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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2006Is this a good thing?
Sorry to interrupt. I wont hang around and be a nuisance. Some time back, a person I know accidentally discovered he had a slightly elevated PSA count after pressuring his doctor about it. Anyway, cut a long story short, he had an aggressive prostate cancer which was apparently not far off breaking loose. So, obviously, as an overweight 51 year old, I got a bit of a scare. It took me some time but I went for the PSA test - back in February. I went for my results last week. My PSA was 0.98 which I thought was excellent. I was talking to yet another person I know, who is 70 and mentioned my 0.98. He said he is 0.6. So, as this is my FIRST EVER PSA score, I thought it was STILL good but now am not really 100% sure. Can any of you who DO know let me know please? The doctor said that all it really is is just a baseline so that when I next get one done, if it is 2, we ask why. Medicine isn't very accurate when it comes to men's problems, is it? 0.98 is not bad, but not great as going only by the numbers. BUT, that may mean absolutely nothing as far as Psa is concerned. Anything can increase one's psa's, from infections, to some kind of prostate massage, to sex a day or so before the exam. The psa system is a closed system similar to a pool pump. If the psa rises, and at what velocity, then you can decide on what you're next move may be. (new psa tests or biopsy). If velocity exceeds .75 points as by consensus, then there is some concern for further investigation. It does not mean prostate cancer though. Recently, I've heard of .50 as substituting the .75 points. 0.98 is not terrible and it may mean nothing at all more than likely. B.A. > Sorry to interrupt. I wont hang around and be a nuisance. > Fear not. (snip) > So, obviously, as an overweight 51 year old, I got a > bit of a scare. It took me some time but I went for the PSA test - back in > February. I went for my results last week. Five months later? Huh? How much of a scare was that? > My PSA was 0.98 which I thought was excellent. > Correct. It was excellent. > I was talking to yet another person I know, who is 70 and mentioned my 0.98. > He said he is 0.6. So, as this is my FIRST EVER PSA score, I thought it was > STILL good but now am not really 100% sure. > Each of us is different. The test results of someone else are meaningless. (snip) > The doctor said that all it really is is just a baseline so that when I next get one done, if it is 2, > we ask why. He's right. > Medicine isn't very accurate when it comes to men's problems, is it? > That's why it's called an art. Which medics *practice*. And it really isn't just "men's problems." At my last meeting with my cardiologist I mentioned the fact that there's little uniformity of opinion re: PCa tx. She laughed and said that it's the same in cardiology and other branches of medicine. Of course, there are medics who are scientists, but IMO they're few and far between. And I have seen that scientists can be vicious when arguing with one another. All we pts can do is study, learn, and take charge of our tx. Anything short of that is a gamble on the professional competence and attitude of our medics. So much for philosophy. 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 Slightly Unsure wrote...snip... > So, obviously, as an overweight 51 year old, I got a > bit of a scare. It took me some time but I went for the PSA test - back in > February. I went for my results last week. My PSA was 0.98 which I thought > was excellent. > Can any of you who DO know let me know please? The doctor said that all it > really is is just a baseline so that when I next get one done, if it is 2, > we ask why. Medicine isn't very accurate when it comes to men's problems, is > it? SU...Your doc is right. One point makes for the start of a baseline. The rate of change of the PSA over time is usually the key. PSA measurement and digital rectal exam (DRE) are two simple ways to try and screen for PCa. Neither test is foolproof. In the case of PSA, there is no value above which you always have PCa, nor is there is value below which you can't have PCa. For reference, one study found that for men 50-59, the median PSA is 0.80 ng/ml (+/- 95% range: 0.25-2.60). Another study found that 10.1% of men with PSA between 0.6-1.0 ng/ml have PCa...Best wishes and good health, ron > Slightly Unsure wrote...snip... > [quoted text clipped - 17 lines] > 0.25-2.60). Another study found that 10.1% of men with PSA between > 0.6-1.0 ng/ml have PCa...Best wishes and good health, ron Perhaps it should be added that some small number of prostate cancers don't produce much PSA. That explains why 10 percent of men with PSAs less than 1 ng/ml might have prostate cancer. In those cases the PSA value doesn't result from the cancer. > Sorry to interrupt. I wont hang around and be a nuisance. > I was talking to yet another person I know, who is 70 and mentioned my > 0.98. He said he is 0.6. So, as this is my FIRST EVER PSA score, I thought > it was STILL good but now am not really 100% sure. No need to apologize. It is a very reasonable question. The fact is, at your age, 0.98 is a good first time PSA. Relax and get on with your life.  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, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 Non Illegitimi Carborundum > ... > I was talking to yet another person I know, who is 70 and mentioned my 0.98. He said he > is 0.6. So, as this is my FIRST EVER PSA score, I thought it was STILL good but now am > not really 100% sure. ... As others have said, .98 is just fine. I've never heard or read anything by any cancer expert who said otherwise, the most radical statement I've ever seen by any doctor was that 2.5 might possibly show some cancer. Most doctors set the bar higher than that. Some PSA is normal. I'd say your 70 year old friend has an unusually low PSA for his age, not that you have a high one. Alan > Sorry to interrupt. I wont hang around and be a nuisance. > [quoted text clipped - 14 lines] > we ask why. Medicine isn't very accurate when it comes to men's problems, > is it? This is an interesting new era alright. One where folks won't trust their docs, but will rely on the word of total strangers on a message board! SignatureJK Sinrod www.SinrodStudios.com www.MyConeyIslandMemories.com > This is an interesting new era alright. One where folks won't trust their > docs, but will rely on the word of total strangers on a message board! Including ANONYMOUS strangers obviously hiding behind nom de plumes. I. P. Freely, my a.s! '-) > This is an interesting new era alright. One where folks won't trust their > docs, but will rely on the word of total strangers on a message board! I don't think a consensus here has ever been wrong. I imagine Steve and I.P., in particular, and probably several others, would say the consensuses here have been more accurate than their initial doctors' recommendations and treatments. 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, 6/06 PSA .07 .05 .06 .09 .08 .132 .145 Casodex added daily 07/06 Non Illegitimi Carborundum >> This is an interesting new era alright. One where folks won't trust their >> docs, but will rely on the word of total strangers on a message board! [quoted text clipped - 3 lines] > here have been more accurate than their initial doctors' recommendations and > treatments. I HOPE this forum's consensus on ADT SEs is wrong, that Steve's statements (and my doctors') are closer to fact. This forum's respondents to my ADT SE poll concurred with Strum and the PCRI, whereas Steve and my docs painted a much less alarming picture, with one exception: all those parties agree (some in words, some in evidence) on the fatigue issue. Beyond that, I'd have a hard time identifying this forum's consensus on any topics. We seem to me to be all over the map on most topics, divided in part by at least two factions: one group favors large-population studies, facts and conclusions; the other prefers relegating life's major decisions to their emotions. (Funny how similar politics and health care are.) I.P. >>> This is an interesting new era alright. One where folks won't trust >>> their docs, but will rely on the word of total strangers on a message [quoted text clipped - 13 lines] > Beyond that, I'd have a hard time identifying this forum's consensus on > any topics. I think there is a consensus that: 1. HT is the way to go when all else has failed 2. The SEs are nothing to ignore 3. Once begun, quitting HT is an option of the SEs are too bad. Really, I think the only disagreement is how soon. > I think there is a consensus that: > [quoted text clipped - 3 lines] > > Really, I think the only disagreement is how soon. 1. Studies, symposium panel discussions among PC professionals and pts, and some pts here disagree that ADT is always preferable to no tx after everything else has failed. It depends heavily on the SEs each pt incurs. 3. Older pts need to be aware that quitting does not always stop the SEs. I.P. >> I think there is a consensus that: >> [quoted text clipped - 9 lines] > > 3. Older pts need to be aware that quitting does not always stop the SEs. El I.Pio, I know that I, Esteben, do not have your superior intellect and education, but could it be that once again, you are angry at something else, and are looking to muddle this issue? Surely, you're not trying to make the argument that any patient may know, prior to trying the treatment, what SEs they will incur. Or, that older patients should be more concerned or as concerned about the reversal of SEs than that which they would, at that point, have already and have come to accept. >> Steve Kramer wrote: >>> I think there is a consensus that: [quoted text clipped - 4 lines] >>> >>> Really, I think the only disagreement is how soon. >> 1. Studies, symposium panel discussions among PC professionals and pts, >> and some pts here disagree that ADT is always preferable to no tx after >> everything else has failed. It depends heavily on the SEs each pt incurs. >> >> 3. Older pts need to be aware that quitting does not always stop the SEs. > El I.Pio, I know that I, Esteben, do not have your superior intellect > and education, but could it be that once again, you are angry at > something else, and are looking to muddle this issue? Just the opposite on both counts: just trying to CLARIFY the facts (and still totally puzzled as to why some folks attribute emotions to facts. Facts are our FRIENDS when they help us deal with other, unwelcome, facts.) > Surely, you're not trying to make the argument that any patient may > know prior to trying the treatment, what SEs they will incur. KNOW? For CERTAIN? No. But BELIEVE they will incur some of the VIRTUALLY certain SEs? Yes. I think it's folly to assume we could escape SEs with statistical likelihoods exceeding 0.9 or PCRI expectations pegged at 100% occurrence. Thus #3 above. > Or, that older patients should be more concerned or as concerned about > the reversal of SEs than that which they would, at that point, have > already and have come to accept. If they already have SEs and know for a fact they are irreversible, I agree that concern is probably useless. But IMO it benefits pts considering ADT to be aware before beginning it that: a. Some of the virtually certain SEs (they were EXTREMELY valuable in my ADT decision) may become permanent. b. If they decide early enough in ADT trials that their SEs are intolerable, as many do, their odds of reversibility decline with age and with greater time on ADT. I don't know at what age the threat of irreversibility becomes significant, but if I were "old" and contemplating ADT, I'd find out. I.P. >> This is an interesting new era alright. One where folks won't trust >> their docs, but will rely on the word of total strangers on a message [quoted text clipped - 4 lines] > consensuses here have been more accurate than their initial doctors' > recommendations and treatments. Yeah but which 8 members will happen to respond, and what's a consensus..... is 5 of 8 enough? I never said that our opinions weren't wonderfully accurate, only commenting on those that seek us out after getting a clear response from their learned docs. SignatureJK Sinrod www.SinrodStudios.com www.MyConeyIslandMemories.com > Sorry to interrupt. I wont hang around and be a nuisance. > [quoted text clipped - 14 lines] > we ask why. Medicine isn't very accurate when it comes to men's problems, is > it? Take a chill pill. You're just fine! Get an annual checkup, including PSA. Deal with ALL the information you get back, but don't fixate on it. (You didn't say wether there is any family history, but even then you're still fine!!) I'm sure you've got much bigger fish to fry!! |
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