PSA wuestion

[Kemba]

Is 0.1 considered a reoccurance when previous scores have been <0.1. Should scans be taken. Virtual visits feel like vigilance has lapsed. Thank you

[Tall_Allen]

Most oncologists would wait until PSA rises above 0.2 before thinking of it as a biochemical recurrence. But a clinical recurrence isn't recognized unless a scan shows a new metastasis, or the PSA doubling time is rapid, or there are symptoms. Some think that ADT should begin at the time of a biochemical recurrence; some think ADT can wait for a clinical recurrence. There is a major clinical trial to see if ADT+2nd line hormonal agents begun when there is a biochemical recurrence can delay progression.

[Kemba in reply to Tall_Allen]

Thank you for such an informed reply. It gives me direction. Haven’t seen oncologist since August.

[BFOFARMO in reply to Tall_Allen]

Thank you Allen, from me too. I also had an uptick from <0.1 to .01; your answer helps me understand “the procedure”. Richard M. (BFOF)

[Garyzw in reply to Tall_Allen]

Mine went from <.1 to .3 after 2 years then a week later it read .1 any ideas or suggestions?

[Tall_Allen in reply to Garyzw]

Did you switch labs or take any supplements that might interfere with the test? Wait a month and retest.

[Kemba in reply to Tall_Allen]

I was wondering if it could be second covid vaccine. I heard it impacts mammograms

[Garyzw in reply to Tall_Allen]

I did not switch labs I have taken supplements for years the one I did increase is turmeric I used to take 1 then when I increased it to 2 when I got the .3 diagnosis. I wondered about that two. Read today where curcuminc can lower psa readings and give a false reading. Hoping this isn’t true and my psa. Is .1

[Tall_Allen in reply to Garyzw]

Curcumin interferes with PSA tests, giving falsely lower readings.

prostatecancer.news/2019/04...

[Garyzw in reply to Tall_Allen]

Thank you! Yes that’s the same article I read. I am going off all supplements and green tea .

[Garyzw in reply to Tall_Allen]

I Lao started taking melatonin to help me sleep

[MrkP]

I’m at .1 two years post RP. My oncologist has started me on ADT and I’m scheduled for SRT. He has an aggressive approach due to my relatively young age (50), Gleason 9, and SVI. I’m being treated at Dana Farber in Boston.

[Kemba in reply to MrkP]

My husband is being treated at Dana Farber as well. We already did 6 mos ADT and SRT post RP. He’s been <0.1 for almost 2 years. That is why this rise makes me nervous.

[Steve507 in reply to MrkP]

My oncologist has an aggressive stance as well since the 0.2 threshold is based on limits of older PSA assays.

[Danish-patient]

It is progression, but at a very small scale. Even the most accurate PET scan will not say anything for certain before PSA is 0.2 or 0.3 or higher. But keep a close watch at your PSA the coming years.

[EdBar]

I’ve been undetectable for about 6 years, but recently my PSA has been flickering in and out of being undetectable using an ultra sensitive test. Both Dr. Sartor and my local MO feel this is a sign of castrate resistance however Sartor has advised me to just monitor until we reach a level of 0.5 and have a PSMA scan done. That is the level at which it is most effective according to him. For an Axumin scan he recommended PSA be at least 2.0. Then depending on what scans show and where they are we would do some whack a mole with IMRT. PSA tests are a bit more unnerving lately than they’ve been in the past.

Ed

[Carp1707]

My experience

ADT for a total of 40 mos. Stopped in Dec 2019, undetectable for 6 mos, 0.029 in June 2020,has since climbed to 1.37 in March 2021, having a PSADT of 2.1 months Went back on ADT, Eligard+Aberiterone. Axumin scan showed 2,3 spots in pelvic area 3 cm. Not accessible to radiate thus ADT until it fails.

1.0 is lower limit of Axumin, as I understand.

PSMA/PET may have been more detailed...probably the same treatment plan.

[ron_bucher]

PSA velocity is more important than absolute value. That's why I get ultrasensitive PSA tests that have two decimal points, and always use the same lab. My oncologists don't put as much value in the "<" sign as they did in the past. They are happy as long as there is not an upward trend. If my PSA velocity causes concern, I get tested more frequently.

[Kemba in reply to ron_bucher]

Thank you. Pre pandemic we used Dana Farber same lab but we live 90 mins away and they don't do ultra sensitive psa here even though that is what our dr order says. We've used the same lab since pandemic every 3 mos ( not ultr) and this is first time it was 0.1 rather than <0.1

[j-o-h-n]

Kemba. wuestions: What is your age? Where are you located?

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/07/2021 5:59 PM EST

[teacherdude70]

There are many that view any rise in psa as alarming and requiring intervention. There is a view that two local Cancer centers, one being the first credited Cancer Center, that looks for doubling time, velocity of change, and psa at 2.0 above NADR. A rise from one test to another is common. Even a rise over a long time is common.

Remember that we are each different even if the case seems exactly the same.

My personal Oncologist(s) say do not worry over an increase over time unless my aforementioned psa stats happen.

So do not worry, but ask questions and get a second opinion.

[Kemba in reply to teacherdude70]

Thank you!

[Cooolone]

For primary treatment, RP recurrence is considered when PSA reaches .05ng, for RT it is somewhat higher as the gland is still there, so a rise of +2.0ng above nadir is considered recurrence.

That all said... There's so much that goes into an accurate and beneficial diagnosis, and PSA alone is not the best indicator for prognosticating PCa conditions. Post primary treatment, PSA Doubling Time is valuable in predicting the possibility of metastasis, again though, used alone it doesn't help much.

Best Regards

[teacherdude70 in reply to Cooolone]

If doubling time is reacted to with Scans then it is very helpful.