Acceptable PSA

[Doseydoe]

My Google searches reveal disagreement on what the age-specific PSA reference ranges should be.

My curiosity has been pricked, as often I see the PSA figure of <4.0 ng/ml for a man of 60 touted as being acceptable. I'm 58, Stage 4, GS 9, PSA 2.7, and my Oncologist wants to see my PSA become undetectable. Indeed, this appears what we are all striving for - myself included.

My question therefore is, if someone at age 60, who has not been diagnosed with PC, and has a PSA of <4.0 is considered to be within an acceptable range, why do we become so anxious when our PSA results rise by small incremental amounts? And, if 3 consecutive rising PSA results is an indicator of cancer activity, what would be an acceptable scale and range be before we should act?

The things that keep me awake some nights, thanks brothers, maintain the rage, cheers 😎 DD

[Tall_Allen]

What may be confusing you is that PSA is used for several different purposes depending on one's situation. PSA <4 is a threshold only for men who haven't yet been diagnosed. Likewise "3 consecutive rises" is only a biomarker for men indicating they may be recurrent after treatment. For someone in your situation (on ADT and post-chemo), lower PSA is better.

[Hidden]

Dosey , I first got dxed five years ago . #4 gl4+4 t-4 non op I didn’t find this cite until two years later . Wish that I had sooner.. I had no one to talk to about pc . I searched the web and the first thing I discovered was a guy talking about his damed PSA going up the down up again. He stated his PSA history . Every time it was up he freaked out , down he was cool . I saw then that they PSA is a mental trap . Easy for me to say because ive been undetectable 41/2 out of five years . The holey grail for APC guys. It’s not with out suffering or pain . The psychology of it all is tremendous . For a normal man yes 4 is ok. But dxed with pc we want it nil. This means chemical castration which has it’s own charms . I chopped the boys after 18 months of Lupron shots every three months . Plus I’m on a test adt drug tak-700 that failed for most and halted . But for me it had worked. The thing is , once Apc goes haywire on us it’s aim is to eat us up in short order. It is a brutal foe inside of us . Don’t let it gain control . My highest PSA was 20 . But it’s been . 006 varying slight amounts over four years. Heal yourself but don’t take pc lightly Be well ... & good luck . You’ve got this . ..Scott

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[Magnus1964]

Not all prostate cancers are alike. A small amount cancer cells in certain types can produce a lot PSA. With others a l lot of cells can produce only a small amount of PSA. That is you must watch trends.

[RonnyBaby]

Your stat (G9) is more than a warning shot across the bow. G9 is advanced and aggressive, although it is not necessarily classed as stage 4.

G9 can still be potentially cured, in some cases, when it is classed as stage 3.

My case is stage T3b - meaning that it has locally spread (lymph nodes), but I might still be one of the lucky ones who caught it 'just in time'.

I'm on an ADT vacation as my numbers climb back into the 'normal' ranges of the world.

I was undetectable for about 1 year before I took a holiday.

In terms of trying to project into the future, the standard of care would TRY to get you to an undetectable state AND stay there for awhile.

That number is around <0.02. (or zero for arguments sake (0.00))

ADT is typically used to achieve that goal.

IF you stay above that level, the next step is to see if the number (PSA) trends / climbs and at what rate.

That assumes we are dealing with castrate sensitive PCa.

Those PSA numbers will drive the process until (if) you reach a state where you become castrate resistant. At that point in time, PSA will become a marginal stat, in the bigger picture.

You may want to get a second opinion or do some more reading / research to make the best decision about your own well-being / healing.

[ron_bucher]

Every guy's PSA is different.

PSA velocity is far more important than absolute value. Most doctors I've consulted with say a doubling every 6 months is a red flag.

I highly recommend this book: prostateoncology.com/books/...

Dr. Scholz is very objective in his views on treatment alternatives, and prostate cancer is all he has done the past 2-3 decades. When I complimented him on his book, he said it was "30 years of work".

[Doseydoe in reply to ron_bucher]

Thanks for the book reference Ron. I am learning all the time about this disease, especially with the help from all the great people on this site, cheers 😎 DD.