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Phillip1950
New Member


Date Joined Oct 2009
Total Posts : 2
   Posted 10/8/2009 12:47 PM (GMT -6)   
I am 59 years old and was diagnosed with Prostate cancer in Sep 2000. My Preop PSA was 7.5. Gleson score was 3+3. The cancer was found in 2 of 11 core samples (3% & 5%). . Dr. Catalona performed my surgery in St. Louis on 12/12/00. Cancer was confined to prostate, all surgical margins were free of cancer including lymph nodes, siminal vesicals, and bladder neck. Pathology report showed 15% involvement with no extracapsular penetration. No signs of cancer left behind. I have been followed by my family physician having regular PSA's. For over 8 years my PSA has been undetectable. My last PSA was performed by another lab because my physician's machine was broken. It came back 0.2
Below are my PSA results for the past 8 or so years.
1/15/01 <0.1; 8/1/01 <0.1; 3/29/02 0.1; 7/24/02 <0.1; 2/19/03 0.1; 3/11/04 0.1; 1/14/05 0.1; 10/19/05 0.1; 12/16/05 .09; 7/11/06 0.1; 9/14/06 0.072; 1/12/08 0.9; 10/14/08 0.1...........9/29/09 0.2.
This has created a tremendous amount of anxiety. To have an undectable PSA for 8 years and then receive a PSA reading of 0.2 is devastating to asay the least. The lab is going to redo the test using the ultrasensitive PSA test. I am afraid to get the results.
Any words of encouragement?????
 
Scared in SC.
 
 

LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 10/8/2009 1:08 PM (GMT -6)   
Welcome Phillip1950

Assay tests can vary from one lab to the next and is quite common to see different readings. It is always best to use the same lab and the same assay method. I don't remember but it seems to me that there are several different methods used.

I know the concern you have, but do your best to wait until you get another test result. Based on the percentages of cancer in the path report, your history of 8 years being undetectable, I am willing to bet that this next test will put you back to all the other results. A big zero.

Keep us informed.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08


Phillip1950
New Member


Date Joined Oct 2009
Total Posts : 2
   Posted 10/8/2009 1:16 PM (GMT -6)   
I am hoping that the ultrasensitive test result is lower; however, I am not familiar with the ultrasensitive test and therefore do not know what to expect. I will try to stay calm, but the anxiety that this creates for me is almost unbearable.

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 3591
   Posted 10/8/2009 1:23 PM (GMT -6)   
Phillip, your concern is well understood. Most of us would be in your same boat. As Les said the machines are just that machines some more sensitive than others. If you anxiety is on overload call you Dr. Speak with him. As others have told me I will tell you. The Dr. works for Us. Hang in there and keep us posted.

Jeff T
Jeff T Age 57
9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable
 10th month  PSA <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 10/8/2009 1:29 PM (GMT -6)   
Some machines might be more sensitive but they all need Sensitivity training in how we react to the test results!

Larry
Father treated for Prostate Cancer in 1997 with Proton Beam - Still doing well.
My Stats
Age at diagnosis 54, PSA 5.1
Biopsy 04/08 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
 
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin 1.8 cm in length Noted in Right Apex


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 711
   Posted 10/8/2009 1:52 PM (GMT -6)   
Even if you did have recurrence after 8 years it is probably local and a course of SRT would probably take care of it.  I am guessing your test was screwed up at the lab though. 

Dx 42
Gleason 6 (tertiary score 0)
OPEN RP 10/08  Johns Hopkins
pT2 Organ confined Gleason 6
PSA Undetectable


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 711
   Posted 10/9/2009 1:28 PM (GMT -6)   
 
Phillip, 
 
Here's your encouragement.  Read these articles.
 
 
 
 
Pay special attention to the parts that say
 
"No DM or PCSM occurred in 15 years."
 
"Even for the rare true organ-confined, Gleason score 6 (no pattern 4) tumor with supposed biochemical progression, some may be false-positive progression based on low post-radical prostatectomy prostate-specific antigen levels and minute tumors that seem highly improbable to progress."
 
"11/38 cases (29 percent) had true organ-confined, Gleason score 6 tumors, and none of these 11 patients developed systemic disease. "  This last study was over 22 years.........In other words your PSA may come back, but the cancer was not found to have spread to other parts of the body.
 
 
 
You had surgery from Catalona.  He is one of the best in the world.  If I could not have gone to Johns Hopkins I would have seen him or the someone at the Cleveland Clinic next.  It is scary, but even if your PSA was not a lab error, you still have no chance of dying of PCa in the next 12-15 years.  Even if you had to go on hormone therapy today, the average survial for Gleason 6 people is 16 years.  I think some other form of treatment will be out in the next 10 years.  Nanotechnology is coming fast.
 
 


Dx 42
Gleason 6 (tertiary score 0)
OPEN RP 10/08  Johns Hopkins
pT2 Organ confined Gleason 6
PSA Undetectable

Post Edited (ChrisR) : 10/9/2009 12:39:22 PM (GMT-6)


ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 711
   Posted 10/9/2009 3:59 PM (GMT -6)   
Forgot one.....You have a greater chance of dying from suicide. Actually you have .84% chance of that. You have .03% chance of dying from PCa.
 
This is a multi-instutional study over 15 years.   Note the part of 1 death out of 3756 Gleason 6 patients.  That is 3/100's of 1 percent died.  In other words 99.97% are still alive.  Yes, that's 99.97% not 99.7%.  If you like rounding numbers then that becomes 100% of not dying from PCa.
 
I know that none of these stats. mean anything to the guy who died, but my guess is that if his specimen was re-examined he would have been upgraded to a higher Gleason score.
 

This is good therapy for me to.  I am glad you asked for this stuff...And with all this said, I just went for my 1 year PSA test and I am still nervous.

By the way here are some other stats.  If you look below we have a much higher chance of dying from other things then PCa.  Including other cancers.....Crap we are back in the same boat and didn't even know it....

1. Heart Disease

Odds: 1 in 5

2. Cancer

Lifetime Odds: 1 in 7

3. Stroke

Lifetime Odds: 1 in 24

4. Motor Vehicle Accident

Lifetime Odds: 1 in 84

5. Suicide

Lifetime Odds: 1 in 119

6. Falling

Lifetime Odds: 1 in 218

7. Firearm Assault

Lifetime Odds: 1 in 314

8. Pedestrian Accident

Lifetime Odds: 1 in 626

9. Drowning

Lifetime Odds: 1 in 1,008

10. Motorcycle Accident

Lifetime Odds: 1 in 1,020

 


Dx 42
Gleason 6 (tertiary score 0)
OPEN RP 10/08  Johns Hopkins
pT2 Organ confined Gleason 6
PSA Undetectable

Post Edited (ChrisR) : 10/9/2009 3:23:06 PM (GMT-6)

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