What does a high Chromoganin A,S test mean?

[Echotango51]

I have been on lupron for 5 1/2 years. My PSA has been slowly going up. PSA 3 months ago at uro was 0.23, last week it was 0.22.

I went to Hollings Cancer Center too see MO for the first time. PSA was 0.3. One of the test was Charomoganin. My number was 145ng/ml , the range should be <93/ml. Does this mean that my adenocarcinoma has mutated into neuroendocrine.

Info about test was, “ Test results cannot be interpreted as absolute evidence for the presence or absence of malignant disease.” So, what does this mean? Any comments will be helpful, going to message MO for his thoughts.

You can read my history in my profile.

Echotango51

[LearnAll]

As years go by.. some cancer cells start turning into Androgen resistant....more years go by some of these Androgen Resistant cells turn into Neuroendocrine Cells...This change from Sensitive to resistant to Neuroendocrine..happens in different men at different speed. In Some change to NE can happen in a year whereas in others it can happen very slowly taking 5 to 10 years or even longer.Chromogranin A is a blood test ,a biomarker for how many cells have turned into NE type..but this test alone is not enough. Two other blood tests..Lactate Dehydrogenase and Neuron Specific Enolase are needed to confirm. If all these 3 tests come abnormally high..it means the chances are that NE conversion is taking place....the rate of rise in these biomarkers give an idea as to how fast or how slow this transition from Androgen sensitive to Androgen resistant to Neuro Endocrine type is happening. It some lucky men, this process can take 20 years or even more.

Its the pattern of constant rise in Chromogranin A which tells the real story..one time reading is not sufficient to make a conclusion.

[Echotango51 in reply to LearnAll]

Thanks for you reply, I understand it better.

[Tall_Allen]

It doesn't mean anything. Some badly informed patients think it does. Blood tests cannot be used. The only way to test for neuroendocrine prostate cancer is to get a biopsy of a metastasis and look at the tissue under a microscope with IHC staining. Because you have no metastases and NEPC was not found on your original prostate biopsy, and your PSA has been rising, you can be very certain that you have do not have NEPC.

[Echotango51 in reply to Tall_Allen]

Thank you TA, I want worry about this test, by the way, I followed you from Healing Well, this a much better site.

[johnscats in reply to Tall_Allen]

Hi TA on firmagon nearly 4 years Mets to 3 places spine had in pelvic lmphnodes now no sign on last pmsa scan was on femour no sign now on same scan but on right iliac Gleason 9 no chemo done Gleason 9 PSA has always been lowest .8 but uaslly hovers between 1.6 to 2 monthly test goes up one month drops back another month however last 2 months has gone to two rises 2.02 this month 2.37 but recent CT scan with contrast all stable starting to get worried is this start of castrate resistant pca another CT scan planned shortly

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Keep rowing the boat Echotango51! I’ve been under the radar myself with no t for over six years . I’m lucky to still be afloat .. 🚣🚣. I Liken it to being inside the eye of the storm . Treading water skills are needed.. 🏊‍♂️🏊‍♂️

[Hidden]

I discussed this with my doctor and he also said this test and others such as NSE can not be used to diagnose NEPC. But if you have been diagnosed with NEPC, my doctor looks at these tests to see if they are high in order to possibly use them as tumor markers.

[Hotrod65]

correct on all acts mentioned by others..my case is very unusual..i mutated to scNEPC at diagnosis, very aggressive disease that didnt responds to a barrage of conventional treatment therapies..Gleason 9 4+5... PSA only 10.5..10 months prior at annual physical 0.02..no Cancer..my bloodwork markers were always in normal range so not an indicator of NE....i am so fortunate to he considered an Exceptional Responder to immunotherapy Checkpoint Inhibitor PD1 due only to having a Hypermutated Tumor Burden after Genomic Sequencing done by Foundation Medicine..going on 7 yrs now in Durable Clinical Remission NED after a 3-6 month terminal diagnosis and 55 infusions of Pembrilizimab..live for the Day and fight the Good fight..God Bless.

[Echotango51 in reply to Hotrod65]

Thank you, God Bless!!!!!

[j-o-h-n in reply to Hotrod65]

Ketruda = wonder drug...... for my lung melanoma...... Kill those M.F'ers

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 10/16/2021 10:59 PM DST