What happened with the PSA???

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justus1292
Regular Member


Date Joined Feb 2009
Total Posts : 63
   Posted 3/31/2009 1:12 PM (GMT -6)   
Its probably too late to care since I've already been through the RP.  But here's my question anyway.
 
Blood test showed my PSA at 6.1 at a local military hospital  in Aug 05.  Set up appointment to uro the following week.  He does a, get this, urine test that shows me at 6.1!  That happened 3 times including my biopsy in Sep 05.  Talked to uro at the universty and blood test showed 4.5 in Nov same year.  Got another opinion at the V.A. hospital, and they're blood test showed 1.6!
 
What the heck is going on?  I've been studying PCa on the net since Aug 05 through today, and still have not seen or read or heard of any urine PSA test.  Also what's the difference in the lab doing the workup?  Seems there's a wide discrepency from 1.6 to 6.1 PSA readings.
 
Maybe there is a doctor reading this that will be able to answer this.

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/31/2009 1:19 PM (GMT -6)   
justus,
The urine test is called PCA3. It is in use in Europe. The Scientific Retreat at Lake Tahoe last October touched heavily on it. It seems that PCA3 is ambiguous but when combined with T2-ergg it is showing some excellent promise to decipher between indolent and progressive cancers. This will be widely accepted here possibly as early as next year. It is used here just not much yet...

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (January 13, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


justus1292
Regular Member


Date Joined Feb 2009
Total Posts : 63
   Posted 3/31/2009 1:46 PM (GMT -6)   
Go fig.  Usually the best kept secrets a kept away from the Army.  But, the other part of my question is, "How much difference can there be between labs that do the blood PSA?

John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 3/31/2009 4:32 PM (GMT -6)   
Justus.
The high normal for a PSA3 urine test is 35, your number of 6 is very low. PSA can vary greatly between labs. The VA lab had my PSA at 26 and another lab had it at 38 and it was about two weeks apart. The other lab was also about 10 points higher when I repeated it 6 mos later. Go figure?
JohnT

64 years old.

I had an initial PSA test in 1999 of 4.4. PSA increased every 6 months reaching 40 in 5-08. PSA free ranged from 16% to 10%. Over this time period I had a total of 13 biopsies and an endorectal MRIS all negative and have seen doctors at Long Beach, UCLA, UCSF and UCI. DX has always been BPH and continue to get biopsies every year.

In 10-08 I had a 25 core biopsy that showed 2 cores positive, gleason 6 at less than 5%. Surgery was recommended and I was in the process of interviewing surgeons when my wife's oncologist recommended I get a 2nd opinion from a prostate oncologist.

I saw Dr Sholtz, in Marina Del Rey, and he said that the path reports indicated no tumor, but indolant cancer clusters that didn't need any treatment. He was concerned that my PSA history indicated that I had a large amount of PC somewhere that had yet to be uncovered and put me through several more tests.

A color doppler targeted biopsy in 11-08 found a large tumor in the transition zone, gleason 6 and 7. Because of my high PSA Dr. suspected lymph node involvement, 30% chance, and sent me to Holland for a Combidex MRI, even though bone and CT scans were clear.

Combidex MRI showed clear lymph nodes and a 2,5 cm tumor in the anterior. I was his 1st patient to come up clear on the Combidex which has a 96% accuracy,

I've been on a no meat and dairy diet since 12-08 and PSA reduce to 30 while I awaited the Combidex MRI.

The location of the tumor in the anterior apex next to the urethea makes a good surgical margin very unlikely. Currently on Casodex and Proscar for 8 weeks to shrink my 60 mm prostate. Treatment will be seeds followed by 5 weeks of IMRT while continuing on Casodex and Proscar. So far no side affects from the Casodex.

JohnT


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/31/2009 6:14 PM (GMT -6)   

Here is the best presentations I have seen yet for prostate cancer...

http://www.sessions2view.com/pcf_library/

PCA3 is explained very well here.

 

Select "View Sessions"

Click next twice...
 
Select "2008"
 
Select "Session VIII"
 
Select "PCA3 and gene fusion based diagnostics...."
 
Impressive stuff.  But you need the T2-Erg test as well. 

Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 3/31/2009 9:26 PM (GMT -6)   

justus1292
Regular Member


Date Joined Feb 2009
Total Posts : 63
   Posted 4/2/2009 4:34 PM (GMT -6)   
Thanks for the replies.  It gives me a broader understanding. wink
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