Previously had radical prostatectomy, 39 salvage radiation treatments, and now on ADT (wonderful Eligard).
Rising PSA from .25 12/14/2017 to .47... - Advanced Prostate...
Rising PSA from .25 12/14/2017 to .47 3/14/2018; should I be alarmed? See my urologist 3/19 and what to know what questions to ask.
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harryb48
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Certainly not alarmed, but if your PSA keeps getting higher and goes over 2.0, it may be time to bring in second-line hormonals. In the US, Erleada has been approved for this and Zytiga soon will be. I don't know if NICE has followed suit. Meanwhile, check your T levels to make sure that the ADT is working properly.
Thanks for the reply, T level about 13.
How long did it take to go from .25 to .47? Also recommend at least bringing in a Medical Oncologist on your team or switching over to one from your Urologist. Preferably one who specialises in PCa.
jrr02 in reply to
Completely agree with bringing on Oncologist at this point, after surgery and radiation, metastasis likely and closely monitoring rising PSA by Oncologist can help to understand next steps. I had radical 2008 with 1 year later radiation, transitioned after 1 year to quarterly Lupron and Demosumab, with daily Casodex for next 6 years. Just moved to Zytiga last September after rising PSA which is bringing PSA down. Petscan, MRI and CTScans identified locations and keep track of any growth for much better piece of mind. Zytiga regimen with prednisone supposedly keeps growth in check.
May be you should discuss with your doctor to do a Ga 68 PSMA PET/CT to determine if there is metastatic disease at this time.
After a radical prostatectomy, there should be no prostate tissue left in the body. That means that any PSA is probably coming from distant metastases. They don't call it Prostate Specific Antigen for nothing.
Not a cause for alarm - prostate cancer is never an emergency. But it should be checked out and watched carefully.
Good luck!
Thanks, hate having the PSA test done and waiting for results.
There is no reason to wait. Go to health-tests-direct.com/ord... and type PSA in the search box. Order your own PSA test for the grand sum of $44.24. Find a Quest lab near you for the blood draw. In 2-3 days you get an email with a link to the results. You can print it out and bring it with you to your doctor.
These are the exact same labs used by doctors and hospitals for their testing. The company has made the same deals with Quest and LabCorp for discounts that all the insurers and hospitals have made.
I order most of my blood tests. It usually works out to be a lot less money than what I pay after insurance deductibles and copays. It also gives me control of all the information and records.
One friend of mine was getting HRT, and needed extensive, expensive hormone testing every 6 months. I sat down with them, worked out which tests could be ordered from Health Tests Direct, and which few had to be taken at the doctor's office or hospital. The savings were over $1500 - twice a year!
No financial interest, just a very satisfied customer.
One word of caution: the PSA test by Quest is a Siemens test referenced to the WHO standard. It reads 22% lower than tests from Beckman Coulter. Just be careful when comparing tests from different vendors.
For tracking changes in your own PSA, these inexpensive tests are fine. They don't read down to 0.01 like the ultrasensitive tests, but you can easily see the difference between 0.2 and 0.5 and whether it continues to climb. That's what matters, not whether it is 0.49 or 0.51
Wow, thanks for the information!
You're welcome, I hope it helps. You can order most tests there; just be sure which ones you need. My doctors don't mind me ordering my own tests (I fired the ones that objected) and part of every visit is reviewing the latest test results that I bring in or email to them, and deciding which tests I need in the future.
Be sure to order all tests at once; there is an $8.50 fee for the blood draw. It's the same no matter how many tests you order at one time. If you order twice you pay that fee twice, even if you get it all done at once.
You have to print out the requisition and bring it with you to the draw center. It's easy. The website has full instructions.
Typical tests are CBC (Complete Blood Count) and CMP (Complete Metabolic Panel). These are routine tests. You can order PSA Free and Total from Labcorp, but that's not as much interest to people with advanced PCa.
I've also ordered CEA (a cancer marker), A1C (glucose/diabetes), Testosterone, Lipid Panel, Vitamin D 25-OH D3, urinalysis, magnesium, and others. All these were requested by one or more of my doctors. Since I have all the results it is easy to bring a new doc up to speed and share one test between multiple offices or clinics.
Some of the bigger hospital clinics try to coerce you. I've had several say "Our tests are better." That's unadulterated BS, tests are standardized unless you are in some sort of trial, and trials for lab tests aren't very common. I simply refuse and make sure I have printouts of all my test results for the past 12 months. They don't like it when patients say "No," but they get over it.
in reply to FCoffey
Good information. Quest lab is the one I use. I've been told that they don't report values below 0.1; less than that just comes back undetectable. One of the nicest words to hear.
** Get A **
Medical Oncologist preferably one who specializes in PCa.
Medical Oncologist preferably one who specializes in PCa.
Medical Oncologist preferably one who specializes in PCa.
"ditto"
Good Luck and Good Health.
j-o-h-n Friday 03/16/2018 5:30 PM EDT
