PSA at 0.285

[Formosan]

I had my RP last January but the cancers had sneaked out to my lymph node already (no other met) so my PSA was always detectable. I started hormonal therapy last April and my PSA went down right away. It had been that way till this week ( PSA was up and down, the lowest was 0.02, usually was 0.05.). Today's reading is 0.285 that worries me. I phoned my doctor to see if I should be on Zytiga or so to control my PSA ( I receive shot of Diphereline monthly and on Casodex daily) but he said it is still all right. I remember I read somewhere saying if PSA goes up to 0.2.., its time to do something. Can some one share your understanding and experience to see what should I do ?I am 81. I am not ready to die yet. Thank you.

[Justfor_]

Re-test to be certain. "Measure twice, cut once", useful advice not limited to carpenters only.

[Formosan in reply to Justfor_]

Thank you, Justfor. I will ask my doctor to order a re-test if he will. Often doctors are not that sensitive to human suffering either psychological or physical. Actually, i phoned him for that and he said the insurance may not cover that. I wonder if PSA will go up and down from time to time.

[Justfor_ in reply to Formosan]

I take monthly PSA tests. The public healthcare system here prescribes up to one every 3 months. But, the cost is low, i.e. 14 Euros or about 15 USD, so no problem paying out of pocket for the remaining 8 per year. As you may understand with more than 60 test undertaken, two of which proved erroneous on retest, I have developed some personal assessment "guidelines":

a) Any test deviating more that +/- 30% from my projected estimate needs to be retested next day with a different lab.

b) Less than 20% variance between the same or even different labs is considered as normal.

[Formosan in reply to Justfor_]

" Any test deviating more that +/- 30% from my projected estimate needs to be retested next day with a different lab. " ----- this makes sense to me. I am with you. Justfor, Thanks.

[Alturia]

I had an RP in January 2022. The cancer had spread to 1 lymph node. I was put on Eligard in April 2022 and abiraterone (zytiga) in June 2022. I stayed on both drugs for 24 months. I also had 32 sessions of radiation to the prostate bed and the pelvic lymph nodes. I think that treatment is pretty standard for when PSA persists after an RP

[Formosan in reply to Alturia]

I did not have radiation because of the serious incontinence after the RP. I still have leakage when walking. I wish I could go through the standard treatment if I could. Thank you Alturia for sharing your experience.

[Alturia in reply to Formosan]

I know what you mean. I was incontinent for about 8 months after the RP and was ecstatic when I finally got continent. Then about 3 or 4 months after the radiation the incontinence was back with a vengeance. Urologist and physical therapist have told me that the only solution is an AUS but I'm not ready for more surgery so I have learned to live with pass

[Tall_Allen]

Why didn't you get salvage radiation?

[Formosan in reply to Tall_Allen]

I always appreciate your response. Do you think at my age I can still risk the possible side effects of salvage radiation such as urination bleeding and colon damaging especially I still have some leakage issues ? I will discuss with my doctor about it.If he can arrange it perhaps I should try. Another question I have is in regard to Gleason score. Mine is 10. Does that mean the metastasis is more likely making the prognosis gloomier?

[vintage42 in reply to Formosan]

"... Do you think at my age I can still risk the possible side effects of salvage radiation such as urination bleeding and colon damaging...?"

I think that would be from poorly-done radiation, and much less common now than in years past. The equipment and ROs are better.

At age 78 I had 20 IMRT without spacer for the prostate, and at age 80 I had 30 IMRT for pelvic nodes. I had no discomfort, and now at age 81, no side effects from those radiations.

[Still_in_shock]

Restest PSA

[Formosan in reply to Still_in_shock]

Thanks. I will and hope it will be lower. if not, my goodness, if I can take it...

[Atdabeach]

I thought the trigger level for concern about PSA rising after treatment was 2 points above nadir, not 0.2.

[Formosan in reply to Atdabeach]

Really? is it 2 not 0.2? I somehow seem to remember I read it somewhere that when the PSA rises to 0.2 from nadir, it's time of concern. I hope I am wrong.

[Lettuce231]

Hi, I too have the cancer in the lymph node, I started on casodex and lupron, but for about 5 of the total 11 years 9 months I have been on Zytiga 500mg, Lupron, 3 monthly and prednisone 5mg. My PSA like yours wouldn't stay low and continued to rise, but it had fallen steadily and remains indectable.

If I was you I would get another blood test done and if the PSA is still rising, insist on Zytiga.

I wish you well.

[Formosan in reply to Lettuce231]

Thank you, Lettuce. I heard Zytiga or Xstandi is really effective. My doctor won't prescribe it to me saying that my health insurance does not cover it.

[Lettuce231 in reply to Formosan]

I'm sorry to hear that, what a dilemma 😕

[Kamilekamile]

hi

My husband was in the same situation like you. He has got salvage radiation afterwards. His treatment finished in 2018. His psa is 0.005 now

My poorly suggestion is:

Always get tested in the same place if possible. Get tested again. Talk to your doctor about radiotheraphy if psa is getting higher.

Good luck

[Formosan in reply to Kamilekamile]

Thank you for your suggestion. I will talk to my doctor about it. I wonder if I am too late for the radiation now since my RP took place 17 months ago. I am happy for you that you have solved the problem.

[Aldo62]

PSA can be affected by your activities; having sex, riding a bike, exercise, etc. I've heard it also varies by the time of day. I definitely would test again. It's still very low!

[VanHalen84]

zytiga is now available cheap on costplusdrugs.com

[Davidl3940]

Salavage Radiation of prostate bed and pelvic lymph nodes beoiuggt my PSA to <0.01.