Mountains out of molehills?

[JazzMan42]

Dx in November 2018, Gleason 9, metastatic in vertebra, ribs and pelvis. On Lupron/Zytiga/Prednisone/Xgeva since December. PSA dropped from 7.57 in December, and kept dropping to 0.69 in May. Latest reading on June 26 showed slight increase to 0.73. Being a natural borne worrywort, should I be concerned about this rise or am I making mountains out of molehills?

[NPfisherman]

Too early to tell....more readings needed...wait for the trend, my friend....that will be the tale of the tape......

Don Pescado

[JazzMan42 in reply to NPfisherman]

Thanks, Don. Will keep watching the tape.

[JazzMan42]

Thanks, Bill68. Just needed to get some reassurance.

[Tall_Allen]

It sounds like you already know the answer.

[tango65]

Do not worry until you have a trend indicating a consistent progression of the PSA.

[tallguy2 in reply to tango65]

Agreed. Successive progression and velocity towards 1.0 is a call to action (at least for me).

[paulparry]

PSA can be affected by a number of things so its no worry.

Markers are usually less than 1, 5 and 10 after that they think about reacting. Normal trend would be it doubling as if you think of cancer cells 1 bad becomes 2, 2 to 4 and so on. Each time I experienced it then something followed. Spine compression, T vertebrae issues, hip issues and now the rib. Radiotherapy to the rescue.

Bone mets are going to be different for everyone.

[MarkBC]

I have a similar diagnosis. It's been over a year now. My PSA bounced around a little. My oncologist thought I may have reached my nadir after three monthly readings of just under 0.3. Then my last two readings were 0.21 and 0.17. I'm hoping this means a further downward trend. Good luck to you.

[larry_dammit]

Mine did that one month, then went back down. Doctor figured it was just a glitch in the test .

[Litlerny]

It’s molehills my friend, but I understand your concern. After nearly 4 years of being undetectable my PSA has recently crept ever so slightly up to 0.12, 0.15, 0.19, and most recently 0.22. Like you, I was concerned. At my most recent Jax Mayo Clinic M.O. visit & labs my M.O. reassured me it was not a reason to panic. In fact, he was actually pleased with how stable my PSA was staying and (more importantly) that I was still totally asymptomatic, which was a great relief for me to hear. He said he would be more concerned if my PSA took a huge leap, or a series of huge leaps, but at this point he looks as much at change in symptoms to change in PSA as indicators of disease progression. He kept me on Lupron and took me off bicalutamide. He said that at this point the bicalutamide wasn’t doing much of anything other than causing side effects. He also said that withdrawing bicalutamide after long term combined androgen blockade sometimes paradoxically causes the PSA to go down. He said my next step, (when that time comes) would likely be to add either Xtandi or Zytiga + prednisone, and “see you in 3 months.” 😎

Take a deep breath and relax. 😎

OK...time to head to the golf course 🏌️⛳️

[JazzMan42 in reply to Litlerny]

The sound you hear is me taking a deep breath and relaxing!

[j-o-h-n]

How about a strum instead.... I used to make mountains out of ant hills...and then one day I discovered chocolate chip ice cream (two scoops)...

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 07/03/2019 6:23 PM DST

[Drphil1938 in reply to j-o-h-n]

Ice cream, and firecrackers go well together on the 4th of July. Happy birthday USA.

[j-o-h-n in reply to Drphil1938]

They sure do...... and a Happy, Glorious Birthday USA.

Good Luck, Good Health and Good Humor.

j-o-h-n Wednesday 07/03/2019 7:15 PM DST