PSA and volume of mets

[Fdccs]

Hi,

Something I've wondered since my husband was diagnosed at the end of last year is why do some men have a PSA of say 200 and Gleason 9 with multiple mets and someone have the same stats but locally advanced or 1 met?

[NPfisherman]

Some of it probably has to do with PSA doubling time... aggressiveness of the strain and mutations ....some of it is just bad luck I think... my case--PSA around 6-- biopsy----Gleason 8--got gram negative (E coli) sepsis and ended up hospitalized after biopsy...then PT3A at surgery---no lymph nodes or seminal vesicle involvement--7 months later--M1, D2--one met, distant metastasis...just bad luck, I guess ....go figure...although I do wander about the sepsis dropping my immune status...

Now, we play the hand we are dealt to the best of our ability... good luck to all...

Fish

[Tall_Allen]

Detectable metastases tend to put out a lot of PSA. There are exceptions, but that is the tendency. In order for a tumor to put a lot of PSA into the blood, it has to have created its own blood supply. Larger (detectable) metastases tend to have more vasculature, while micrometastases tend to have less. That said, some types of prostate cancer just express more of the PSA protein than other types. PSA is one of several biomarkers we look at.

[Lynsi13 in reply to Tall_Allen]

I’ve always wondered about that as well. My dad had a PSA of 257 and an enormous prostate gland...so huge it had caused his kidneys to go into failure and required two months with double nephrostomy tubes directly into his kidneys. However, his met was only to one nearby lymph node and his cancer has responded incredibly well to treatment. He’s nearly four years out since diagnosis and is still on his first line of treatment.

I read an article once about how sometimes large prostate tumors are a sign of lazy and less than ambitious cancer cells that rather than packing their bags and heading out to make mets, they just hang around and make the prostate larger and larger!

Based on my dad’s initial prostate size, single metastasis and response to treatment, I have to wonder if it isn’t true!

[Fdccs in reply to Lynsi13]

This is encouraging. My husband PSA was 167 with one single lymph node. What hormone therapy is your Dad on?

[Lynsi13 in reply to Fdccs]

Glad that it can be on encouragement to you!! Every year that he gains is another year that research can find new and (hopefully) better treatments! He had chemo initially and has been on Lupron + Casodex ever since! Last PSA was .07.

[monte1111 in reply to Lynsi13]

Sounds like your dad is doing well, and that is great. Since I am lazy and less than ambitious I do hope my cancer cells are just lazing around and not packing their bags. Too much trouble to make mets today. Just going to hang around. Maybe I should start smoking pot again. Really make those cancer cells lazy. I guess edibles would be better. Don't want to add lung cancer to the mix. Enjoy.

[Lynsi13 in reply to monte1111]

Hahaha! If that’s the case then I think all of you blessed souls on Lupron should be doing just fine! Haha! It sure has been a battle for my dad to find ambition since taking it. He manages to drag himself to his treadmill every day for his thirty minutes, but it’s not without its challenges! 😂

[monte1111 in reply to Lynsi13]

That is just great! If dad is doing 30 minutes on treadmill, that's 29 minutes more than me. I actually have spent all afternoon deciding on some pot. Recommended by those who say it has medicinal value. Ha, ha. Your off the wall remarks have started me on a new journey. Of course, on my mind already, you just gave me that little gentle push. Am I lazy? Having it delivered. Enjoy.

[dockam in reply to Lynsi13]

Sounds what I had: GL7, PSA at 840, Huge median lobe on prostate, mets to L ureter lymph nodes - stents placed to avoid kidney failure. ADT in 01/2015, 1st of 15 Taxotere chemos two weeks later. PSA nadir at 0.7. Stopped ADT after 30 months, T got to 1002, PSA to 10.8, restarted Lupron and PSA down to 6.6. Best to y'all - Randy

[Lynsi13 in reply to dockam]

Wow! You guys do sound very similar! Same year of diagnosis, same mets and even the nephrostomy tubes (not too often I hear of others with those!). My dad also had chemo.. he only had six rounds. He’s been on Lupron and Casodex ever since. I would love for his doctor to give him a vacation from it but he doesn’t like to take risks and believes that if it’s working, don’t change anything! How old were you when you were diagnosed? My dad was 74. All in all he’s doing well. The hormone therapy zaps his energy but he pushes through and exercises and eats healthy and I think that helps!

[dockam in reply to Lynsi13]

I was hit at 57, totally caught me by surprise. Yes, staying/eating healthy will help offset the ADT. A story from my local paper: theloopnewspaper.com/story/...

Also, scroll thru my previous posts, if you wanna.

I'm off work and headed home.

Take care and keep us posted - laters - Randy

[charlesmeyers1964]

for almost 11 years i had no mets off and on with the lupron shot its all about the hot flashes individual the first time i took the lupron shots i had some hot flashes and then when i was off of it for months then went back no hot flashes. my mets started recently

charlie

[j-o-h-n]

Why is caramel pronounced KARR-uh-mel, or KARR-uh-muhl, or KAR-muhl?

I'm sure Tall_Allen's explanation (way above) is correct.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 02/20/2019 7:08 PM EST

[GeorgesCalvez]

There is a strong correlation between metastases and Gleason Score.

There are Gleason 7 tumors that do not seem to go anywhere fast.

I had a PSA of 131 with a Gleason 7b at diagnosis that dropped to 2 after the prostatectomy so a very high proportion of the tumour has to be presumed to have been in the prostate, I have no detectable mets and my PSA dropped to below the limit of detection after 3 months on Firmagon.

After 66 Gys of radiation to the prostatic fossa as well, I doubt that I am cured but I suspect that the levels of cancerous cells are now very low.

Who knows?