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trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 11/8/2011 8:32 PM (GMT -6)   
PSA Climbing

I had my second PSA test and over a 3 month period (6 mo out from RP), it went from .06 to .160 is this normal or any concern ?? I have read that in that low range the number can vary a lot and is not vary accurate, is this true ??
5/05- PSA 2.008
12/08- PSA 2.87
2/11- PSA 4.357
3/11- 12 needle biopcy performed with cancer detected in only 1 core with a Gleason Score of 3+3,
6/11-Robotic Prostatectomy performed, Path report showed tumor size 1cc stage pT2c with no signs of cancer ouside the prostate
9/11 PSA .060
Age 60

Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 197
   Posted 11/8/2011 9:00 PM (GMT -6)   
trimix-sorry to hear of your rising psa.  To answer your question, I would say "no", it's not normal or what you would hope for and it is a concern.
 
While the psa readings can vary a bit, the increase isn't a simple variation.
 
What did your doctor say about it?  Did he (or she) discuss further treatment options to start considering?
With your pathology report your post surgery psa readings are surprising.
 
I'd be interested in hearing what your doctor had to say.
 
Dave

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 977
   Posted 11/8/2011 9:03 PM (GMT -6)   
Hi Trimix, your PSA result looks as though you have a BCR. What does your surgeon/uro say. You need to talk to them if you have not already. BCR seems unusual will your stats.
Dx Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4)
Robotic RP March 2009
Path Report: T2c, G8, organ confined, neg margins, lymph nodes - tumor vol 9%
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT/SRT .01, < .01
End ADT3 5/11
PSA 10/11 < .01, T 103

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24280
   Posted 11/8/2011 9:22 PM (GMT -6)   
On the surface, looks like you are heading for BCR, you next reading in 3 months might solidfy that opinion, especially if you get another rise. Hopefully, you won't. Good luck.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81, 6/11 5.8
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2685
   Posted 11/8/2011 9:59 PM (GMT -6)   
Retest , thats quite a rise especially with your post op path. They really do have lab errors. If doc doesnt suggest insist on retest
Diagnosed 8/14/09 psa 8.1 66,now 68
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving 7/11<.1

trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 11/9/2011 4:47 AM (GMT -6)   
My regular Dr had no concern, I will speak to my Uro about it and get a new test done.
5/05- PSA 2.008
12/08- PSA 2.87
2/11- PSA 4.357
3/11- 12 needle biopcy performed with cancer detected in only 1 core with a Gleason Score of 3+3,
6/11-Robotic Prostatectomy performed, Path report showed tumor size 1cc stage pT2c with no signs of cancer ouside the prostate
9/11 PSA .060
Age 60

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2087
   Posted 11/9/2011 5:42 AM (GMT -6)   
A PSA rise like that needs to be watched very carefully. No need for action yet, but the next PSA test will give a clearer picture. You are now doing another form, an advanced form, of Active Surveillance.

Alf
Age dx 48
04/09 PSA 8.6, DRE neg. Biop 2/12 pos. G=3+3
07/09 RALP at AVL Amsterdam
Cath out at 1wk Dry at night
PostOp G=3+4 Bladder neck & Left SVI -T3b. No PNI No vasc.inv. Clear margins
09/09 No pads
11/09 PSA 0.1
03/10 PSA 0.4 04/10 CT.
Summer/10 66Gy SRT
09/10 PSA<0.1
01/11 PSA<0.1
04/11 PSA<0.1
07/11 PSA<0.1
10/11 PSA<0.1
No real ED

trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 11/9/2011 6:34 AM (GMT -6)   
I am really going to dig into this. Thanks for all the information so I can be proactive, I am now really concerned, I thought I had a good chance of beating this !!!!
5/05- PSA 2.008
12/08- PSA 2.87
2/11- PSA 4.357
3/11- 12 needle biopcy performed with cancer detected in only 1 core with a Gleason Score of 3+3,
6/11-Robotic Prostatectomy performed, Path report showed tumor size 1cc stage pT2c with no signs of cancer ouside the prostate
9/11 PSA .060
Age 60

Raddad
Veteran Member


Date Joined Jul 2011
Total Posts : 1857
   Posted 11/9/2011 7:19 AM (GMT -6)   
trimix

You do! Do not get discouraged.

Bud
63 as of April 2011
Gonna Make Myself A Better Man [img]tinyurl.com/28e8qcg
Blood test showed high PSA (1447 - Scary aint it? - It's just a number! ) on 12 July 2011
Scans showed active prostate cancer widespread in bones
X-Rays showed bones are at this all normal
Started HT treatments Casodex, Zoladex and Zometa for bone
Last Casodex - 29 August
PSA 31 Oct 2011 - Result 46.6

trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 11/9/2011 10:58 AM (GMT -6)   
So the way I understand this is: either it was a bad test and I need it redone, my current indicated .16 PSA needs to stay this low for years and not go up anymore, or I have a real problem and my cancer was not contained in my prostate and it is now active again, is this correct ???
5/05- PSA 2.008
12/08- PSA 2.87
2/11- PSA 4.357
3/11- 12 needle biopcy performed with cancer detected in only 1 core with a Gleason Score of 3+3,
6/11-Robotic Prostatectomy performed, Path report showed tumor size 1cc stage pT2c with no signs of cancer ouside the prostate
9/11 PSA .060
Age 60

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2685
   Posted 11/9/2011 11:27 AM (GMT -6)   
Thats my take.And peoples psa have stabilised at the level re.2nd point. I would get it retested, if same or a bit higher, I would still wait 3 months for another psa test. Cancer society defines recurrence, as .2 and then 2 consecutive rises after that. Could be residual prostate tissue from nerve sparing op. The post op pathology is so good I think its lab error or residual.Stay cool you are going to be fine. Logo
Diagnosed 8/14/09 psa 8.1 66,now 68
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving 7/11<.1

Dave7
Regular Member


Date Joined Jul 2006
Total Posts : 197
   Posted 11/9/2011 11:28 AM (GMT -6)   
It doesn't mean the cancer was not contained in the prostate.  It could be that some tissue was left behind, it could be an erroneous reading, or, as you said, it may be that the psa will not rise from here.  Your pathology report was excellent and I don't see anything that would make me think it spread.
 
IMO,  it warrants getting retested and meeting with a doctor who is more on top of things than your regular doctor that wasn't concerned with the psa reading.
 
Dave

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2685
   Posted 11/9/2011 11:36 AM (GMT -6)   
My analysis is based on the pathology you presented, can you give more info from pathology. Just one 1cc tumour? I am real curious about this one. You have to know if anything, this is very unusual. It does not mean however that it is not a problem. I think it is more a mystery, that needs to be figured out. Time and digging will reveal
Diagnosed 8/14/09 psa 8.1 66,now 68
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving 7/11<.1

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2685
   Posted 11/9/2011 11:47 AM (GMT -6)   
Trimix. I am sorry but have to back up on this, I read in my mind, and apologise for it, 1cc being small like, 1mm. its not. 1cc is a significant tumour so the rise could be real. It could still be all I said but that chance is lessened. The good news is gleason 6. I think I read some where, mortality rate as .6%. again I feel stupid for not seeing the the 1 cc as big. Logo
Diagnosed 8/14/09 psa 8.1 66,now 68
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving 7/11<.1

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2087
   Posted 11/9/2011 11:51 AM (GMT -6)   
1cc (= 1cm3) has to be seen in relation to how big the prostate is. if your prostate is about 30cm3 then 1cm3 is only about 3% cancer which is a low percentage.

I thought I had much more tumor than that.
Alf

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2685
   Posted 11/9/2011 1:43 PM (GMT -6)   
trudat Alf, Mine was 9%, however more aggressive and/but I fully expect to die with it, not of it
Diagnosed 8/14/09 psa 8.1 66,now 68
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving 7/11<.1

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 717
   Posted 11/9/2011 2:06 PM (GMT -6)   
Trimix,
 
I am slightly confused. 
 
1.) You stated this was a 6 month test.  If you had surgery 6/11 this would be a 5 month test.  Why did you test 1 month early or are your dates off?
 
2.) Your signature does not state much about your post-op pathology.  Did your Gleason score change?  Did you see a copy of the report with your own eyes?  If not I would get one and read it.
 
3.) Did you get a copy of your latest PSA result from your doctor.  I can't tell you how many times we have seen on this board where results were mis-read over the phone to people.  I would get a paper copy of your test results and make sure your name is on the page and it is your most recent test.

trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 11/9/2011 2:50 PM (GMT -6)   
Hi ChrisR- This all started with a check up by my regular GP Dr. on 10/26/11. I went in to see him and go over what I had been through since I saw him last, he is the one that recommended the prostate biopsy and also a bone marrow biopsy because of the results of my blood test results.

With this visit, he had several blood tests done to follow up with my earlier test results.

My 3 month post op checkup with my Uro and PSA check was done on 8/1/11, 3 months after my RP. That PSA check came in at .060.

I do have an appointment set with my Uro towards the end of this month for my 6 mo check.

I have been out of town for almost 2 weeks and when I got home I had a letter from my GP with my test results. He said that the results were all good news and that no further treatment was needed.

The PSA part of the report said: PSA(Prostate cancer test) 0.160 (range: between 0.1-4.0)

The part that he forgot is that the normal range stated in the test results is no good for someone that just under 6 months ago had an RP done.

If it wasn't for this forum and all you guy's helping out, I would have not known this was wrong !!!! Thanks, Thanks, Thanks.

I had a new blood draw done this morning and will have the results later today and I hope the last test was wrong.

More info on my history: My prostate was 50 grams, my tumor was 1 cc, all margins were negative and all tissue testing were without evidence of malignancy. Extent of invasion was "Multifocal and present within both lobes, but confined to the prostate gland".

I get a copy of all my test results and have a complete file, my Gleason Score did not change from my biopsy report to my final RP path report.
5/05- PSA 2.008
12/08- PSA 2.87
2/11- PSA 4.357
3/11- 12 needle biopcy performed with cancer detected in only 1 core with a Gleason Score of 3+3,
6/11-Robotic Prostatectomy performed, Path report showed tumor size 1cc stage pT2c with no signs of cancer ouside the prostate
9/11 PSA .060
Age 60

ChrisR
Veteran Member


Date Joined Apr 2008
Total Posts : 717
   Posted 11/9/2011 3:16 PM (GMT -6)   
I think as everyone says here, it is very unusual for a G6 like you to have BCR so quickly. I guess anything can happen, but you would be the first case like this I have seen in my 3.5 years of scouring the WEB over PCa.  Keep us updated....
 
Dx @ 42 years old on 4/2008 PSA 2.76
1st PSA ever @ 38 years old 2.4
Gleason 6 (50 Point Biopsy) (6 Cores positive - Small Focus Each)
open RP 10/08 Johns Hopkins Dr. Partin
pT2 Organ Confined Gleason 6 (tertiary score 0)
1/15/2009 (3 Month) <.1
10/15/2009 (1 Year) <.1
10/15/2010 (2 Year) <0.03
8/26/2011 (3 Year) <0.03

Post Edited (ChrisR) : 11/9/2011 1:19:39 PM (GMT-7)


trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 11/9/2011 3:24 PM (GMT -6)   
Well, I really hope the test was a bad one and this is just one big nightmare with a good ending, I should know more at the end of the day and will post the results.

Maybe they read the last results wrong and it really was < .016 which would make more sense to me.
5/05- PSA 2.008
12/08- PSA 2.87
2/11- PSA 4.357
3/11- 12 needle biopcy performed with cancer detected in only 1 core with a Gleason Score of 3+3,
6/11-Robotic Prostatectomy performed, Path report showed tumor size 1cc stage pT2c with no signs of cancer ouside the prostate
9/11 PSA .060
Age 60

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2358
   Posted 11/9/2011 3:45 PM (GMT -6)   
trimix, from reading your last post, your first test was done by your Urologist and the second one by your GP. I would guess that the tests were done by different labs that have different calibration. The test that you did today at your Uro should clarify whether it was a lab error on a real rise. I hope it was alb error. Please keep us posted.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
DaVinci surgery 2/9/09 Gleason 4+4 EPE,
Margins, SV, clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
PSA tests every 3 months undetectable
latest at 32 months: .005

trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 11/9/2011 3:49 PM (GMT -6)   
The retake test is being done by the same testing lab through my GP. I called the office of my Uro and they said the test results should be the same weather they do it or someone else does. My 3 mo test was done by another lab.
5/05- PSA 2.008
12/08- PSA 2.87
2/11- PSA 4.357
3/11- 12 needle biopcy performed with cancer detected in only 1 core with a Gleason Score of 3+3,
6/11-Robotic Prostatectomy performed, Path report showed tumor size 1cc stage pT2c with no signs of cancer ouside the prostate
9/11 PSA .060
Age 60

FrackMe
Regular Member


Date Joined Jun 2011
Total Posts : 348
   Posted 11/9/2011 4:22 PM (GMT -6)   
I'm confused by all this talk about different labs having different results. If that's true, how can there ever be standards such as failure meaning 0.2 or higher?

trimix
Regular Member


Date Joined Oct 2011
Total Posts : 373
   Posted 11/9/2011 4:58 PM (GMT -6)   
I agree- Testing should have a standard or none of it could be considered reliable or accurate causing big problems just like this one, how could you trust and believe anything.
5/05- PSA 2.008
12/08- PSA 2.87
2/11- PSA 4.357
3/11- 12 needle biopcy performed with cancer detected in only 1 core with a Gleason Score of 3+3,
6/11-Robotic Prostatectomy performed, Path report showed tumor size 1cc stage pT2c with no signs of cancer ouside the prostate
9/11 PSA .060
Age 60

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5912
   Posted 11/9/2011 5:22 PM (GMT -6)   
Several of us here have done parallel tests with different labs, and different results seem to be the way things go.
 
Two different labs can show different result because they use different lab equipment (the case between my GP and uro - completely different machine manufacturers), they use a different test, or they report results differently (my GP reports to three decimals, my uro tests to two, rounds down, and reports to one, so 0.499 at my GP is 0.4 at my uro). The key seems to be having the same lab do all of your tests, and always the same test (lets say standard or ultrasensitive as desired, but always the same), and last to understand how they report.
 
Everything in the test process which is not identical is different, and adds uncertainty.
Moderator - Prostate Cancer
(Not a medical professional)

DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808
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