PSA Signals What Exactly?

[NWLiving]

Ok after 4 3/4 years of wrapping our lives around waiting for PSA scores and responding to PSA scores, what creates that little antigen anyway. My husband’s scores have creeped up from 1.9 to 3.3 over the past five months but then stabilized for a month. He is post dosetaxl, provenge, cabatzitaxel (sp?) and still on lupron (since beginning) and xtandi since Aug 2017. I also wonder what they’ll try next. He has had stable Mets to his bones.

[cfrees1]

PSA is an antigen produced by prostate cells in your body. If the prostate was removed via RP, you would expect undetectable PSA because there would be no more prostate cells producing PSA. If PSA is detectable, that would suggest that prostate cells (in the form of PCa) exists somewhere in the body and are producing the antigen. If the PSA goes up, that would suggest that MORE prostate cancer cells exist (ie. the cancer is advancing).

[NWLiving in reply to cfrees1]

Sneaky little bastards... so the antigen produced by their existence. It goes up because their numbers have gone up. Still it’s way too early to burn down the house to get rid of the termites.

[cfrees1 in reply to NWLiving]

Someone is bound to chime in that a rising PSA is not the only indication of PCa. There are some rare forms of PCa which do not elevate the PSA as the more common varieties do. But that was not your question.

[GranPaSmurf in reply to NWLiving]

I would think that more specifically, a noticeable drop in the circulating level of the Prostate Specific Antigen protein would signify cellular death - releasing the protein into the circulation. Since most (normal) cells turn over in about 3 weeks, a 'normal' level can be calculated. An increase means more growth (and death) of Prostate tissue.

Hence, 2 'undetectable' results separated by about a month should mean that there are no prostate cells growing in the body.

But I kind of doubt the body will ever allow that ideal to be reached.

[tom67inMA]

Here's my understanding: In a healthy prostate, the PSA is supposed to go into the seminal fluid where it allows sperm to swim freely (according to wikipedia), and other than a trace amount it's not supposed to get into the blood. In my particular case (intraductal carcinoma), my PSA didn't elevate at all until the cancer had metastasized, so even though I had PSA screening tests they did not indicate a problem.

As far as I know PSA doesn't perform any function in the prostate itself, it's just a product of the prostate that's needed for successful reproduction. Cancer cells that mutate and stop producing PSA will do just fine, and perhaps better now that they're no longer making a substance they don't need.

I've also heard a rumor that metastases don't produce much if any PSA until they've reached a certain size where they're big enough to have a blood supply and thus have the extra resources to make PSA. Obviously when a metastasis produces PSA it will all go into the blood.

So while a high or rising PSA is almost always bad, a low or dropping PSA is better interpreted as "not bad" rather than "good". Alkaline phosphatase, scans, and physical symptoms can also give a clue as to what the cancer is doing, though of course those aren't 100% reliable either.

[NWLiving in reply to tom67inMA]

Many thanks!

[j-o-h-n in reply to tom67inMA]

Good post tom✔...I'll give you a 67 out of 100. Thanks.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/08/2019 2:52 PM EST

[Stegosaurus37]

My understanding is the level of PSA isn't important. It's the doubling time - the time it takes to get to twice its original value that's the key metric. The shorter the doubling time, the worse it is.

[NWLiving]

Many thanks for your responses. It helps putting it down in black and white. But too much thinking about it is a good way to ruin a perfectly fine day/week/month/year. No more thinking about that until next month if you know what I mean.

[j-o-h-n]

We know what you mean...... Just go on NWLiving and laugh your ass off.

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 03/08/2019 2:54 PM EST

[Haniff]

"But too much thinking about it is a good way to ruin a perfectly fine day/week/month/year. No more thinking about that until next month if you know what I mean." well said sometimes its good to keep the mind still and not give in to mind chaos... take a break and have some dark chocolate both hubby and you ❤️

Take good care, even if this wish comes in two years old... lol

Haniff

[NWLiving]

Still great timing,we go in for an appointment today..🤤