PSA to have stabilized after skyrocketing. What does this mean?

[SViking]

With PSA rising very rapidly four months ago after finishing Eclipse Trial, I had SBRT done immediately followed by Provenge. PSA on the day of SBRT was 2.0. It’s my understanding that Provenge will not affect PSA testing so it’s hard to determine progress. Obviously, there is still cancer still there since I don’t have a prostate. Since I’m not on any kind of ADT since last August, it appears that my immune system has at least slammed the brakes on the cancer. What do you guys think?

[Justfor_]

Stabilized PSA is always good news.

What is not so good news is that your free PSA shows an uptrend. When I was researching the matter I bumped onto some papers claiming that after RP the lower the free PSA the better (the exact opposite compared to before RP). Check it out.

[SViking in reply to Justfor_]

Somewhere along the line I heard that free PSA was aanirrelevant. Not true?

[Justfor_ in reply to SViking]

My understanding from what I have read, although I may be wrong: Irrelevant after RP is considered the ratio free to total PSA, not the absolute values of each. Before RP, this ratio gives us an indication on the origination of the elevated PSA. Higher the ratio, higher the probability that the total PSA comes from BPH and not from cancerous cells. After a successful RP, there are no prostate cells (benign or malignant) to put out any PSA, so apart from a very tiny amount put out by some other organs, the bulk of it comes from metastasized cancerous cells. In this environment, papers claim that the less the absolute value of any detectable free PSA (which ideally should be zero) the better the prognosis as to the development of the disease.

[SeosamhM in reply to Justfor_]

Awesome reply, Justfor_!

[SViking]

Anyone else out there have experience with Provenge stabilizing cancer without changing PSA?