Home | Contact Us | FAQ | Search & Site Map | Link to Us
Sign In | Join | Other 45 Sites in Network
Home
Discussion Groups
General
GeneralCardiologyVisionDentistryPharmacyLaboratoryNutritionAlternative
Diseases and Disorders
AIDSAlzheimer'sArthritisAsthmaCancerBreast CancerDiabetesEpilepsyGlaucomaHepatitisHerpesLupusProstate BPHProstate CancerProstatitisSinusitisTinnitus

Medical Forum / Diseases and Disorders / Prostate Cancer / January 2007

Tip: Looking for answers? Try searching our database.

Rising Psa 14 Mos. after Surgery

Thread view: 
Enable EMail Alerts  Start New Thread
Thread rating: 
callalily - 20 Jan 2007 23:33 GMT
Dear all,

It has finally happened.  My husband got the results of his psa test on
Friday.  The reading was .12.  (The test had been done about 2 wks
before.)  He had had his RP on 10/15/05.  I believe his previous PSA's
were < .01.  I'm pretty sure both tests had been done by the same lab.

We left a msg for his md yesterday midday but have not heard back.  For
some reason, his doc is unresponsive.

Is there any way this can be anything but bad news?

thanks,

Leah
ron - 20 Jan 2007 23:53 GMT
> Dear all,
>
[quoted text clipped - 11 lines]
>
> Leah

Hi Leah...I can imagine how you both feel, but there are other
possibilities...
1) It could be a lab error; sample mix-up, bad chemicals, calibration
error, and the list goes on
2) There are other organs that produce small amounts of PSA.  It's
possible that if they get inflamed, they could secrete enough PSA to
produce a reading on the ultrasensitive test
3) In a study run by Brooks, he found that about 9% of the men who have
biochemical  recurrence post-RP, don't really progress.  Their PSA
increases at an extremely slow rate.  Whether this is due to growth of
residual tissue or something else, the abstract doesn't say.
Hang in there and you'll both get through this.  I'm hoping that the
next PSA test will be back to <.01...Best wishes and good health, ron

Urology 2003 Feb;61(2):380-5
Biochemical recurrence without PSA progression characterizes a subset
of patients after radical prostatectomy. Prostate-specific antigen.
Shinghal R, Yemoto C, McNeal JE, Brooks JD Department of Urology,
Stanford University Medical Center, Stanford, California 94305-5118,
USA.
OBJECTIVES: To characterize a subset of patients with biochemical
recurrence after radical prostatectomy but with little, if any,
subsequent rise in serum prostate-specific antigen (PSA) and no
clinical progression during long-term follow-up.
METHODS: Of a series of 600 patients, 158 with biochemical recurrence
after radical prostatectomy were examined. We identified a subset with
measurable serum PSA levels during long-term follow-up, but with very
low PSA velocity and no clinical recurrence. Serum PSA was measured
with the ultrasensitive TOSOH assay with a PSA recurrence defined as a
serum PSA of 0.07 ng/mL or greater.
RESULTS: We identified 14 patients (8.8% of biochemical recurrences)
with a detectable serum PSA level after radical prostatectomy yet
without clinical or PSA progression at a mean follow-up after radical
prostatectomy of 10.3 years. The mean time to PSA recurrence was 5.8
years, and the mean PSA velocity after recurrence was 0.028 ng/mL/yr.
No clinical or pathologic features were found that could be used to
identify this subset of patients.
CONCLUSIONS: A subset of patients with biochemical recurrence after
radical prostatectomy will not exhibit a progressive rise in serum PSA
or clinical progression at 10 years follow-up. This suggests that serum
PSA kinetics should be observed after biochemical recurrence before
adjuvant hormonal therapy or radiotherapy.
Alan Meyer - 21 Jan 2007 00:46 GMT
> Dear all,
>
[quoted text clipped - 7 lines]
>
> Is there any way this can be anything but bad news?

I'm terribly sorry to hear this Leah.

The news is bad, but there have been a few cases reported on
this newsgroup by people who had an anomalous PSA test
after RP, with a reading that was not repeated.  There have also
been some surprising cases where the PSA went up a little
but never really went up much more, or did so at an extremely
slow rate.

So it is likely that your husband has failed primary treatment,
but you still don't know yet for certain and don't know how serious
his disease is.  It is possible he could live another 15 or 20
years even if he has a recurrence without more treatment,
or possibly not.

Salvage radiotherapy is often successful, especially if the PSA
has not climbed too high.  With a low PSA like this, it is very
likely that the recurrent cancer, assuming it is a recurrence, is
still in the vicinity of the prostate bed where it is reachable by
radiation.  I think you should start now to find the best radiation
oncologist you can find for a consultation.

Best of luck.

    Alan
kh - 21 Jan 2007 02:26 GMT
> Is there any way this can be anything but bad news?
>
> thanks,
>
> Leah

It's not great news but it's not bad.

Even if it suggests that the cancer "got away", that number is so low.

The other thing about it is that it's just one test.   I would not
worry until I see 2 or 3 more tests, spaced out 3 months and can
project a trend, calculate a doubling time.

Even then, the number is low.

If this is treatment failure or mets, that it just happened.   If it's
mets, there's a tiny colony somewhere responsible for the .12.

If it's local, then an IMRT might clean it up.

If its distant and slow growing, then you're looking at a long time
frame.

If it's not slow growing, and you won't know that for a half year or
year, then there is still Lupron and other options.

Whatever it turns out to be, there is always the possibility that
someone will find the silver bullet.

-kh
Steve Kramer - 21 Jan 2007 02:37 GMT
> It has finally happened.  My husband got the results of his psa test on
> Friday.  The reading was .12.  (The test had been done about 2 wks
[quoted text clipped - 5 lines]
>
> Is there any way this can be anything but bad news?

You should not have an increase in actual PSA if the cancer was contained in
the prostate and the prostate was removed.  So, I would say that the best
way for this not to be bad news is if there was a screw up with the assay
(which has happened to several people here).

I must be frank with you though, Leah.  It has been my experience watching
people in this NG that when they begin the upward trend, it is usually
between 12 and 18 months.

However, all is not lost.  You know you need three straight raises.  You
know there could be a problem with the assay.  And you know that radiation
might knock it out if there is a recurrence.

Don't lose hope.

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,
2/06, 6/06
PSA  .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
PSA <0.04
Non Illegitimi Carborundum

rosbif - 21 Jan 2007 11:18 GMT
>Dear all,
>
[quoted text clipped - 11 lines]
>
>Leah

This must weigh heavily on you both. I think your husband's figures
and strategy were similar to mine and I know the anxiety and
uncertainty that accompany all this are debilitating (my first post-op
psa next week).  There are still options and time ahead so I'm hoping
for the best for you  - the bullish side of ron's #3 would be good, #1
even better.
callalily - 21 Jan 2007 20:55 GMT
>> This must weigh heavily on you both. I think your husband's figures
> and strategy were similar to mine and I know the anxiety and
> uncertainty that accompany all this are debilitating (my first post-op
> psa next week).  There are still options and time ahead so I'm hoping
> for the best for you  - the bullish side of ron's #3 would be good, #1
> even better.

Dear Rosbif,

Don't let this get you down.  I have seen people with a 4+3 who have
done well over the long term.  And I was looking up the predictive
effect of Gleason scores just the other day, and I read that that what
really matters is the totality of the circumstances, not just one
thing.

I really wish there were something out there that could make those
3-month tests easier to bear.  I can't think of anything except maybe
trying to incorporate some relaxation techniques into your life.  It
works for some people.  Michael Milken gives his meditation some credit
for his defying the odds.

Also, I wanted to mention something I had come across in another group,
which a number of people recommended highly.  I had never heard of it,
but it might work for somebody who was interested in incorporating some
non-traditional religious/spiritual practice into their life.  (Note: I
am not addressing you in particular, rosbif, just seizing an
opportunity to sneak something in.)

It is called taize (pronounce tezay) and there are some chapters in the
US.   It was started by some Christian monks in France, and what
appeals to me about it is that there appears to be a lot of chanting
involved.  I think chanting is really healthy for inducing relaxation,
and it appears that brain scans of tibetan monks has backed this up!

BTW, rosbif, you are being very brave about not sharing any of your
worries with Lady R.  But my guess is that she can handle it, and it
might make your burden a little easier to bear.

Take care,

Leah
rosbif - 23 Jan 2007 09:07 GMT
>Dear Rosbif,
>
[quoted text clipped - 30 lines]
>
>Leah

Thanks Leah, there was a craze here - or at least a burble of
publicity - hanging round various celebs in the later '60s who'd taken
up with transcendental mediation, or TM, after the media and
fashionable dinner parties had familiarised it.  I think the Beatles
where dabbling in between tabs of LSD.  A similar thing perhaps?
Definitely chanting.  I think the idea was that you met with a guru
who fitted you out with your personal mantra which even on pain of
death was not to be divulged to anyone.  I picked up reliable reports
of real benefit but more as a system battery re-charger than an
anxiety antidote.  I tried to do it - an aunt who'd done it and liked
it short-circuited the guru and mantra'd me up - but it never worked
for me.  Perhaps I didn't try hard enough, not enough at stake. Maybe
it's a bit like those 3D pics embedded in abstract designs that popped
up 15 years or so ago.  If you could just get into the right head
space....
Incidentally, I got my psa at <0.1 which I suspect is the uk version
of "it's low, that's all we can tell you".  I'll see what the uro says
on Friday.
To me, it still looks like early days for you.  Just a matter of
putting a strategy on standby - in that respect we're on the same
journey.
Best of luck to you.
Steve Kramer - 23 Jan 2007 13:25 GMT
> Incidentally, I got my psa at <0.1 which I suspect is the uk version
> of "it's low, that's all we can tell you".  I'll see what the uro says
> on Friday.

I do not know if the assay is all you can get under your health system, but
<0.1 for that assay is as good as it gets - "virtually undetectable".

Congratulations!!

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,
2/06, 6/06
PSA  .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
PSA <0.04
Non Illegitimi Carborundum

rosbif - 23 Jan 2007 16:06 GMT
>I do not know if the assay is all you can get under your health system, but
><0.1 for that assay is as good as it gets - "virtually undetectable".
>
>Congratulations!!

thanks for the cheer, Steve.  The assay, no, I don't know either, IIRC
I think Mary posted a <.01 for her hubby so maybe these tolerances are
local?  Anyway, I'm content for the moment but will remain wary and
continue to do a spot of homework here and there...
RML - 21 Jan 2007 11:46 GMT
Were his previous readings less than .01 or less than .1?

I just had my first post surgery PSA and it was the latter, and the
doc was happy.

So maybe .12 is not so bad? Scardino says .2  or more after surgery is
where to be concerned.

>Dear all,
>
[quoted text clipped - 11 lines]
>
>Leah
ronju99 - 21 Jan 2007 12:50 GMT
Hi Leah,
I can understand your concern. It happened to me once and a few others
here. I went out three days later and had another PSA test at another lab
at my cost. The first test was 0.1. The second test three days later was
<.06. Quest labs was the first and I don't have much faith in there work.
Other than the one blip, all mine have been <0.1. It's now been three and
a half years. I don't see the results as bad news as others have stated.
Only would if it continued. For piece of mine go get another test. Mine
only cost me $90.

Ron S.
CIL - 21 Jan 2007 18:28 GMT
Leah,

After my Surgery in 1999 the surgeon told me that their may be "blips" with
the PSA.  Some may go over 0.1 and he  was not too concerned until 2 back to
back were over.  I have had one that "blipped" and scared me good, the
follow-up a few weeks later was <0.1.

Good Luck
cil

> Dear all,
>
[quoted text clipped - 11 lines]
>
> Leah
callalily - 21 Jan 2007 20:22 GMT
Dear All,

I can't thank you enough for responding.  I still have to process all
this info.  My head isn't working too well right now.

I am completely broken up mostly because I am so sad for him.  It
wouldn't be so bad maybe if other things were ok.  But husb. has not
had regular work since he finished a job assignment a few months ago,
and that, of course has been difficult psychologically, and has led to
money problems.  It's even worse because he has consistently been
getting interviews for good jobs, but when he goes there in person they
see that he's 55 -- and he doesn't end up being hired.  It used to be
that all he had to do was show up at a job interview and he'd get the
job.  His manner and his intelligence haven't changed, so I believe age
is the reason.

Anyway,  without regular work JJ. has nothing to distract himself with.
And then there's the feeling of the domino effect, that one thing
after another has come tumbling down on you.

I wish I had not been the one to have had to break the news to him.
Doctors know better how to do these things.  My husb. had the test done
at his internist's office for convenience, and they hadn't responded
for 2 weeks.  He then called them back Friday, and they faxed him a
piece of paper.  I had to "interpret" the result.  Husb. then left a
msg for the surgeon and faxed the results over to him (around midday),
but he hasn't heard back yet.  If he doesn't hear from the surg. by
tomorrow I am going to freak out -- maybe it was injudicious of me to
make some critical remarks about his doc and the med. profession??
(Only to make things easier for the next person.)

I looked at the Scardino book and that has made me feel even worse.  He
says that if a person gets radiation while they still have "stress"
incontinence, that makes their overall prognosis of long-term
incontinence much worse.  Also, apparently I didn't understand that a
person could develop mets right away.  I thought that in every case the
ca would first spread locally, and there would be years before we would
even have to worry about mets.  But apparently, I was wrong.

Also, it must be very difficult for husb. (or any man)  to think that
he has had the surgery with all its attendant side-effects for nothing.
And it was just the other day that I noticed that his penis was curving
like a banana; even worse, it was kind of bending in the middle at a 45
degree angle.   I had mentioned this to him before, but he "hadn't
noticed anything".  The other day husb. agreed to call the ED doc about
it, and then this comes up.  I'm sure it is very painful for him, or
any other man, to have to watch their genitals "change shape", as Dr.
Scardino puts it.

Thank you again.

Leah

"The Lord is with me through my helpers; therefore, I have the strength
to face up to my enemies."

   Psalm 118:7
kh - 21 Jan 2007 21:02 GMT
> I am completely broken up mostly because I am so sad for him.  It
> wouldn't be so bad maybe if other things were ok.  But husb. has not
> had regular work since he finished a job assignment a few months ago,
> and that, of course has been difficult psychologically, and has led to
> money problems.

Oh no.   He's not alone there.   This is a very common story.  

-kh
Dragonlady - 22 Jan 2007 08:37 GMT
> > I am completely broken up mostly because I am so sad for him.  It
> > wouldn't be so bad maybe if other things were ok.  But husb. has not
[quoted text clipped - 5 lines]
>
> -kh

My first post to this group.  my husband has prostate Cancer his
Gleason was 4 + 3 T2b his PSA was 19.7.  Age 58

He had brachytherapy last July (2006), His PSa has now dropped to 1.1,
no incontinence, no bowel problems, has gained 28lbs in weight and is
working full time,  Only had two weeks off work post Brachytherapy
implant.  Our sex life is returning to normal.  We have been warned
that PSA could spike in two years.  his oncologist wants to see him
again in March this year and commented he is doing far better than
expected,  He opted for Brachytherapy, as the most radical with the
least side effects.

We live in England.  Treatment was done on NHS, we had to fight for it
though, because all they wanted to do locallywas EBRT and with the side
effects that has, this would have inmpacted greatly on his lifestyle.
We had to fight for a referral to the Oncologist we knew to be the best
in treatment with Brachytherapy.  he was guarded at the first
consultation because the PSA was so high.  They did some more
investigations, and agreed to to the Brachytherapy.  75 threaded seeds
implanted.

Do they really know what the outcomes are and why the PSA rises,
especially now as they saty the PSA test is not all that reliable.

We are watching that PSA in case it rises as warned.  The oncologist
said they don't know why this happens.
Steve Jordan - 22 Jan 2007 19:26 GMT
(snip)

> Do they really know what the outcomes are and why the PSA rises,
> especially now as they saty the PSA test is not all that reliable.
>
> We are watching that PSA in case it rises as warned.  The oncologist
>  said they don't know why this happens.

The PSA rise (bump) is not uncommon.

"Approximately 35% of patients experience a temporary rise in PSA after
first having a decline in PSA after completion of brachytherapy. (It) is
defined as an increase of 0.1 ng/mL or greater above the preceding PSA
level followed by a subsequent decrease below that level. The average
time to PSA 'bump' is 18-20 months."

(From _A Primer on Prostate Cancer_ 2nd ed., page 103, by medical
oncologist and PCa specialist Stephen B. Strum, MD and PCa warrior Donna
Pogliano.)

Also: "The 'bump' follows a benign clinical course and usually resolves
itself within a year. The main danger of the PSA 'bump' comes when
physicians mistakenly conclude that the rising PSA represents recurrent
cancer and decide to start ADT when no cancer is present."

-- From the authoritative website of the Prostate Cancer Research
Institute [PCRI] at

http://www.prostate-cancer.org/education/localdis/scholz_newlydiagnosed2.html

So far as the reliability of the PSA test is concerned, that is
controversial. And the controversy is related to use of the PSA test as
a diagnostic tool *before* treatment. It is not relevant to the
Dragonlady's husband's situation. (That's awkward; what's his name?)

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.
Justin Case - 22 Jan 2007 21:06 GMT
My reflections at the bottom.

: (snip)
:
[quoted text clipped - 23 lines]
: -- From the authoritative website of the Prostate Cancer Research
: Institute [PCRI] at

http://www.prostate-cancer.org/education/localdis/scholz_newlydiagnosed2.html

: So far as the reliability of the PSA test is concerned, that is
: controversial. And the controversy is related to use of the PSA test as
[quoted text clipped - 11 lines]
: Problems Mailing List
: Thank you, Brian.

Last week I had a PSA blood check and review with the oncologist who
performed RRP surgery 5½ years ago.  It required radiation somewhat later to
bring the PSA level down to an insignificant level where it stayed at <0.1.
Last week I received a more precise (?) reading of 0.04 and both the doctor
and I were only just short of congratulating ourselves.  I remarked on the
"bump" or "spike" I had heard about and he said that frankly he would not
have been surprised to see it by now.  When I asked him, from his own
personal experience and his readings, what I might expect over the next five
years, he told me that it would probably rise during that time.  Well, heck,
I'm 76 and five more years may be greater than my expected lifetime anyway.

FWIW.  Ken Bland
Steve Jordan - 22 Jan 2007 21:31 GMT
On January 22, Ken Bland replied to me:

> Last week I had a PSA blood check and review with the oncologist who
> performed RRP surgery 5½ years ago.  It required radiation somewhat later to
> bring the PSA level down to an insignificant level where it stayed at <0.1.
> Last week I received a more precise (?) reading of 0.04 and both the doctor
> and I were only just short of congratulating ourselves.  

Oh, what the heck, it's "undetectable" per Strum et al., so why not be
congratulatory?  :-)

I like the ultrasensitive PSA test because it can give early warning of
approaching problems than can the usual test. I have seen argument that
what I call "twitches" of few hundredths of a mL in results can cause
concern. Well, I say, not if the medic and the patient are knowledgeable.

> I remarked on the
> "bump" or "spike" I had heard about and he said that frankly he would not
> have been surprised to see it by now.  When I asked him, from his own
> personal experience and his readings, what I might expect over the next five
> years, he told me that it would probably rise during that time.  

I guess it could, but it seems unlikely to be from the prostatitis that
is the suspected cause of the "bump."

Regards,

Steve J

"The author of the Iliad is either Homer or, if not Homer, somebody else
of the same name."
-- Aldous Huxley
fred - 23 Jan 2007 06:42 GMT
> Is there any way this can be anything but bad news?
>
> thanks,
>
> Leah

Leah....so sorry to hear this. As you can see below, i've been through
a similar situation. The consensus of my docs was not to act on one PSA
test but to do WW for some months and see if there's a persistent trend
up. If so, your husband will probably want to consider radiation, which
will likely be effective if it's a local recurrence, rather than a met
(unfortunately there's no reliable way to know which it is).

I did my radiation using the Trilogy IMRT machine which is supposed to
be state-of-art in terms of accuracy, which theoretically improves
effectiveness and minimizes SEs.

To date, all has worked out as advertised. PSA level cut to less than
1/4 of prior level, very tolerable SEs during treatment and after, I'm
still playing tennis and walking 5 miles. Of course, I know it ain't
over yet, and my PSA may still rise, but so far, so good. Neither you
or your husband should give up yet!

Fred

4/99     PSA 1.58
10/01   PSA 1.68
9/02     PSA 2.7
10/03   PSA 3.8
11/03   needle biopsy. Positive for Gleasons 6 on left side.
12/03   Radical Prostatectomy performed at the Cleveland Clinic.
           Gleasons 3+4 = 7, clear surgical margins, extracapsular
            extension established.
3/17/04 PSA 0.003
4/27/04 PSA 0.003
7/22/04 PSA <0.1 (not 3rd generation test)
11/10/04 PSA <0.1 (not 3rd generation test)
5/10/05 PSA <0.1 (not 3rd generation test)
10/19/05 PSA 0.050
2/3/06    PSA 0.082
3/23/06   PSA 0.110
3/06-6/06 IMRT SRT
9/06       PSA 0.044
12/06     PSA 0.025
callalily - 24 Jan 2007 03:35 GMT
Dear Fred,

I can't thank you enough for the response.  I am still numb and
extremely depressed, so my head isn't working too well.  But I do
appreciate your writing and going into such detail, because your story
is so similar to my husband's.

And it is uplifting that you are doing so well.  I hope it stays that
way.

I was just wondering how you deal with the stress of recurrence
hovering over you all the time.  I assume you just don't think about
it.

Also, I am current in assuming that you had no treatment between time
of RP and 3/06.  (brain is a little fuzzy.

Finally, why are some tests <.05 while others are <.1.  I just don't
get it.  do you recommend a particular type of psa test?

Again, I am grateful that you took the time to send me this message.

Love,

Leah

> > Is there any way this can be anything but bad news?
>
[quoted text clipped - 38 lines]
> 9/06    PSA 0.044
> 12/06   PSA 0.025
fred - 24 Jan 2007 20:11 GMT
> I was just wondering how you deal with the stress of recurrence
> hovering over you all the time. I assume you just don't think about
> it.

Well, the fact is that it's hovering over all of us whether we choose
to acknowledge it or not. I don't have a good answer, except to say,
it's there, and you just accept it or at least get used to it after a
while. Since my initial diagnosis, I've become much more accepting of
the certainty of death for all of us, and it bothers me less than it
used to. Interestingly, I've noticed I never get nervous flying now;
the fear just isn't there anymore!

> Also, I am current in assuming that you had no treatment between time
> of RP and 3/06.

Right. There was some consideration given to doing radiation after
surgery because pathology showed an (unexpected) extracapsular
extension, but the consensus was to do WW, carefully watch PSA levels
and see if there was an re-occurrence.

> Finally, why are some tests <.05 while others are <.1. I just don't
> get it. do you recommend a particular type of psa test?

The local lab does not do the supersensitive tests, and for a while I
had the regular tests (minimum result <0.1). But my family dr wanted me
to get the supersensitive tests (min result <0.001), so that we would
know if PSA began an upward trend. And it did. I don't know the names
of the assays but expect that Steve Kramer or others will. It is good
to use the same test and the same lab for consistency, but I don't
think the actual brand of test matters much.

As it was explained to me, there are at least 2 schools of thought as
to PSA tests and salvage radiation. My docs wanted me to use the
supersensitive tests to watch for a series of upward ticks, and
recommended radiation as soon as they saw 3 consecutive rises with the
last one being >0.1.

The other school of thought is that PSA tests aren't very reliable
below 0.1; and anyway you shouldn't be concerned until PSA is >0.2; and
you don't radiate until PSA is >0.4. The argument is that radiation is
still effective (if the recurrence is local and not a met) until PSA is
somewhere around 0.6 to 1.0; so why not wait and see if your PSA
continues to go up, and if so, at what rate?

If your husband's PSA continues to increase (not a certainty right
now), he'll have to make the decision as to how to proceed. As you saw,
I chose the first option above, and (so far) it's worked out well, but
I think the other approach also has merit, and you'll find many in this
NG who agree with that approach.

Hope this helps. But remember, I think your dr will tell you that the
evidence you have now does NOT necessarily mean he has a recurrence.
You need more PSA tests showing a consistent trend up to reach that
conclusion.

Fred
Maui Mike - 24 Jan 2007 20:52 GMT
>snip<

>Well, the fact is that it's hovering over all of us whether we choose
>to acknowledge it or not. I don't have a good answer, except to say,
[quoted text clipped - 3 lines]
>used to. Interestingly, I've noticed I never get nervous flying now;
>the fear just isn't there anymore!

I find this statement interesting. When I was first dx'd with PCa, I
was scared to death of dying, being incontinent and being impotent. I
spent weeks on a roller coaster of worry and despair. With the help of
this group, I was able to come to terms with the challenges my future
may hold. No sooner had I accepted my fate, I was diagnosed with
cardiac ischemia, a silent killer that could take me even before I
have a chance to battle my PCa. But I am no longer afraid. It seems
that finally acknowledging my mortality made the fear go away.

Here's hoping that you all find peace in your lives.

Mike

Diagnosed with PCa Nov/2006 at age 55
PSA 13.8  Gleason 3+3=6  T1c
Asymptomatic  No ED or Incontinence
da Vinci RLRP planned for Feb 2007
Diagnosed with cardiac ischemia Jan/2007
RLRP postponed pending cardiac evaluation
I.P. Freely - 27 Jan 2007 04:31 GMT
> When I was first dx'd with PCa, I
> was scared to death of dying, being incontinent and being impotent. I
[quoted text clipped - 4 lines]
> have a chance to battle my PCa. But I am no longer afraid. It seems
> that finally acknowledging my mortality made the fear go away.

I researched snakes in grammar school, and have never had any qualms
about picking up a passing snake at mid-body to look at it or move it to
a safer, less traveled spot . . . as long as it isn't poisonous, which I
can usually tell at a glance. But spiders scare the $#+! out of me
because I know very little about them.

I also figured out decades ago that I was highly unlikely to live
forever. PC gives me an alligator -- a slow one at that -- to focus on,
which gives me a little extra control over the swamp as long as I keep
watching over his shoulder for another one. Even if we can't *really*
control the swamp, the feeling gives us some power and hope, especially
for a G6, T1 pt.

I.P.

Rate this thread:






 
Sign In
Join
My Latest Posts
My Monitored Threads
My Blog
My Photo Gallery
My Profile
My Homepage

Start New Thread
Enable EMail Alerts
Rate this Thread



©2008 Advenet LLC   Privacy Policy - Terms of Use
This website includes both content owned or controlled by Advenet as well as content owned or controlled by third parties.