Should I sell and retire with PSA at 0.1 following 9 months undetectable?

[LakeT]

Diagnosed early 2022, Gleason 4+4. Metastasis to multiple sites on the pelvis, no other detectable spread. Triplet therapy with ongoing goserelin and abiraterone with prednisone. Abiraterone is once per day with a low fat meal.

Following nine months of undetectable PSA results, I recently received the news that my PSA is no longer undetectable and is now at 0.1. While this value is still relatively low, it has understandably caused me some stress and uncertainty. I worry that this is likely to be a sign of progression to castrate resistance and stressed in a similar way to the initial PC diagnosis.

I had been maintaining a positive outlook, envisioning myself among the fortunate survivors who have gone 18 years or more on ADT without recurrence. However, browsing through the experiences shared on this site has made me realize the unpredictable nature of this journey.

Despite these concerns, I still feel relatively well, albeit more tired than usual while managing my small business, playing tennis, and engaging in resistance training. However, I am apprehensive about the potential impact of intensified treatment on my energy levels and brain additional brain fog, particularly as the work I do is more mentally demanding than physical.

I am contemplating whether now might be the right time to sell my business and retire before any increased health issues make the selling process too difficult. Any advice or insights you can offer on navigating this decision would be greatly appreciated.

[NanoMRI]

I began the closing of my business after my diagnosis; 9 years ago. After my RP, I bought an RV and have been wandering the mountains and high plateaus from TX to MT and back, since. In fact, departing TX tomorrow. Also, spent time over three years renovating a rural France granite farm house. Yes, I live an even more modest life and may be broke if I make it to my 90's, but for me, best decision.

[Gearhead]

Are you certain that your PSA test result wasn't reported as <0.1? And were your prior "undetectable" results quantified?

[LakeT in reply to Gearhead]

The testing lab shows results as undectable from <0.5. All results over the prior 9 months came back as <0.5

[Tall_Allen]

0.1 is excellent!

[LakeT in reply to Tall_Allen]

Thanks, I’m encouraged by you brief response and slept better for it. I do wonder if 0.1 is less than excellent following 9 months at <0.5 and lead the change in treatment plan when I next visit my MO in 2 months.

[Tall_Allen in reply to LakeT]

There may always be some PSA, but 0.1 is about as good as you can expect and shouldn't lead to any changes in therapy. It was 120!

[LakeT in reply to Tall_Allen]

Thanks again.

[Maxone73]

Tough decision, a lot depends on how much you like your job. Can somebody help you in case? Sometimes I feel like we should create a network of remote workers on this site and manage businesses together! ok ok, disney movie...

[LakeT in reply to Maxone73]

My son in law joined the business after my initial diagnosis which has helped to reduce workload. Not enough to walk away though. It seems that 40+ years business experience is not easily replaced!

[mrscruffy]

In the end it is up to you. I was diagnosed at 54 and planned retirement at 56. So, I went 2 years early as i was financially prepared to retire. Sold my rentals and sailed into retirement without a regret. Being retired has been a blessing. Travel and experiences with friends beats working any day

[Cackalacky_cyclist]

I don’t mean this literally, but I view work as analogous to one of wife, girlfriend, acquaintance, stranger (benevolent or toxic). Feelings change overtime, of course, but you should be able to gauge your passion for your work against whatever you’ll be replacing it with. If you don’t know what you’ll be doing instead of work, that’s a red flag

[LakeT in reply to Cackalacky_cyclist]

Thanks. Work is enjoyable or I would have already retired. Business is competitive though and if I can’t compete adequately the fun will not be there.

[skiingfiend]

Each person's situation is unique and based on a myriad of personal factors.

Here is what I did and why:

1. I was diagnosed at 62 with "Stage 4 High Volume mHSPC". This is a fatal disease and my projected lifespan is considerable shortened from that of a healthy 62 year old.

2. I operated a 1-man IT consulting practice with long term recurring clients. I was already in the process of reducing my workload to 1/2 time with the original goal of retiring at 65. My wife had just recently retired prior to my Dx.

3. We have a financial plan and had achieved about 90% of saving and investment targets for retirement. We have no debt and we have an investment portfolio that generates annual cash flow well in excess of our spending needs including projected cancer spending. We have achieved financial security and independence and no longer need to work to survive. My wife is provided for and will be secure after I'm gone.

4. I retired immediately upon getting my diagnosis. Three factors colored my decision:

a. The best remaining years I'm gonna get are the first years after diagnosis. As the disease progresses QOL and capability will decline and burden of treatment will increase.

b. After 40+ years of hustling to stay afloat and get ahead I was ready to throw in the towel and live a simpler life.

c. Everybody in my peer and age group who has retired is generally happy with their decision and nobody wishes they had worked longer. I too am happy I retired and I will never go back to work.

5. I have plenty to keep my mind occupied managing my cancer and my financial plan and honestly don't need any other stressors in my life.

6. Being retired is like being a teenager with money. I mostly do what I want, when I want and live in the moment. I have plenty of hobbies and activities I enjoy. My wife and I can plan for larger goals like travel or special events. I can always generate personal projects to work on.

7. Disease progression is unpredictable. I recently experienced a large setback that left me in debilitating pain for over a month. During that time I would not have been able to work and would have been essentially forced into retirement away since my clients would have to drop me.

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I, like many on this forum, am on the bad news train and once you board at the station you can't get off and each stop is just progressively more bad news.

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That is my experience, hope that helps.

[LakeT in reply to skiingfiend]

Thanks for your detailed response which encourages me to join you retirement.

[Skippy3]

I used my diagnosis to barter for more money at work and then work half time. I enjoy my job and the extra money doesn't hurt. I take off from work when I want. What are they going to do, fire me? I've owned my own business in the past and I know how stressful that can be. Selling it while it is worth something is not a bad idea. Your son and law may continue to work for the company after you sell it. Good luck.

[gsun]

Sell it. Hopefully to your son. If so, you can keep your finger in it when you want or when he needs advice. I wish I could have done that but my kids were not interested. I'm broke now but wouldn't do it any different!

[j-o-h-n]

If you love your job........ it's not a job.........

Good Luck, Good Health and Good Humor.

j-o-h-n

[garyjp9]

What I did: I was diagnosed with Gleason 9 PC in 2020 at age 70. I immediately had an RP, only to find out it had already spread to lymph nodes. 39 RT treatments in 2021. I had multiple complications from the procedures, esp the RP, some causing great pain. I was a lawyer with a federal agency, and I really enjoyed my job. Had I not gotten sick, I'd have continued working. Even with the cancer, I tried working through all the pain and treatments and appointments anyway, but I found it very difficult to focus on work. My office was very accommodating and did not pressure me, but I found I was not performing at a level that I considered acceptable, so I retired at the end of 2021. Everybody's situation is different, though. Good luck with your own decision.

[JR0912]

Like Tall Allen said, .1 is great. I too had a scare when I switched labs. At the first lab <.08 was undetectable. When I went to another lab <.14 was undetectable. I was expecting <.08 and only saw .14 instead of <.14. I was sure the cancer had returned until the urologist pointed out the "<" in front of the .14 and explained that the new lab used a slightly different analysis method where the couldn't detect PSA under .14. It has stayed there for the last 3 years. Good luck with your journey.