Posted 1/27/2008 7:16 AM (GMT -7)
I have had a question for months now, but found no definite answer. In reading here and elsewhere, I see that PSA doubling after surgery is an indication of possible cancer return, even if it is from .5 to 1.0 or 1.0 to 2.0. Now, almost all men have higher than that scores before being diagnosed with PCa. I'd guess most men have a 'normal' test of 2.0 to 3.0 and think nothing of it, along with their doctors. Some have had docs who suggest they do a biopsy if in this range, my brother-in-law being one. His was triggered by a PSA of 2.6 and a 'slight abnormality felt' during a DRE. In my case, I had PSA results ranging from 3.8 to 4.2 with a grossly enlarged gland but nothing detected DRE for 15 years or more, before it jumped to a level (7.6 in 6 months)to trigger my doc to refer me on to a specialist.
I have lots of my friends who, when I asked about their score after I became aware of my cancer, are in the range from 2.0 to even 3.5 or higher and they and their docs aren't doing anything about it.
So, just what would the PSA limits be for possible un-detected PCa before further testing by biopsy or otherwise be started. Is there an agreed national standard, like "no greater than 100/150 for bp or for triglycerides , etc." I realize that PSA testing, especially at an earlier age, is controversial in some circles of medicine, so what does the average man need to know about it, if their docs aren't educated enough or aggressive enough in reacting to their PSA tests. Should a guy accept a running series of 3.1 PSA's or 2.6 PSA's and wait for a sharp increase or detectable DRE, or should he be pro-active in pushing for further exams?
When's a guy gotta worry?
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7 06/05/07
7/11/07 Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07 Path report: 3 of 16 PCa, 5% involved, left lobe , GS 3/3:6.
9/24/07 Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07 ED- begin 25mg Viagra nightly, Fully continent
11/15/07 ED-continue 25mg Viagra, no response, begin Vacurect pump-
11/15/07 1st PSA-0.01
12/17/07 ED- 3 mts.-continue Viagra and pump-no change-no response
01/01/08 First use of Caverject 2.5mcg, successful, erections at last
01/14/08 Caverject abandoned due to pain and aching, Bimix ordered