Psa 0.4 ?

[Mish80]

Hey there,

My dad has had a much needed 5 week holiday in the sun post diagnosis and treatment. We’ve all had a break from this crappy disease consuming us daily. Now it’s back to reality though. Dads first psa reading post radiation for a bone met and two months on Zoladex was 0.4 (down from 1.4). Now 8 weeks later it is still 0.4. Is this ok? Dad seems flat after the appointment, has also been given bone strengthening meds and mentioned that he didn’t realise how aggressive his cancer is. How do they even determine how aggressive it is? He was first diagnosed 9 years ago T2 Gleason 7, radical prostatectomy and no treatment until this year....

[LearnAll]

To determine how aggressive prostate cancer is ,you have to take a combined look at many factors...some of these are:

(1) How well differentiated OR poorly differentiated the cancer cells are ? This is indicated by Gleason Grade...A Gleason grade of 3+4=7 is certainly much less aggressive than say a Gleason grade of 5+5=10 or 4+5=9.

(2) Extent of metastasis...is it only in bones or its also in visceral organs? Once who are confined to bones only.. tend to be less aggressive.

(3)Active symptoms: In general more prominent the symptoms are..more aggressive the cancer tends to be.

(4) Overall general health...More comorbid medical conditions such as Diabetes, High lipids, High BP, Obesity etc..more aggressive cancer tends to be.

(5) Histologic type: Acinar Adeno-carcinoms type are less aggressive than ductal, small cell or neuroendocrine types. Fortunately, only 5% fall in the second category.

(6) Good Diet, less stress and solid family /friends (support system)...has a positive effect.

Remember Prostate cancer is not a single entity...it is heterogeneous.. means it varies from one person to the other. That is why some people live only 2 years after diagnosis of mets and other lives up to 15 to even 20 years after diagnosis of mets. (Proof of such long survivors are all over this forum)

Lets come to issue of bone streghthening meds...they have many nasty side effects...so I will not consent to take them UNLESS my bone density scan shows clear cut severe osteopenia or osteoporosis. Until then, foods and supplements to support bone health. Many Doctors have become blind pill pushers out of fear of legal problems and to overtreat to protect themselves from litigious families/lawyers.

You and your dad need to empower yourself with knowledge and emotionally support each other. Best wishes for your Dad's good health. He is lucky to have a caring child like yourself.

By the way, a PSA level of 0.4 is not just OK..it is more than OK.

[Hidden in reply to LearnAll]

👏

[Mish80 in reply to LearnAll]

Thanks very much. This is what I will try and tell dad - aggressive has many levels and besides knowing his Gleason was 7 on diagnosis 9 years ago, the only other info we have is his PSA scores and evidence of one met on his spine.

[Hidden]

In simple, non medical terms, I would be very happy if it were me. However I have zero medical training, I know only what my oncologist tells me and what I read online.

[Tall_Allen]

That's an excellent PSA response. What were you expecting?

[Mish80 in reply to Tall_Allen]

You’re right TA. I don’t know... I think I’m just responding to my dads low mood. I’m guessing the Zoladex is catching up to him. He was also previously told that he could stop hormone therapy after a year (no idea why the onc said that), and now the radiologist said he has to stay on it for as long as he can tolerate it.

[Tall_Allen in reply to Mish80]

Yes, with a bone met, ADT is lifelong. It is managing his disease well, it seems. His mood, not so much.

[Hidden]

Boy that’s

quite a journey that he’s been on . I hope the nine years were spent well . Just when you think all is done and forgotten . This is the ugly nature of APC . Love him much . That’s the best medicine.... .4 ain’t too bad . Going in the right direction. May his Psa continue to stay low . Take care of PaPa. 😎

[j-o-h-n]

It's a Mish Mosh.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 08/30/219 4:16 PM DST - Pinnes