern that my PSA after RRP was creeping
> up:
[quoted text clipped - 17 lines]
> totally contained at post-RRP pathology report. Some people have a
> small residual PSA reading after PSA that never rises.
ron - 08 Dec 2005 15:03 GMT
Buttercup's Dad wrote...snip...
> What I meant to say is that I wonder if they are really doing us a
> disservice by reporting the numbers under 0.10?  How much of the fluctuation
> is due to other factors, e.g., the batch of reagents used in the test
> processing, the machine calibration, the temperature, and so forth?  I
> detect a lot of tension in some of the posts here when a result goes up .01
> point.   Does that really indicate anything of significance?

The us PSA test provides at least 2 pieces of additional information
for post_RP men or men using HT.  First, the lower your PSA goes after
RP or during HT (or after RT for that matter), the better the
prognosis.  Second, it provides earlier visibility to recurrence and,
consequently, more time and datapoints to plan and estimate doubling
time respectively.  Dr. Strum and a number of others recommend its use
in these settings.  Using the same lab and routine (time of blood draw,
etc.) helps to minimize variation.  Although the test reads to 3
decimal places (e.g. 0.003 ng/ml), many labs round it off to 2 decimal
places (e.g. 0.02 or >0.01 ng/ml) to further limit the effects of
variation   Of course, it's a personal choice as to how much data an
individual chooses to have, but make no mistake, there is valid data
there.  We need to keep in mind, however, that just as with the
standard PSA test, the trend is more important than any single
datapoint...Ron
Steve U - 08 Dec 2005 22:46 GMT
jhhte,
Wonderful news!May you have many more happy results.
Steve U
 
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