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Medical Forum / Diseases and Disorders / Prostate Cancer / July 2008

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new PSA to report

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chasjac - 20 Jul 2008 13:47 GMT
Hello:

Just checking in.  For Steve K:  my latest PSA as of July 2008 is
0.02.  So, it's been steady.  I do wonder a bit about it.  My uro says
it's just noise, but it seems odd to have two in a row like that.
But, hey, it's low, and I'm happy about that.

Erections are coming back online.  I still have enough stress
incontinence that I still need the pads.  No big deal.

But I did get back to Australia!  I took 24 students on a month long
tour in May.  Since it was in Australia that I first learned that I
had a problem (in 2006), this trip was a huge triumph for me over the
disease.  I even overcome my fear of staining myself in front of the
students and got into the ocean once more at the Great Barrier Reef.

I am posting from the office, so I don't have my usual sig.  Sorry.
Anyway, thanks a million for all the support.  I do lurk, still.  Bye.

Charlie

5/2006:  PSA 5.1
7/2006:  Biopsy:  2 of 10; Gleason 7(3+4)
11/2006:  LRP at Johns Hopkins.  Clear margins.
1/2007 - 7/2008:  PSA tests at or below 0.02.
So far, so good.
Steve Kramer - 20 Jul 2008 20:29 GMT
> Just checking in.  For Steve K:  my latest PSA as of July 2008 is
> 0.02.  So, it's been steady.  I do wonder a bit about it.  My uro says
> it's just noise, but it seems odd to have two in a row like that.

0.02 is fantastic 1½ years following surgery.  If you were doing the
standard assay, your results since surgery would be < 0.10 which is
considered undetectable using that assay.  I have opined that people should
use only the standard assay following surgery.  I don't see any reason to
know what it's doing down to the 100th of a nanogram unless you're on ADT.

> Erections are coming back online.

Great news!!!

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            PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32                       PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA  .07 .05 .06 .09 .08 .132 .145       PSAD 1.4 years
Casodex added daily 07/06
PSA <0.04, <0.05, <0.04, <0.04, <0.1  2/12/08
Illegitimati non carborundum

Peter Headland - 22 Jul 2008 18:23 GMT
> my latest PSA as of July 2008 is 0.02.  So, it's been steady.
> I do wonder a bit about it.  My uro says it's just noise, but it
> seems odd to have two in a row like that.

As luck would have it, I was discussing this very topic with Dr James
Brooks at Stanford on Monday. He tells me he has a number of patients
with detectable very but low and stable (over many years) PSA
following RRP. He speculates that this is due to normal prostate
tissue cells that occur naturally outside the prostate itself. Such
cells have been found in the anal sphincter muscle, the bladder, the
kidneys, etc., and even occur in some women. Caveat: patients with
this profile are a *very* small percentage of the whole post-RRP
population.

Even more interesting was his description of one particular patient.
This man had RRP in 1983. In 1987, his PSA became detectable (by the
cruder tests of the day), and began to rise slowly. A trans-urethral
biopsy of the join between the urethra and bladder revealed prostate
cancer cells. Despite this, the patient declined salvage radiation.
After a while, his PSA stabilised, then actually declined somewhat. He
is still alive today at the ripe old age of 90. Dr Brooks does not
expect him to die of prostate cancer. The moral of this tale is that
some PCa is*very* indolent. Sadly, there are still no reliable tests
to tell us how aggressive any particular case is.

If it should come to salvage radiation, Dr Brooks says their group has
about a 60% success rate driving PSA back to zero with no subsequent
recurrence after several years, so he considers it well worthwhile.

--
Peter Headland
 
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