Long story short. I have Had prostate cancer 10 years now. When we first fond it I had my prostate removed. My PSA was only 6. A little over 5 years went by and my PSA started going up. When now I was in stage 4. I had a tumor where my prostate was and it was in my bones. By the time if finished radiation and started hormone therapy my PSA was only 7.85. We got back to .01 but as the years went by my PSA went back up to 7.9. We did immunotherapy and spot radiation and brought it back to 2.0. It is climbing again and I'm at 4.8. Waiting to start new treatments.
Anyway the point is my PSA has never been above 7.9 but over the years we have learned that once it stats claiming 4.0 is the magic number to start looking where it is and what it is doing.
You need to learn your numbers and what they mean to you. All of us are different and your numbers mean different things to each of us. My dads magic number is 1000. So there is a big difference. Set your baseline early. If used properly PSA can be very helpful to know where you are at and what is going on in your body.
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Rexwayne
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PSA numbers are person specific. If 4 were a magic number then I should be healthy. My cancer cells are so deformed they are high Gleason and low PSA producers. Dr. Myers has said in the past that many cells are low PSA producers when they are healthy and become high PSA producers when they are about to die. Not sure if this is true but you can find his talks on you tube.
As I understand it the important numbers to look at are the doubling rates for PSA and not necessarily the numbers. MSKCC gives me a graph of my PSA on the ap and I check it out. Down and to the right is good while up and to the right is something to worry about.
As you said PSA numbers are specific for each person. We each need to know what that is for our indivual case. We all want to see 0.0. Many use 2.0 as the number we want to stay close to. That is what we were trying to do. 4 was the number we set to do CTs and bone scans. I my case we found new activity. So for me 4 was the magic number to start looking.
For som it's 1 for my dad it was 1000. So everyone needs to know there own numbers and know when to do scans.
My PSA was 2.7 when a DRE turned up a very palpable gleason 8 tumor. After treatment my PSA is now undetectable but I am wondering if monitoring of a low PSA cancer will be sufficient. Urologist says further scans not warranted until PSA reaches 2. It barely reached that with a nasty tumor in place.
The absolute number is not as important as the rate of rise or doubling time. Remember there is uncertainty in all these numbers. Negligible PSA is < 0.05 . If say the next (every three months) two readings are 0.06 and then 0.12 even then you still should not worry as it is all in the uncertainty range but is trending wrong. If after another few months it jumps to 1.0 something is wrong.
If however the same numbers occur but after several years then waiting for a PSA of 2.0 is probably appropriate. You can use the MSKCC doubling time calc as a guide.
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