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Medical Forum / Diseases and Disorders / Prostate Cancer / May 2006Risng PSA
I am 2 months into hormone treatment (casodex and lupron). My first month PSA wnet from 44 to 6.1 to 3.1 on 4/25. My PSA taken 5/24 showed a rise to 5/14. Could this be an aberation, a bounce or early signs of refraction setting in? Duke On May 24, Duke Slater inquired: > I am 2 months into hormone treatment (casodex and lupron). My first > month PSA wnet from 44 to 6.1 to 3.1 on 4/25. My PSA taken 5/24 showed > a rise to 5/14. Could this be an aberation, a bounce or early signs of > refraction setting in? > I assume that Duke meant 5.14 for the 5/24 result. Does this mean that the tests are of the ultrasensitive variety? Hope so. What does the medic say? And I do hope for Duke's sake that the medic is an oncologist, preferably one who is experienced in tx of PCa. The result could be any of the above, or a lab error. I recommend having the test redone. There are cases, including mine (from 0.01 --> 4.87 in 28 days), of lab errors. Lastly, though I know it's difficult to do, I recommend patiently having a series of at least three monthly tests. A single test result proves little. Regards, Steve J "The thing is to expect nothing in particular, but (to) be aware of the lack of enforceable guarantees or enforceable contracts with nature/god/entropy as to the condition or durability of our bodies." -- Brian Brunner, PCa survivor, December 12, 2005 on The Prostate Problems Mailing List Thank you, Brian. Yes it was 5.14. I was a little taken aback by the news. The test was at the onc yesterday and I am waiting for a call back. I'll ask about a retest. it was supr;rising and disocuragin since I feel gooda nd things were going well. Damn this! Now to tell the wife and kids tonight. Duke I wonder what Duke's Gleason scale was on the biopsy. Assuming he had a biopsy. I can't imagine they'd start any kind of treatment, (other than Cipro) without one. 44 is a pretty high psa, but I've heard infection can do that. Correct? David > I wonder what Duke's Gleason scale was on the biopsy. Assuming he had a > biopsy. I can't imagine they'd start any kind of treatment, (other than > Cipro) without one. 44 is a pretty high psa, but I've heard infection > can do that. Correct? > > David 9 w/ pos bone scans Yes it was 5.14. I was a little taken aback by the news. The test was at the onc yesterday and I am waiting for a call back. I'll ask about a retest. it was supr;rising and disocuragin since I feel good and things were going well. Damn this! Now to tell the wife and kids tonight. Thanks for the repsonse. Duke > Yes it was 5.14. I was a little taken aback by the news. The test was > at the onc yesterday and I am waiting for a call back. I'll ask about > a retest. it was supr;rising and disocuragin since I feel good and > things were going well. Damn this! Now to tell the wife and kids > tonight. Thanks for the repsonse. > Duke Duke, I'm very sorry to hear about the rising PSA. There are several possible causes for a rising PSA besides reaching hormone refractory condition. One is prostatitis. Another is having sex within a day or two before the test - though that can be difficult to manage on Lupron. Another is just normal variation which, I have been told by a doctor, can be as much as 30%. However a resurgence of the cancer is a serious possibility. I agree with Steve that a retest is a good idea. I also agree with Steve that, if possible, you should consult a medical oncologist (as opposed to a urologist) who has a lot of experience with prostate cancer. A medical oncologist will be a doctor who specializes in medical (e.g., hormone therapy and chemotherapy) treatment as opposed to surgery, which is what most urologists do. You might also start to investigate clinical trials. You can find them at: http://www.cancer.gov/search/clinicaltrials/ You can search both for prostate cancer trials and for "solid tumor, unspecified adult". Prostate cancer is a solid tumor type cancer and there are many trials of drugs that appear to be effective against many of them. One trial I've been interested in is: http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=68802 It's a trial of phenoxodiol, a drug that was used with considerable success in its first trials against both Ovarian and Prostate cancers. One advantage of clinical trials is that they are generally conducted by doctors who have a great deal of experience in the specific field. A consultation with a clinical trials doctor will often be free (no insurance required, their research funds pay for it) and the doctor may be conversant with the latest ideas for things to try in addition to what he is offering in his trial. Best of luck. Alan > ... > One trial I've been interested in is: > http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=68802 > ... Oops. I notice that trial was listed in 2001. It may be closed by now. This may be the one that generated the good results that I am remembering. >I am 2 months into hormone treatment (casodex and lupron). My first > month PSA wnet from 44 to 6.1 to 3.1 on 4/25. My PSA taken 5/24 showed > a rise to 5/14. Could this be an aberation, a bounce or early signs of > refraction setting in? It is not a sign of refraction. It is not a sign that there is no refraction. It is virtually meaningless. I'm surprised your doc supported three PSA tests in the first 2 months after your first injection. Having done so, he has set up up for impatience (IMHO). Also, IMHO, I'd 86 the PSAs and get one in June. Then get one in September. Then, let's see if it goes from 44 to 3 to 1.5 (or something like that).  SignaturePSA 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, 2/06 PSA .07 .05 .06 .09 .08 .132 Non Illegitimi Carborundum Duke My PSA while on Zolodex and Casodex got down to 6.6 and I felt fine. At six months the PSA came in at 6.9. No reason to worry, yet. The next one was 27.6. Odviously the hormones were no longer effective. I've been through 2 different chemo treatments. Taxotere worked well and drove the PSA down to 9.9. One month after the end of the treatment it was up to 14.1 then 27.6. He then put me on Navelbine which I feel did nothing. After 4 weekly treatments the PSA was 93.5 and rising. I'm hoping to get into the trial of Provenge within the next month. 3.1 to 5.14 is not much of a rise. See what subsequent tests show. It could have been a glitch in the testing procedure. If the next test shows another rise then it's time to be concerned. Good luck Jim >I am 2 months into hormone treatment (casodex and lupron). My first >month PSA wnet from 44 to 6.1 to 3.1 on 4/25. My PSA taken 5/24 showed >a rise to 5/14. Could this be an aberation, a bounce or early signs of >refraction setting in? > >Duke
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