This one I did research a little bit when I first set out with my knowledge I had PCa. So first off not a dumb question. My brother is sitting on 1.9 and does not have PCa. My father is at 2.5 at the age of 73 and does not have PCa. I was tested at 19.8 and had metastatic disease. After reading books I discovered that readings as high as 4000 existed and were brought back to remission. Obviously not always the case but it has given me hope to know I likely have alot of time to work with. Gordy's situation is different in that he has had a recurrance without PSA rise. This is extremely rare but as Gordy can testify, possible. Normal is <4.0 in most cases. I have read where a person averaged over several tests 5.5 to 6.0. Never tested positive in several biopsies. BHP can cause elevated PSA;s without cancer detection. What I do understand is normal PSA will test consistently. If a person tests at 1.9 for say six straight years, then goes in and tests at 3.0, he should repeat the test and if the same or higher then have a biopsy. Even though he is below the 4.0 standard red flag, it is not standard to test at 3.0 for this individual. Most urologists will tell you rising PSA is a concern even if it has not risen above the 4.0. That stated when PSA recurs after surgery or RT, it is looked at for its doubling rate for its prognosticating factors. A person who doubles every three months will likely not respond well to treatment and has a poor prognosis. A person who doubles every 15 months may do quite well with treatment but is still likely to have a poor or if lucky a fair prognosis. PSA does not kill and as far as I know it can rise quite high in many cases. What's more PSA does not indicate at which point a person may succomb to the disease. What kills is prostate cancer cells metastisize and start growing out of control where they aren't supposed to and causing other complications. It is at that point an oncologist can suggest the disease is terminal. PSA Nadir is the measurement of the lowest point that PSA will go after surgery. For example, if after surgery my PSA drops to undetectable then my nadir will be <0.1. Should it rise to 0.11 then it is recurrent. How long it takes to get to .2 will be my doubling rate. If I get additional treatment it will be monitored to see if it will return to nadir levels at which time it can be viewed as in temperary remission. If when additional treatment is removed and it stays at nadir levels it well be declared a durable remission.
If I missed anything let me know...
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
My PSA did drop out after surgery to undetectable. It has not returned and I will continue HT until January '08.
My Life is supported very well by family and friends like you all.