Squirm thanks for printing the age related chart. That was part of my problem. My first PSA at age 50 was already over 2.0, don't remember the exact number. And each year, it moved up .5 to 1.0 in size, then at age 55, it hit a little over 4.0, then the GP sent me to my current uro/surgeon, A negative biopsy and a year later, it had nearly tripled, 2 back to back biopsies, then pay dirt, and the PSA was in full "Need for Speed Mode". In my opinion, at age 50, further investigation should have been done or suggested, but again, my GP, long term with me, simply looked at the paper with the blood work analysis, and as long as it was under 4.0, guess it never occured to him to do or suggest anything to me, and in those days, never ever once thought about
a prostate, wasn't even sure where it was located or what it did, plus I was young at 50, not some old man with prostate problems. Little did I know.
Tim, thanks for your point. Yes, psa velocity both before and after primarty treatment for PC is more of an indicator of long term prognosis for men with PC, more so sometimes than someone with a higher staging or even gleason number. The velocity is a better indicator of actual agressiveness, both my uro and rad. oncologists agreed on that point. The psa number is not as important by it self, as much as how fast it got there, and is it still increasing rapidly.
I could be wrong, but knowing what I know now, I don't feel like I have a good long term prognosis. True to the nature of the psa velocity theorists, I already have evidence of reaccurance despite a good surgery. And if the theory follows through, if I do salvage radiation, at best, it will slow down the velocity a bit until it regroups on the other side. I wish someone or something could prove me wrong on this theory, but even my own doctors seem to think its on a "bent to hell" path ultimately.
My wife and I are really spending a lot of time discussing options and choices, quality of life issues, etc. What's better? Five or so years of pretty normal life together and put the cancer out of mind, or 10 years or so of always being a patient to one degree or the other, and constantly have PC on the front burner in our lives, and especially on my mind.
Just sharing some thoughts, I am sure many of you do the same thing from time to time. Not a question of giving up and doing nothing, but as a person of extreme logic and having spent a life of living in the world of stats, percentages and numbers, I am not real good at faking myself into believing something that I don't feel is possible.
Hopefully for the next generation, there will be better testing, earlier testing, lower psa standards, new drugs, and an accurate way to distinguis the difference between a slow moving pc that really requires nothing, and those that are on the move all the time, despite appearent "good" numbers. Might not help some of us, but be nice to think it could help our pc brothers in the future, or even our own sons, I have two myself and I am already worried sick for them. The older one ,age 32, promised to get a baseline psa at 35, so only 3 years from now, and my youngest 26, said he would do the same thing. That's all I can ask of them.
Sorry for the rambling, been deep in thought the past day or so.
David in SC
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, 8/9 .16
Lastest 7/13 met with Rad. Oncl, considering options, 7/20 Catheter #6 after complete blockage, 8/14 met with Rad Oncl, 8/18 - laser scope surgery to clear blockage, now on Cath #7, 8/26 - cath removed