PSA doubling time

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DanaA
Regular Member


Date Joined Jan 2009
Total Posts : 71
   Posted 8/5/2009 8:10 AM (GMT -6)   
Before surgery, Bill's PSA went from 10 to 15 in 4 months. I calculated this as about a 6 month doubling time. After surgery, it went from .11 to .2 in about two weeks. I calculated this as .6 month doubling time. Something seems off. How does his doubling time get so much faster after surgery? Is this as scary as  I think?
 
Best to all,
 
Dana


SO diagnosed 4/15/09 age 47
1/15/09=PSA 10
Dx 4/15/09=Right side= Gleason 4+4=7, 40% involved, 5 out of 6 cores positive, perineural invasion present
Left side+ Gleason 4+4=8, 60% involved, 5 out of 6 cores positive, no perineural invasion present
T2c
5/14/09=Robotic surgery at Cleveland Clinic by Dr. Gong
pre-op PSA 15, MRI shows extracapsular penetration
Pathology 5/21/09-T3a, N1MX, positive margins, 1 out of 13 lymph nodes positive, left nerves spared
7/7/09- pad free
7/10/09- PSA 1.1


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 8/5/2009 11:09 AM (GMT -6)   
First of all, this is not yet particularly scary. These are both low PSA numbers and could be within the limits of error for some labs, so I wouldn't even calculate doubling. I don't understand why there was a second PSA test only two weeks after the first. Did your doctor have some particular concern that made him order a quick retest?

With a high Gleason and some lymph node involvement there may be some radiation treatment in your husband's future, but that is not the end of the world and you will find lots of guys on this site who have finished off their cancer this way.

Keep us informed.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 8/5/2009 12:03 PM (GMT -6)   
Dana,
Sorry to hear about your husband. A PSA doubling time of less than one year before treatment is indicative of a serious, agressive PC. Doubling time after surgery is usually faster because the PSA is a combination of psa generated by the prostate, which is slow, and psa generated by the PC which is fast. Doubling time increases because the slow or stable psa has been removed and only the fast growing psa generated by the PC remains. If PSA is still doubling at less than one year after treatment you should see an oncologist specializing in PC. The positive lymp node and high PSA doubling time indicate that the PC had already spread before his surgery. Radiation would not be a curative option.
Please get your husband to a good prostate oncologist as soon as possible.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT


DanaA
Regular Member


Date Joined Jan 2009
Total Posts : 71
   Posted 8/5/2009 6:46 PM (GMT -6)   
Thank you for the replies. He got a test a couple weeks later because it was at another hospital he is probably going to have radiation at. The other hospital also said it might take a little longer for the psa to go down after the surgery, so they were hoping it might be lower in a couple more weeks. He will definitely have radiation. His decision now is whether to have hormone treatment now as well. He was originally wanting to wait until after radiation to see if it rose after that and then do the HT. But all the doctors have been urging him to do it now. I think the rise in his psa may convince him to do it now rather than wait. Any thoughts?
 
Many thanks,
 
Dana
SO diagnosed 4/15/09 age 47
1/15/09=PSA 10
Dx 4/15/09=Right side= Gleason 4+4=7, 40% involved, 5 out of 6 cores positive, perineural invasion present
Left side+ Gleason 4+4=8, 60% involved, 5 out of 6 cores positive, no perineural invasion present
T2c
5/14/09=Robotic surgery at Cleveland Clinic by Dr. Gong
pre-op PSA 15, MRI shows extracapsular penetration
Pathology 5/21/09-T3a, N1MX, positive margins, 1 out of 13 lymph nodes positive, left nerves spared
7/7/09- pad free
7/10/09- PSA 1.1
7/25/09-PSA .2


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 8/5/2009 8:21 PM (GMT -6)   
Hello Dana,

Your husbands stats are pretty much on the heavy side, sounds like your most recent post's mention of what the doctor thinks might make sense to try to finish knocking out the rest of the PC before it does get out of hand.

David in SC

Good luck to the both of you
Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
 Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsule, one post. margin, clear lymph nodes 
2009 PSA   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, scarring closed up bladder neck, corrective laser surgery scheduled for 8/18
 
 


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4269
   Posted 8/5/2009 9:48 PM (GMT -6)   
Dana,
If it wasn't for the positive lymph node I would agree with radiation approach. The lymphnod indicates the PC is in his blood stream and is no longer localized. The sooner he goes on HT the better.
JohnT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DX BPH and continue to get biopsies yearly. Positive Biopsy in 10-08, 2 cores of 25, G6 less than 5%. Scheduled Surgery as recommended.

2nd Opinion from Dr Sholtz, an Oncologist said DX wrong, path shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G 4+3 approx 2.5cm diameter.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and burining urination. Daily activities resumed day after implants.

Scheduled for 5 weeks IMRT in July

JohnT

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