PSA Anxiety--how long

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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 6/22/2010 8:04 AM (GMT -6)   
I thought this might be an interesting topic. Let's face it, for most of us, PC is still that elephant in the room. Most of the time, it is closer to the back burner. But sometimes it is intrusive. One of those times concerns an upcoming PSA test.
 
I'm wondering at what point you guys start to really feel it. That is, is there a specific time when the concern is...well...PALPABLE?
 
For me, it was when I returned from a KC working trip last Thursday. I was due for one and I was VERY anxious. So, that's basically 6 days (I got the result today -- see my signature or other thread). BUT, had I not been extremely busy, I suspect the anxiety would have set in earlier. Last time, it was 2 weeks.
 
Now, if one is stable for a few years, maybe the anxiety time is lessened. Maybe.
 
Your thoughts
 
Mel

63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.

Second post-op PSA on 6/21/10--0.02--


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 6/22/2010 8:22 AM (GMT -6)   
Mel...I really think it is all individual...just as the cancer is. Many men have the psa anxiety for years...others just a few months after surgery. I suppose it gets better with time, as it wears on...but from my observation of you...I suspect you will be dealing with psa anxiety for some time to come. No offense, it is quite common with men dealing with personal health issues and cancer in particular. I am just being honest with you. Having that said, you could probably should look into the various resources and methods that deal with stress and anxiety and apply those to yourself. For many men facing the same road you are on will deal with the stress and anxiety in their own specific ways and will chime in shortly.

I was in the same boat as you about a year ago. Today, even knowing that I have a recurrence, I have learned that I am also in control, and not the cancer. I can chose to deal with this in my way, and in my own time and knowing that I have complete control, it has taken the anxiety and fear away. I am at peace with my disease and I know I will have many many years ahead of me. I chose not to worry and enjoy the life I do have...I am in control. But that is me.

Good luck on your journey ahead.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009     .06
                   6 month Apr 2009     .06
                   9 month Jul  2009     .08
                 12 month Oct 2009     .09 
                 18 month April 2010   .19


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7082
   Posted 6/22/2010 8:26 AM (GMT -6)   
I've said before - treat it like a leave or pass in the military. Go out and live until they close the gate, and be walking in as they do it.

It makes no sense to worry about the results until you have them.

I've just gotten my third back yesterday (still undetectable, good stuff), but I promise I did not spend the weekend over-stressing about it.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/22/2010 8:28 AM (GMT -6)   
Mel, you got another "strong" zero. That is something to reflect upon, and to celebrate.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4849
   Posted 6/22/2010 8:30 AM (GMT -6)   
God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
 
I get more nervous about meeting a blind date then I do a PSA test. Ya never know if their dog will bite ya or not.
 
 "It is what it is."
Age 55   - 5'11"   215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
05/18/10 - 24 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 6/22/2010 8:30 AM (GMT -6)   

Interesting. When your numbers were creeping up, weren't you anxious?

It sounds like you are handling that stress very well.

 

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.

Second post-op PSA on 6/21/10--0.02--


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 6/22/2010 8:36 AM (GMT -6)   
If you meant me, I feel PSA stress each and every test period. I just don't focus on it, because I am a "numbers" person by trade, and a "facts" person by nature. I was only in the zero club for my first post reading, then I immediately hit .1, then easily went to 3 rises above .1. With my pre-treatment PSA velocity so strong, and a single positive margin, my uro/surgeon and I were expecting recurrance out of the bag. It was one educated guess that I wish we hadn't won.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2461
   Posted 6/22/2010 9:27 AM (GMT -6)   
Mel,
I think I was the most anxious before my first PSA test. However, one week before every PSA test I get the nerves. With my high Gleason, I'm always wondering when and if my PSA start rising. I guess, I'll always be nervous about it as long as I live but may be less as time goes by. A friend of mine who has been in the zero club for 4 years, said that he no longer gets nervous.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 5 months
2 months PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 6/22/2010 9:51 AM (GMT -6)   
The clock started ticking on our end the day we were born. Be it PC or something else, there is a hidden problem ( likely many of them) festering inside of us that can at anytime surface

Worry and anxiety is something that one can change to joy and satisfaction
Stats:
Age: 52, PSA (2008)=1.9
Biopsy on 01/09/09, Gleason Score = 3+3
One (1) out of twelve (12) cores was positive, plus external nodule found
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Post Op Path 3+3
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, <0.01 - 3 months post-op
PSA 1/10 undetectable, <0.01 - 9 months post-op
Trimix provides 100% erectile function


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6075
   Posted 6/22/2010 10:23 AM (GMT -6)   
The anxiety you are talking about really does reflect the different, shall I say personalaties. Some people are worriers, some not so much, I get the std test cause my surgeon said thats all I need plus I get it at 6mos intervals. I agrre with him on that because I worry. I do think we all have the power to change our personality to that which we want. In one of my long ago posts, I talked about believing and expecting the result I want and I believe it works for me. I would rather believe a positive, than a negative, until the " facts " get in the way and when and if they do, I will still believe in the positive as it relates to the new " facts " I don't know , is perception reality??? Having said that as the psa date approaches, I believe a little stronger, iguess thats anxiety, but I.m sure even with you this dis-ease has given you positive insights you are glad you have experienced. Life is great. Remember in " Blade runner " when the replicant was dying as He chased Harrison ford, He stuck the nail in his hand so the pain would give him additional life. We didn't make up this crazy life, but, it is what it is
age 67 First psa 4/17/09 psa 8.3, 7/27/09 psa 8.1
8/12/09 biopsy 6 out of 12 pos 2-70%, rest <5% 3+3
10/19/09 open rrp U of Washington Medical Center, left bundle spared
10/30/09 catheter out. continent from the jump.
pathology- prostate confined, only thing positive was the report.everything else negative
9% of prostate affected. gleason 3+4, I suppose thats a negative
After reading pathology myself, gleason was 3+4 with tertiary 5, 2-3 foci That is a negative, but I am a positive !!
Ed an issue but keeping the blood flowing with the osbon pump
Dec 14,2009 psa 0.0 May 10 2010, psa 0.0

" Hypocrisy is vice's homage to Virtue " read it in Bartlet's book of quotation years ago stuck with me, can't remember who said it.


John T
Veteran Member


Date Joined Nov 2008
Total Posts : 4268
   Posted 6/22/2010 10:59 AM (GMT -6)   
I've been getting psa tests for nearly 12 years. There is always some anxiety. I got my 3rd post treatment psa yesterday and feel a little anxious; I guess it never goes away and never will.
JT

64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology 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. G7, 4+3, approx 16mmX18mm.

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. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.

JohnT


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 6/22/2010 6:29 PM (GMT -6)   
By nature, I am a worrier. I start worrying when the blood is drawn. I am able to have the results in about 20 minutes so I am happy for the short turn around. I am on a 6 month testing interval and believe even if the doc tells me to come back in one year, I would go back in 6 months. I wish mentally I could go a year but know I cannot.
 
Age 48 at diagnosis
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 6/22/2010 7:15 PM (GMT -6)   
Mel,
 
As most have said, most likely it wll never go away.
 
But you most likely hit the nail on the head yourself.  If you sit around and dwell on it, it will be much worse.  I think keeping busy is an important part of dealing with many of the issues of old age. I think you have said how much you enjoy your job, and how it takes your mind off of your worries.  Work, hobbies, vacations, etc. are one the keys from my view point of handling these things.
 
I think it also helps to somehow deal with our mortality, so that when it becomes closer,  we aren't so shocked by the possibility.  We are most likely all going to die one of these days, be it 5, 10, or 20 years from now.  So be it.
 
I guess for me, while I am still a little anxious every three months, I guess I feel as tho I am less anxious than if I thought I was going to live forever and if I'm just killing time playing cross word puzzles waiting for my next PSA.  Heck, I have to make a hole in my schedule to get the blood drawn.
 
I think your results are looking good, certainly much better than other guys we see on here.
 
Goodlife

Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 6/22/2010 7:34 PM (GMT -6)   
  Mel, I don't worry about it until I'm on the phone with the uro's office and the nurse comes back on the line and says, "Bob, it's ...."
I either then reply, "Thanks so much," or mumble "Ah, S--T!"
 
You can't worry about things you cannot change.  Just hope for the best, as I do for you.
I'm 20 miles south of KC.  Would have been nice to meet you.  I go for my 6month post RT Psa tomorrow, so will find out on Thursday where I am.
 
Bob
 AGE:58
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
 9 month Psa,  0.2  Doubled! Criminy!
 Started RT 10/28...one year since diagnosis.  RT over 12/22.
 3 month post RT Psa 0.1.


pa69
Regular Member


Date Joined Mar 2009
Total Posts : 260
   Posted 6/22/2010 9:52 PM (GMT -6)   
Hi Mel,
I've had it pretty easy compared to many members of this forum but each time the dreaded PSA test approaches I keep wondering if this is the time for the other shoe to drop. All we can do is hang in there and hope for the best.

Regards,
Bob
Age 70, First ever PSA 7.8 taken June 2008, Biopsy July 2008, 10 of 12 cores positive, Gleason 3+3=6
da Vinci surgery December 10, 2008, catheter removed December 29 2008
St. Lukes Hospital, Bethlehem, Pa.
Dr. Frank Tamarkin
Prostate weight 73.0 grams, Gleason 3+3=6, stage pT3a
Tumor locations: right anterior apex, right posterior apex to mid
left anterior mid to base, left posterior apex to mid
extensive perineural invasion in right anterior apex, right and left posterior apex to mid
seminal vesicles negative
Six PSA tests undetectable, latest April 30
Pad free beginning Mar. 18, 2010!


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 6/22/2010 10:00 PM (GMT -6)   
My mother, who is a 50 year plus breast cancer survivor, once told me the first five years she thought about it several times every day. Sometime in the second five years she started to think about it only once a day, sometimes. Somewhere after ten years she realized she'd gone a whole day without thinking about it, and somewhere around 25 years she went a whole week.

Me? I fret a week ahead of getting the blood drawn and then really get up tight for the several days I have to wait for a result. The next one, in a couple of weeks (yup, starting to think of it a lot) will be my one year mark. A big milestone if I make it. But, I don't imagine I'll fuss any less about the next one.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
 
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
 
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
PSA on Jan 8 less than 0.02
PSA on April 9 less than 0.02 
 
  

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