? re; low psa and still having Pc

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cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/24/2008 5:24 PM (GMT -7)   
I have been reading people heres info and it seems alot of guys here had PSA's below the number 4 which is supposed to be normal for over 50 but they still had the prostate removed and had cancer.
 
Why ?

Johnny Canuck
Regular Member


Date Joined Jan 2008
Total Posts : 88
   Posted 6/24/2008 5:36 PM (GMT -7)   
I guess the easy answer is that the PSA is only part of the process. An elevated count can simply indicate an inflammation. The rate at which it rises can be a sign of trouble...PSA velocity, along with some blood where there oughtn't be, for me...and if there's no change using antibiotics...zingo, a biopsy.
 
That's how I joined this special club...
 
I hope this addreses your question.
Age: 54
Gleason Score: 3+3=6
PSA: 3.33
Biopsy:7/8 Positive
Stage: "Bulky" T1c
Prostate Size: 27cc
 
Diagnosed: December 05, 2007
Brachytherapy: February 26, 2008
68 seeds, (Iodine 125). 
 
Walk my path at:
 
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/24/2008 5:52 PM (GMT -7)   
CVC,
Currently a PSA of 4 is a signal for further investigation.However at a recent local prostate group meeting we were given an address by a pathology lab doctor. He stated that this was being revised and the new guidelines will reduce this to a PSA reading of 2.5 . PSA is just a guide ..................changes in PSA readings are as important as the reading itself. For example a PSA reading one year of 1 followed the following year by a PSA of 2 is a cause for concern.....although well within the current limits it has in fact doubled and should be investigated. That is why it is important to know your actual readings rather than accept the bland "the reading is fine for your age". The younger you are generally the lower the readings should be. Also not all PCa will produce the same levels of PSA. Some cancers will not produce largely elevated readings at least not early in the piece. It is , unfortunately, not an exact science.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.1 undetectable


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/24/2008 6:14 PM (GMT -7)   

why does it seem so many opt to have the gland removed isn't there other better methods ??

 

Do PSA's rise faster when its Pc or slower ?? Is a fast rising PSA BPH ?

 


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 6/24/2008 6:33 PM (GMT -7)   

cvc

There are more options becoming available.  I think most people think of surgery to just get the cancer out of their body.  Sometimes that works but sometimes it does not.  I guess to be honest there is no 100 percent certain way.  I think there are 3 aspects to treatment; financial, emotional, and physical. The individual needs to deal with all three of these and then after much research make a decision as to what treatment he will take. 

There are many here and vertually every option was choosen by someone who will be glad to respond to any questions you might have.

My final choice was proton but I am getting a 3 fer.  Hormone therapy to starve the sucker, Photon Conventional radiation to try and target any cancer outside the prostate, and finally 17 dose of Proton to the prostate and a suspect lymph node.  We, my wife and I, feel very comfortable that we made the right choice and look forward to completing treatment and getting on with watching our 12 grand kids and soon to be first great grand child grow to adulthood.

You have come to a great place for support and information.

You could not ask for a greater group of people who are going down the same path as you and dealing with it each and every day.

The best to you and yours

Richard yeah tongue yeah


Retired USAF Richard & Debbie on The Shores of Toledo Bend Lake Louisiana
Biospy 1/10/08 Gleason 10, Stage T1C  8 of 12 samples positive all Less Than 5% 
Jan & Feb & Mar all tests clear
MD Anderson = No surgery and No Proton only Hormone and IMRT
Contacted with Loma Linda and UFPTI in FL
Started Treatment at the U of Florida Proton Therapy Institute in April 2008
May 2, 2008 LUPRON & Casodex
IMRT to started  5/27/2008 Will get 42 treatments 19 IMRT and then 23 Proton
Turn Stumbling Blocks into Steping Stones and Keep Smiling
Our Journey is on WWW.GLEASON10.COM
 


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/24/2008 6:42 PM (GMT -7)   

Well I HOPE I wont have to explore any of these anytime in my life but I am reading up. I still wonder if my enlargment is some kind of infection as I feel a discomfort or pulling feeling below scrotom.

 

Dr said may be pendula nerve ????

 

I will see what my PSA is next week. I hope its either lower or a worst the same. I take Saw Palmetto and started doing it when I was having frequency urinating. Seems fine now but still some discomfort sitting sometimes...


Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 6/24/2008 6:53 PM (GMT -7)   
cvc-

I could be wrong (I was wrong once before - 1973, I think, sometime around September), but I think the saw palmetto may artificially lower your PSA reading. Suggest you Google it and/or check with your urologist.

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - PSA undetectable, T is 20 and only one nodule has grown (from 8mm to 12mm). Feeling much more confident than after 2/2008 reports


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/24/2008 6:56 PM (GMT -7)   
my uroligist told me it was ok to try it for the frequency so he knows im taking it...should I not take it ???

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 6/24/2008 6:59 PM (GMT -7)   
Wouldn't hurt to remind him that you're taking it and ask if it might influence the results. Or....I might be hallucinating again and there is no effect.

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - PSA undetectable, T is 20 and only one nodule has grown (from 8mm to 12mm). Feeling much more confident than after 2/2008 reports


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/24/2008 6:59 PM (GMT -7)   

googled it says NO Saw will not lower PSa??

 

The 26-week Permixon vs. finasteride trial (Prostate 29:231-40), involved
1,098 men. Finasteride lowers by 50% the level of prostate specific antigen
(PSA), routinely used to screen for prostate cancer and monitor prostate
cancer therapy. Finasteride does not affect prostate cancer, but PSA values
must be doubled. Unexpectedly, saw palmetto had "absolutely no impact
whatsoever" on PSA, noted Thompson.

 

 


Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 6/24/2008 7:01 PM (GMT -7)   
Google: saw palmetto psa and start reading.

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - PSA undetectable, T is 20 and only one nodule has grown (from 8mm to 12mm). Feeling much more confident than after 2/2008 reports


Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 6/24/2008 7:06 PM (GMT -7)   
Obviously, I'm hallucinating again.

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - PSA undetectable, T is 20 and only one nodule has grown (from 8mm to 12mm). Feeling much more confident than after 2/2008 reports


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/24/2008 7:06 PM (GMT -7)   
American Cncer Society and others say no effect, I believe my Uroligest said same thing

cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/24/2008 7:10 PM (GMT -7)   

here is another, i think its ok based on reliable web sites, thanks

 

We have conducted a randomized clinical trial, presented at the Annual Meeting of the American Urological Association last May, showing clearly that saw palmetto does not affect the serum PSA levels (either total, free, or % free).


Roger G
Regular Member


Date Joined Apr 2008
Total Posts : 150
   Posted 6/24/2008 7:18 PM (GMT -7)   
To answer the first question about why some of us elect to have our prostate removed when there are other options.
 
Simply stated I elected to go with the technique with the longest track record.  Proton beam radiation sounds great but what are the long term risks?  I looking at a 40+ year window.
 
Roger
Age: 43 (2008)
DRE Small Ridge on prostate, PSA 1.5
07/2007: Diagnosed cancer, T2c, Gleason 3+4=7
09/2007: Laparoscopic prostectomy @ Hamilton General, 4 hrs.
              Both nerve bundles spared
              Pathology Report: Tumor confined w/in prostate
              T2c, Gleason is 3+3=6
              Went home with JP drain
10/2007: Made return trip to hospital.  All urine was comming out JP drain.
10/2007: Catheter removed. Next to no leakage
11/2007: 1st PSA <.003 :)
              ED: Started Viagra, no response yet.
12/2007: Had confidence to go padless!!!!!
12/2007: ED:  Stopped Viagra as it's causing hemroid problems.
01/2008: 2nd PSA <.003 :)
              ED: next to no response.
04/2008: 3nd PSA <.003 :)
              ED: next to no response.  Changed the Viagra prescription.
 


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/24/2008 7:23 PM (GMT -7)   

Roger, your PSA was 1.5 ????

 

This is crazy this test seems very very unreliable. I had a friend 62 yrs old that his psa was 2.9 and his dr told him he has Pc

 

He went to an Oncologst who asked him "who sent you here ??"

 

He had a biopsy and nothing showed

 

It makes you wonder how many hack Dr's are out there. Not saying thats the case with you Roger but a 1.5 psa and you had Pc ....


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 6/24/2008 10:23 PM (GMT -7)   

Gordy,

I really hate to correct you, but it was October 1972 instead of September 1973 when you were wrong the last time.  You predicted that Oakland would beat Cincinatti in five games for the World Series instead of seven. 

You've never been wrong since then. tongue

Barry


Barry ~ (a.k.a. "Idaho") - Prostate Cancer Forum Moderator

 

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

1st PSA  09/11/2007  <0.04 (undetectable)

2nd PSA 12/10/2007  <0.04

3rd PSA  03/17/2008  <0.04

4th PSA  06/17/2008  <0.04

My web site: http://pca-info.blogspot.com


Roger G
Regular Member


Date Joined Apr 2008
Total Posts : 150
   Posted 6/25/2008 8:12 AM (GMT -7)   
CVC,

A psa of 1.5 for a 42 year old is high. Do a google search of age adjusted PSA tests. PSA testing is only one of many signs and symptoms of prostate cancer. In my case I had more than a few; urine leakage, trouble emptying my bladder, 2am-4am-6am bathroom calls, and blood in urine. I also have a family history of prostate cancer.

Biopsies can also miss small tumors as they only samle a small section of the gland.

Hope this helps.

Roger
Age: 43 (2008)
DRE Small Ridge on prostate, PSA 1.5
07/2007: Diagnosed cancer, T2c, Gleason 3+4=7
09/2007: Laparoscopic prostectomy @ Hamilton General, 4 hrs.
              Both nerve bundles spared
              Pathology Report: Tumor confined w/in prostate
              T2c, Gleason is 3+3=6
              Went home with JP drain
10/2007: Made return trip to hospital.  All urine was comming out JP drain.
10/2007: Catheter removed. Next to no leakage
11/2007: 1st PSA <.003 :)
              ED: Started Viagra, no response yet.
12/2007: Had confidence to go padless!!!!!
12/2007: ED:  Stopped Viagra as it's causing hemroid problems.
01/2008: 2nd PSA <.003 :)
              ED: next to no response.
04/2008: 3nd PSA <.003 :)
              ED: next to no response.  Changed the Viagra prescription.
 


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/25/2008 12:09 PM (GMT -7)   

Roger, now I am really confused you say " a psa of 1.5 is high for a 42 year old"

 

In my other post I was linked to this site and read what they say is normal for 42 year old.

Does normal PSA vary with age?


Age PSA Level (ng/ml)
40-49 2.5
50-59 3.5
60-69 4.5
70-79

6.5

So what is the real story. It shows 40-49 2.5 ??????

Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 6/25/2008 3:43 PM (GMT -7)   
Barry-

I shoulda "knowed" someone would remember, but I never thought it would be you.

Be well, my friend.

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - PSA undetectable, T is 20 and only one nodule has grown (from 8mm to 12mm). Feeling much more confident than after 2/2008 reports


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/25/2008 3:53 PM (GMT -7)   

So Selmer, if you were me and your PSA went from .99 to another number when I go next week ( which is a year since it was .99) what number would it have to go to to get you nervous ?

 

My PSA was .82 in 2/06 and .99 in 9/07 is there a chance it will be lower ??

 

Here is the numbers and dates

 

1/2000   .4

5/02     .5

7/03    .38

2/06  .82

9/07  .99

 

I hope it comes back the same or lower as everyone does probably. He still thinks I may have BPH or something.

 

I do have some discomfort sitting on a hard seat, may be hemroids ???

I get up maybe once a night unless I drink alot before going to bed then probably twice. I am 49 yrs old


Gordy
Veteran Member


Date Joined Jun 2005
Total Posts : 528
   Posted 6/25/2008 4:03 PM (GMT -7)   
Hey cvc-

RELAX! You're making yourself crazy over something which is probably nothing.

Start thinking about something else - like politics or nuclear war or something.

-Les
1/2005 Dx PSA 26.5 Gleason 7 (4+3) @Age 61
1/2005 Start Casodex and Zoladex
PSA drops to <0.01
7/2005-8/2005 5 weeks of IMRT and then HDR brachy
1/2007 Rad Oncologist orders CT scan of pelvis
because of complaints of pain in both thighs
MRI confirms pain not caused by cancer BUT
1/2007 CT scan of pelvis picks up a nodule at bottom of left lung
5/2007 CT scan of lungs shows 1/2007 nodule has grown and
there are numerous nodules on both lungs.
6/2007 Thoracic surgeon removes wedge of left lung for biopsy
6/2007 Path report says 95% chance of metastatic PCa, but she's
never seen cells like this before.
8/2007 2nd opinion at M.D. Anderson in Houston.
They confirm: mutated PCa, very rare, but seen there 2 or
3 times. Recommendation: have CT scans every 6 weeks
and watch for change. At that point start chemo and will
survive for 22 - 24 months thereafter.
PSA still undetectable, but get Lupron shot to bring T down from 27
2/2008 Trip to Houston – PSA now 0.5 and nodules larger. Lupron shot.
6/2008 Trip to Houston - PSA undetectable, T is 20 and only one nodule has grown (from 8mm to 12mm). Feeling much more confident than after 2/2008 reports


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/25/2008 5:39 PM (GMT -7)   
You are right, its terrible to be this paranoid it is making me sick.

IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 6/25/2008 6:06 PM (GMT -7)   

Hi cvc,

Here is my suggestion.  I think you need to take a break from everything prostate cancer.  I got too steep in things early on when I could not handle it mentally.  I hate to say it, but you may need to take a break from us as well. 

Do something that you would naturally do every day.  Have some fun.  Watch a movie.  Eat someting really tasty.  Get your mind off the big "C."

You'll be fine.

 


Barry ~ (a.k.a. "Idaho") - Prostate Cancer Forum Moderator

 

Da Vinci Surgery July 31, 2007… 54 on surgery day
PSA 4.3  Gleason 3+3=6  T2a  Confined to Prostate

1st PSA  09/11/2007  <0.04 (undetectable)

2nd PSA 12/10/2007  <0.04

3rd PSA  03/17/2008  <0.04

4th PSA  06/17/2008  <0.04

My web site: http://pca-info.blogspot.com


cvc
Regular Member


Date Joined Jun 2008
Total Posts : 436
   Posted 6/25/2008 6:16 PM (GMT -7)   
eaiser said then done.... I know what you are saying though
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