End of a trend!

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Red Nighthawk
Regular Member


Date Joined Oct 2009
Total Posts : 289
   Posted 7/27/2010 11:10 AM (GMT -6)   
Should I be nervous? My recent PSA came back .05. The previous three, since surgery, have been:

.04 at four weeks post op
.03 at three months
.02 at six months

.05 at nine months

I realize it's still low, but should I be concerned that it went up at all?

thank,

john
Age: 62
Pre-op PSA: 4.1
Post-op pathology:
Gleason grade: 3+4=7, present in both lobes, at least 1.1 cm, and occupying less than 5% of prostate by volume. pT2c NX MX
No lymphatic/vascular invasion present.
Seminal vesicles and extraprostatic soft tissue free of tumor.
Inked margins are free of tumor.
High grade prostatic intraepithelial neoplasia is present
Robotic RP: Sept. 15th, 2009 1 day in hospital, cath out on 9th day
Post-op PSA: at 4 weeks ---> .04
at three month intervals -> .03; .02 (the trend is my friend!)
ED: Improvement is very slow but there are positive signs. Doc has NOT put me on ED drugs yet but I am starting to anyhow.
One pad/day for the first six weeks. Two pairs of underpants, just to play it safe, for a few months.
Surgery: Dr. Jim Hu. Brigham & Women's Hospital, Boston


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 7/27/2010 11:53 AM (GMT -6)   
Hi John.
 
I was told by my Dr that I shouldn't be too worried about slight variations in PSA reading until an upward trent is evident (3 consecutive increases). Your latest increase may just be a bump in a long string of low PSA readings. Try and relax until your next test.
All the best to you.
 
Magaboo

Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
Open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 days - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09=0.05; July 09 <0.04; JAN 10 <0.04; Jul 10 <.04


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 7/27/2010 1:32 PM (GMT -6)   
Your doctor, who sees lots of results from the same lab, is the best one to advise you on this.
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
6 mo. PSA 0.00 -- 1 light pad/day
9 mo. PSA 0.00 -- 1 light pad/day ED remains
12 mo. PSA 0.00 -- still one light pad and ED
16 mo PSA 0.00 -- light pad just for security, ED still an issue


Ricky2
Regular Member


Date Joined Dec 2009
Total Posts : 97
   Posted 7/27/2010 3:47 PM (GMT -6)   
Your stats are very good. Your chance of reoccurrence are very small. Relax and don't worry about it..
Age 70

PSA 5/2008- 3.6, PSA 7/2009- 6.1, retested 9/2009-5.1.
Biopsy 9/2009. 4 of 12 positive. Gleason 3+4=7
CT and bone scan negative.
Robotic De Vince Surgery 10/29/2009. 1 night in hospital. No pain. Cath out on 11/6
Pathology Report: Gleason score 3+4. Margins slightly involved <.1mm to .25mm. Perineural invasion present, stage pT2c. Tumor 18%. Seminal Vesicle - absent, Lymph Nodes 0 of 6.
Continence- first 4 weeks after cath out Dry at night, rest of time, bladder held nothing. 6-7 pads per day. as of 12/30 no pads most of time. almost dry except for a few drips. I keep doing Kegels.
ED. Started VED on 12/17/2009. Every other day for 15 min. Cialis .20 mm twice a week
PSA 02/08/2010 <.1
02/22/10 Trimex injection .2ml less than 50% just a little discomfort.
PSA 05/14/2010 <.1
ED still no natural erection at 5/14/2010. Trimex at .5 cc gives 80% erection..urn to increase potency of trimex..pg to .45.


Red Nighthawk
Regular Member


Date Joined Oct 2009
Total Posts : 289
   Posted 7/27/2010 7:52 PM (GMT -6)   
Thank you to those who responded. I really appreciate the reassurance. I am awaiting my doctor's advice and councel. This is definitely one of the drawbacks of having the super-sensitive PSA test done. Otherwise, I'd be zero, zero, zero, zero and I would be a clueless and happy camper. However, if something IS going on here, this kind of test will give me a year or two heads start on treatment, if I ever get to that stage.

Thanks again and may the wind be at your backs.
Age: 62
Pre-op PSA: 4.1
Post-op pathology:
Gleason grade: 3+4=7, present in both lobes, at least 1.1 cm, and occupying less than 5% of prostate by volume. pT2c NX MX
No lymphatic/vascular invasion present.
Seminal vesicles and extraprostatic soft tissue free of tumor.
Inked margins are free of tumor.
High grade prostatic intraepithelial neoplasia is present
Robotic RP: Sept. 15th, 2009 1 day in hospital, cath out on 9th day
Post-op PSA: at 4 weeks ---> .04
at three month intervals -> .03; .02 (the trend is my friend!)
ED: Improvement is very slow but there are positive signs. Doc has NOT put me on ED drugs yet but I am starting to anyhow.
One pad/day for the first six weeks. Two pairs of underpants, just to play it safe, for a few months.
Surgery: Dr. Jim Hu. Brigham & Women's Hospital, Boston


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 7/27/2010 9:09 PM (GMT -6)   
Red

I am following mine like you are. Mine went from <.01 to .01 and I started thinking just like you. Then it went back down to <.01.

We probably are a little paranoid, and we cetainly can't certify that the lab is that close on their calibration, but I have decided in my own private battle that I am going to strike early in my next skirmish.

Most likely the 3 consecutive rises, be they .01 increments or .05 increments is the better part of wisdom. I guess if you can't stand the guessing, have another one drawn in 30 days. Might be worth the stomach acid.

Good luck !
Goodlife
 
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3733
   Posted 7/28/2010 7:57 PM (GMT -6)   
Hey Red Nighthawk
How consistent were you?
Was the blood taken at the same time? Did you either eat the same food or fast for all tests? Did you refrain from having sex for at least 48 hours? Did you have the same amount of exercise before all tests.
If you want to demand consistency you need to be consistent too. You are a part of the equation.

Here is my PSA routine: I eat nothing after midnight. I refrain from sex for 72 hours. I always use the same lab. I have the blood drawn first thing in the morning.

Keep us posted.
Jeff
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 3+4=7, 3+3=6. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day. Try controlling fluids.
12/11/09 5 months: 3 pads per day, 400-450ml/day
02/26/10 7 months: 3 pads but leak is now 320 ml (5 day avg.)
03/22/10 8 months: 3 pads per day, 280 ml/day (5 day avg.) PT says all muscles are tight and working properly. "There must be another issue."
5/22/10 10 months: 2 pads per day, 190 ml/day Scope on June 15 "Short sphincter"
7/15/2010 one year: 2 pads per day. 140 ml/day, dry in bed.
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05,
4/14 9 months - 0.04 (Siemens Centaur) and <0.01 (Roche ECLIA).
7/12 1 year - 0.03 (Siemens Centaur, direct chemilum); <0.01 (Roche Cobas 601 ECLIA)


Red Nighthawk
Regular Member


Date Joined Oct 2009
Total Posts : 289
   Posted 7/29/2010 9:40 PM (GMT -6)   
Jeff, those are very good points to keep in mind for now on. I think I was fairly consistent, using the same lab, basically the same time of day, no sex before (I should be so lucky!), but one thing I didn't do that I have done in the past is consume some tomato sauce a few days before having blood drawn. I have a feeling the ingredients in the sauce lowers PSA a tad, so maybe that explains it. I'm not worried--yet. Thanks for the reply.
Age: 62
Pre-op PSA: 4.1
Post-op pathology:
Gleason grade: 3+4=7, present in both lobes, at least 1.1 cm, and occupying less than 5% of prostate by volume. pT2c NX MX
No lymphatic/vascular invasion present.
Seminal vesicles and extraprostatic soft tissue free of tumor.
Inked margins are free of tumor.
High grade prostatic intraepithelial neoplasia is present
Robotic RP: Sept. 15th, 2009 1 day in hospital, cath out on 9th day
Post-op PSA: at 4 weeks ---> .04
at three month intervals -> .03; .02 .05 (darn it!)
ED: Improvement is very slow but there are positive signs. Doc has NOT put me on ED drugs yet but I am starting to anyhow.

Surgery: Dr. Jim Hu. Brigham & Women's Hospital, Boston


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3733
   Posted 7/30/2010 2:37 AM (GMT -6)   
Red,
Red Nighthawk said...
I'm not worried--yet.

I'll worry for you. It's my job. ;-)
Jeff
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