I've been on a ADT vacation for a little over two years - and my PSA is rising and i was expecting to go back on ADT this month - but my results came back and showed a dramatic drop. My recent history is:
June&July 2022 - 0.2
Sept 2022 - 0.4
Nov 2022 - 0.6
Dec 2022 - 1.1
Jan 2023 - 1.5
Feb 2023 - 0.4
I am having a retest done for free/total PSA and testosterone - but I won't have those back for another week because they have to send it out of state for analysis - and my MO appt is on Monday.
The february test was at my PCP's inhouse lab vs the others at the local commercial lab (SonoraQuest) -
I have also boosted my aerobic activity so i'm adding some running to my routine (5 days a week).
I'm hoping this is good news, but i'm skeptical - I have a hard time believing that there would be that big of a difference between the two labs - esp at these levels (maybe at the ultra low DL - but this should be squarely in their wheelhouse).
Is this kind of drop feasible - and then i have the "man with two watches never knows the correct time" issue of having two results and not knowing which is correct - hopefully the out of state result will bring some clarity.
thanks
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PabloK
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Different labs use different "assays" and the actual result should indicate which was used. At least mine do. The estimate on mine is a 20% difference between 2 referenced assays which yours exceeds. Hopefully something great happened and your immune system kicked in to stop the progression.
From your lips to God's ear - i hope so - and I would think 20% would be the max ( i worked w/environmental labs for 40+yrs and am familiar with lab certifications/testing so i'm assuming its the same w medical labs). thanks
From what I can tell, you are not on ADT "vacation." You had limited term adjuvant ADT and it is over. It may be several years before you know if you are cured.
You should have the same lab doing your PSA. There is no "right" answer, there is only consistent observation. I have no idea what free/total PSA means after treatment.
Well according to my Research Professor of Genitourinary Diseases and Professor of Genitourinary Disease at a major Medical School; both of who specialized in Advanced Prostate Cancer, the same. As a Guinea Pig since 2004, they always order Testosterone, Total PSA, Free PSA, and % Free PSA. I have had in excess of 130 tests through the years. Added are also, CBC, CMP, and Lipid Panel …. At least quarterly.
I grant you that I may be different than those treated by community oncologists as I live in the world of academia.
And what does it mean if the free/total is high or low after radical prostate treatment? You may want to ask your doctor why he is ordering those tests.
I have to agree - although i have much faith in my PCP, I think it was just a thought as he looked at the list of analyses and decided to go with the free/total test because "more data is better" -
damn I learned a new definition. No longer does radical in medicine mean: relating to or being surgery that is extreme or drastic in an effort to eradicate all existing or potential disease.
What defines a cure - after coming off of Hormone therapy (Zytiga) - what period is a long enough period with PSA <0.01 that determines if you are cured. I am assuming that the first year after coming off Zytiga (PSA nadir) - all other years of PSA free may be used as a guideline... - is there any research that indicates "cure"
Cure is a word patients use, including me. A doctor can only say that there is no evidence of disease. When the cancer is localized or even if stage N1, curative therapy is attempted - radical prostate treatment, whole pelvic radiation if indicated, and limited term hormone therapy. They look for the earliest indication of biochemical (PSA) progression. When the cancer is stage M1, the goal is maintenance and delayed progression.
just got an update from my confirmatory sample - and its 0.7 so my PSA has gone down - which is fabulous news - at least the upward trend has been broken......for now at least but i'll take it.
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Probably the trend is more important than the absolute number. For that reason I think it's important to have your PSA tests done consistently at one reliable lab.
I agree - i'm just figuring it out - i didn't know that my pcp has his own lab - the guy who takes the blood sample in his office appears to be an employ of our local commerical lab (SonroaQuest) - but apparently they have an arrangement where they send the routines to the Dr's lab and all other go to SonoraQuest so some of my samples are split between those two labs. I would just do the Mayo but they are about a 45 minute drive one way so I have been hesitant to drive that far.
I'll figure it out - but i concur that reducing the variables is always a good thing
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