Can cancer prostate spread or grow when psa is low

[Bob10]

When psa is really low or nondetectable can prostate cancer grow

[Tall_Allen]

Only if it’s a rare type.

[Bob10 in reply to Tall_Allen]

So cancer tall ?.cancer stay at bay with a psa of let's say 1

[Tall_Allen in reply to Bob10]

It depends. That's high for a recurrence or persistent PSA

[cesanon in reply to Tall_Allen]

"a psa of let's say 1" Bob10

"That's high for a recurrence or persistent PSA"

Tall Allen, can you explain what you mean. Is it that a PSA of 1 means it is likely on the way back???

[Tall_Allen in reply to cesanon]

Bob10 didn't explain in what situation he is asking about - recurrence/persistence after prostatectomy? Recurrence after salvage radiation? after 2nd line therapy?

[cesanon in reply to Tall_Allen]

What long term psa levels would you expect after

1 prostatectomy

2 salvage radiation

3 2nd line therapy (what is 2nd line therapy)

4 first time radiation therapy

[Tall_Allen in reply to cesanon]

You want PSA to be undetectable after prostatectomy with or without salvage radiation, to reach a nadir below 0.5 after primary radiation, to be less than 1 after 2nd line therapies when there has been no radical therapy.

[cesanon in reply to Tall_Allen]

Where do you learn all this stuff. It would seem hard to integrate all this just reading studies. LOL

[j-o-h-n in reply to cesanon]

You don't really think Tall_Allen is a human? He's a Class M-3 Model B-9 General Utility Non-Theorizing Environmental Control Robot, known simply as the Robot.

Good Luck, Good Health and Good Humor,

j-o-h-n Monday 01/28/2019 7:12 PM EST

[Bob10 in reply to Tall_Allen]

Sorry I'm not very educated about this tall .I was wondering I guess if someone could be newly diagnosed with prostate cancer and Mets some lungs.. Could the PSA stay at 1. For along period of time with just lupron and maybe bicalutamide

[Tall_Allen in reply to Bob10]

CHAARTED showed that early use of docetaxel had big gains for survival in men diagnosed with visceral mets.

[DeanNelson]

My highest PSA ever was 3.66, I have Stage 4 ductal adenocarcinoma with Mets to Lymph nodes, bladder, bones...

[Tall_Allen in reply to DeanNelson]

Yeah - ductal is one of those rare types. It makes it hard to monitor progression.

[tom67inMA in reply to Tall_Allen]

What about alkaline phosphatase? Does that indicate possible progression in bones independent of PSA?

[Tall_Allen in reply to tom67inMA]

Sometimes. Bone alkaline phosphatase is released when bone overgrowth is occurring.

[DeanNelson in reply to Tall_Allen]

TA...how will they monitor my progression?

[Tall_Allen in reply to DeanNelson]

Good question for your oncologist. Probably more frequent scans.

[Kimmilemo in reply to Tall_Allen]

How do you know what kind you have, is it on the path report?

[Tall_Allen in reply to Kimmilemo]

Ductal is indicated by pathologists on both the biopsy and the whole-mount report.

[AlanMeyer]

As others have said, the answer is that spreading cancer with a low PSA is rare, but it can happen.

If you provide more information we may be able to provide you with more useful answers. How old are you? Have you been diagnosed with cancer? Have you been previously treated? What information do you have about your diagnosis (Gleason score, stage, PSA at the time of diagnosis, other biopsy results?)

Bet of luck.

Alan

[NurseRatched]

Yes, it happens. This has been the case for my husband since at least 2017 (he was diagnosed in ‘09). Testing done at MD Anderson in November indicates that it’s [still] adenocarcinoma; he simply has never expressed much PSA (his highest was 15).

As a result, since spring 2017 he is scanned qtrly. Had been doing great, but recent worsening bone pain caused his MO to scratch Xtandi (he also took Zytiga), and last week he started chemo (Taxotere + Carboplatin). 🤞🏻

[StayingOptimistic in reply to NurseRatched]

What kind of scans he gets? MRI or ct?

[NurseRatched in reply to StayingOptimistic]

An annual brain MRI (from the get-go) due to skull mets, and qtrly. CT and bone scans (since learning that he no longer produces PSA).

[StayingOptimistic in reply to NurseRatched]

Aren’t you worry about the qtrly ct & bone scans becuse of the radiation exposure? I am asked to do chest, abdomen and belvic CT and a bone scan and I am very nervous about the radiation, although I had done 39 sessions of SRT two years ago and don’t want to add more radiation, any thoughts please?

[NurseRatched in reply to StayingOptimistic]

Ahk1: I think it’s a personal decision, much like deciding for or against qtrly. Zometa.

[StayingOptimistic in reply to NurseRatched]

Thank you.

[cujoe in reply to StayingOptimistic]

Somewhere in the past I heard or read of a doctor justifying regular scans with something like: "We are treating you for the cancer you have, not the one you might get down the road". I never much liked hearing/reading that, but it does make sense from a diagnostic/disease monitoring point of view.

Be Well - cujoe

[StayingOptimistic in reply to cujoe]

Good point. Thank you very much

[Bob10 in reply to NurseRatched]

I think bone scans don't have radiation or little. MRI scans are Magnetic ct scans have radiation

[monte1111]

Bone scan has minimal since they inject radioactive tracer or whatever they call it before scan. Would make my hand feel like it was on fire for a few seconds. And the often advice of don't go to the airport as you will set off their radiation alarms.

[j-o-h-n in reply to monte1111]

But it sure is convenient using my hand to signal opening my garage door and to start those hand dryer blowers in the men's room.

Good Luck, Good Health and Good Humor.

j-o-h-n Monday 01/28/2019 7:23 PM EST

[Jimhoy]

Hello again Bob

In my situation, I am currently completing 18mo’s of Eligard. My previous Urologist wanted to go 24 to 36mo’s. He’s my X urologist because I felt that he doubled as an Eligard salesman! My quality of life is in the gutter so my new guy stopped the treatment. We agreed to a plan to perform regular PSA tests @ 4 month intervials and as long as it remain low (constant 1.0 - 2.0 (as my T levels rebound {???})) and doesn’t all of a sudden spike (indicating possible cancer activity) , then we’ll call the treatment a sucess after (at-least) 2 years. I am expecting that at some point there will be more testing even if my PSA behaves but we’ll see!!

I’m sure there is an exception to every rule so, again, this is my story, my plan.

Summary as I understand it....PSA is an indicator. There can be false positives but Dr’s will allways eliminate the possibility of cancer. Especially with yours and my history. {Why wouldn’t we?!!!!}.

Low / No PSA [as a norm] means no cancer activity. Likely not the case once diagnosed though!!!

Jim