PSA update

Uncle Dan,
My PSA went from 0.02 to 0.04, and despite the assurances that all was well, I was worried about the upward trend. However they were right, at my next check it was back down to 0.02 and it has stayed there since. My Doc says until it gets to 0.1 it's still listed as undetectable. Relax and don't worry.....I know it's easier said than done.
Best,
Mike

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June 2005 - Age 53 PSA 4.8 at regular physical October 2005 - After several rounds of anti-biotics, PSA 5.2 at Urlogist November 2005 - Biopsy negative July 2006 - PSA 5.9 at regular Physical October 2006 - After several more rounds of anti-biotics PSA 8.1 November 2006 - Second biopsy - Positive December 2006 - Gleason (3+4=7), Tumor T1c, CT Scan and Bone Scan Negative
January 2, 2007 Robotic Prostatectomy, University of Rochester Medical Center - Tumor confined but larger than thought, only one nerve able to be spared. Margins clear. February 2007 - Three to fo ur pads a day, no erection with viagara. April 2007 - First Post-Surgical PSA 0.02. Down to one pad a day.July, 2007 - Six Month Post-op: PSA 0.04 No change in ED. October, 2007 - Nine Month Post-op: PSA back down to 0.02!Almost totally dry! Only slight improvement in ED - Will try injections if not improved by next appointment. January 2008: One Year Post-OP PSA 0.02 still dripping, but improving. Tried 500 dose of MUSE for ED, no luck. Will try 1000.

Thanks, I guess it is just easy to worry about it starting all over again somewhere else. Thanks Again, Uncle Dan

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Age 67
DRE negative, 10 - 06 PSA 5.44, 01 - 07 PSA 6.47
5 - 07 CT and Bone scans negative, 05 - 07 Biopsies, 2 of 6 positive
Gleason Score (3+4) 7 Stage T1c
08 - 14 Da Vinci RAP, five hours surgery
Some right nerve and all left nerve removed,
8 -16 Negative margins, Encapsulated, 50% left side
Lymph nodes 2 R & 1 L - Negative, R & L seminal vesicles - Negative
Gleason changed (4+3) 7 closer to 8 than 6
9 - 26 1st PSA 0.00 11 - 28 2nd PSA 0.00 Some stress drips

In general, any PSA result that can give a lower number than 0.1 is "ultra-sensitive", at least that's my understanding. I had originally requested the "standard" test from my local urologist because a) I had a good pathology report, and b) I thought I would fret over possibly more "noise" in the movements of PSA results over time. However, what I received the ultra-sensitive type.

The question is a bit more complicated as there have been several generations of lab equipment and assays. I don't have a link to post, but a quick search on "PSA ultra sensitive" should bring up a lot on the subject. There is more than one generation of equipment of the ultra-sensitive variety, and variations between equipment manufacturers as well. I found it useful to actually look up the specs of the equipment used on my PSA result, which was right there on the report. I also learned that there is a lot of variance in the results when the reported PSA level is near the lowest level of sensitivity for that particular equipment/assay, hence the importance of knowing which machine was used. There is a term "functional sensitivity" which is the level that test results are repeatable for a given test, and this level is higher than then the lowest sensitivity specified. For example, a test that has a sensitivity of "<0.008ng/ml" may yield a result of 0.009 for a particular man, but that number may vary greatly over multiple tests. On the other hand, a result of 0.015 may be very reproducible. This is just an example.

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Age:45 (44 when diagnosed)

Father diagnosed and cured at age 52.

08/21/07: Diagnosed with T1c cancer

1 of 12 biopsy cores positive; 10% tissue

Gleason score: 3+3=6

PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)

10/19/07: da Vinci prostatectomy by Dr. Vipul Patel

              Difficult surgery due to prostate inflammation.

              Both nerve bundles spared.

              Spongy erections began within 24hrs of surgery!

10/24/07: Catheter out; down to 1 Serenity pad/day next day.

              Final pathology: neg margins, no capsular penetration,

              Gleason 3+3=6, 5% tumor involvement, multi-focal.

11/04/07  First usable erection with Cialis

11/22/07  Thanksgiving - Bye-bye, pads

01/17/08  First post-surgery PSA result: < 0.008 ng/ml

Uncle Dan,

I just got the same 6 mo. PSA .04 result and went through a terrible weekend of anxiety and fear. I emailed my surgeon and here is his response:

"With the current technology used in commercial PSA assays, it is very hard to measure PSA concentrations below 0.1 ng/ml. Therefore, anything less than 0.1 is the same as zero. Some assays provide results to two or three decimal places, but it is wishful thinking. In most instances, a PSA reading of 0.04 is essentially the same as zero."

Sure hope he is right! :)

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42 yo. now

5/07 PSA 4.65 at routine physical

6/07 biopsy positive for cancer...Gleason 3+4...diagnosed at 41 y.o.

6/07-9/07 manic research and interviews with physicians across the country in search of the "right" decision.  I went to Mass General in Boston, Loma Linda, University of Chicago and Northwestern.

9/17/07 - Radical Retropubic Prostatectomy Surgery at Northwestern Memorial in Chicago by Dr. William Catalona.  Thankful the father of the PSA test was right here in Chicago.

Post op pathology was Gleason 3+4 with negative margins, no seminal vesicale involvement, no lymphatic or vascular invasion, bladder and urethral free and tumor volume was 5% of 27.3g.  

9/27/07 - Catheter removal...let the games begin...

12/07 - Threw out the pads.  I only had to use 1 pad per day for protection against minor drips. 

I started Trimix 8 weeks after surgery with success.

 

I hope someday I won't need injections, but I hope more that my PSA stays at 0 forever.