An increase, a blip, or perhaps a new technician.

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BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 9/17/2010 7:32 PM (GMT -6)   
For 3 years, almost to the day, of receiving undectable PSA results at the ultrasensitive level (always <0.01 at the same lab) the latest result comes in at 0.01 ( same lab) on the button. Mmmm. It will be interesting to see the next result in December. I noticed a slightly different format in the way the report was written so I'm leaning toward a different tech writing it up but time will tell.
Bill
Biopsy

4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007

Post-op

Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct '07 <0.1 undetectable
PSA Jan '08 <0.1 undetectable
PSA April '08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August '08 <0.001 undetectable (disregarded due to lab "misreporting"-----it is not possible for any lab to get a reading of less than .003)

Post-op pathology rechecked by new lab:

Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September '08 <0.01 (new lab)
PSA February 09 <0.01
PSA May '10 <0.01

www.yananow.net/Mentors/BillM2.htm

Never underestimate old people ............ you don't get to be old by being stupid.

Post Edited (BillyMac) : 9/17/2010 6:41:54 PM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 9/17/2010 8:09 PM (GMT -6)   
Hi Bill
Don't sweat it and get back on the golf course. Should be approaching spring there and you may just have to take a layer off and improve the farmers tan a bit.

I don't anything that should worry you as yet. 0.01? That's still pretty low.

Tony
Disease:
Advanced Prostate Cancer at age 44 (I am 48 now)
pT3b,N0,Mx (original PSA was 19.8) EPE, PM, SVI. Gleason 4+3=7

Treatments:
RALP ~ 2/17/2007 at the City of Hope near Los Angeles.
Adjuvant Radiation Therapy ~ IMRT Completed 8/07
Adjuvant Hormone Therapy ~ 28 months on Casodex and Lupron.

Status:
"I beat up this disease and took its lunch money! I am in remission."
I am currently not being treated, but I do have regular oncology visits.
I am the president of an UsTOO chapter in Las Vegas

Blog : www.caringbridge.org/visit/tonycrispino

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 9/17/2010 8:20 PM (GMT -6)   
No worry nor anxiousness here at all Tony, rather a clinical look ..... I do so like to pull things apart. As for the golf course I am leaving right now .....11-15 am here and I hit off in an hour. It is an outstanding day as well ..........fore!!!!
Bill

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 9/17/2010 9:12 PM (GMT -6)   
Bill,

I went through the same experience. It went back down the next 3 month test to < .01

Good to hear from you. It's been a while !
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

Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 9/17/2010 9:26 PM (GMT -6)   
Hey Bill, don't make me nervous, I'm very similar in stats, and just behind you. I'll be watching with interest.
Heres hoping your theory re different tech, comes good. I recon you could be on the money. Keep us all posted and happy golfing.....................Kev
Age 52yrs [Gold Coast Qld, Australia]
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4 Gleason Score 3+4=7 Stage T1c
RP 24/12/08
Upgrade Gleason Score 4+3=7 Gleason Differential 60%/40%
Stage T2c Three small foci total volume <10%
Neg Margins and Nodes
Nil - EPE
Dry less than 1 week. ED- okay with Meds.
PSA at 18mths no change remains 0.03
"Everday in Everyway, I get better"

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 9/17/2010 10:16 PM (GMT -6)   
billy, my friend, even though its been reported slightly different, as tony said above, .01 is low low and then even more low, lol. you have done very well for yourself so far, and I hope you continue on that roll for years to come. must be all those beans you eat, lol.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

windquest
New Member


Date Joined Aug 2010
Total Posts : 9
   Posted 9/22/2010 12:57 AM (GMT -6)   
Just a comment here about labs. Few that I have found actually tell you anything about the test, just the results. It is interesting that MDAnderson requires all post op patients send samples to them for testing to take out the error than may occur. According to Dr. Bahn who did my biopsy, labs will and do change their procedure, change the reagents and of course change personal....all with the potential of changing the results. Since I move around the country on a continuing basis, Dr Bahn recommended my follow up psa either with the same lab with the same assay or be content with testing more often and live with averaging. I hope the future brings us a better psa test for all of us.
2008-Age 60-PSA 3.4
2010 April-PSA 4.3
2010 July-PSA 5.3
July-August Cipro 21 days, Follow up PSA 5.3
August 19th-Color Doppler Ultrasound / 6 Core Biopsy
Results Negative!!!Next PSA October 15th No further biopsies recommended.

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 9/22/2010 7:54 PM (GMT -6)   
Hi Bill,

I hope that the result you had was just a change in reporting format, it does happen, sometimes without any explanation. Given all you have been through though, I was hoping you could provide some advice to us.

My husband also has his surgery (but not the biopsy) with Dr Stricker and he is going to have his first PSA test post-surgery in a week. Dr Stricker has given him a Douglas Hanly Moir pathology referral to get this blood test and I suspect that it is the standard and not the ultra-sensitive test.

With all the research you have done on doing the ultrasensitive test in Sydney, how do you go about organising this? Do we ignore Dr Stricker's referral and get our GP to refer us to a lab that does do ultrasensitive? Does Douglas Hanly Moir do the ultrasensitive test or am I just assuming it doesn't? If not where would be the best place to go for a reliable ultrasensitive test and what did you say to your GP/Dr Stricker, to get this to happen?

Like you, we would also like to know very early if there is a reoccurance. I hope that the chances of reoccurance are low with my husband having a small volume cancer but it does have a little Gleason 4 in it which makes it just that bit unpredicatable.

Another issue I have is with the pathology report of the tumour. Dr Delprado did the expert independent review of the biopsy specimens (based on your recommendation a few months ago) and he also did the final pathology report of the prostate post-RP. I have the utmost respect for Dr Delprado's experience, my only concern is that Dr Delprado does do all of Dr Stricker's patients post op and there is a tiny niggling paranoid part of me that wants an independent opinion. If I did a second review of the prostate here in Australia, would you have the name of an alternate specialist pathologist?

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.

Post Edited (An38) : 9/22/2010 7:01:36 PM (GMT-6)


logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6085
   Posted 9/22/2010 8:55 PM (GMT -6)   
You don't seem concerned, rightfully so,IMO. I'm sure you are aware of this but , why not, double check with the lab. I bet it was written down wrong. So then you would know and no concern whatsoever.
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, extensive PNI, 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 " Francois de la Rochefoucauld, source courtesy of Tatt2

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted Yesterday 8:01 AM (GMT -6)   
An38 said...
Hi Bill,

I hope that the result you had was just a change in reporting format, it does happen, sometimes without any explanation. Given all you have been through though, I was hoping you could provide some advice to us.

My husband also has his surgery (but not the biopsy) with Dr Stricker and he is going to have his first PSA test post-surgery in a week. Dr Stricker has given him a Douglas Hanly Moir pathology referral to get this blood test and I suspect that it is the standard and not the ultra-sensitive test.

With all the research you have done on doing the ultrasensitive test in Sydney, how do you go about organising this? Do we ignore Dr Stricker's referral and get our GP to refer us to a lab that does do ultrasensitive? Does Douglas Hanly Moir do the ultrasensitive test or am I just assuming it doesn't? If not where would be the best place to go for a reliable ultrasensitive test and what did you say to your GP/Dr Stricker, to get this to happen?

Like you, we would also like to know very early if there is a reoccurance. I hope that the chances of reoccurance are low with my husband having a small volume cancer but it does have a little Gleason 4 in it which makes it just that bit unpredicatable.

Another issue I have is with the pathology report of the tumour. Dr Delprado did the expert independent review of the biopsy specimens (based on your recommendation a few months ago) and he also did the final pathology report of the prostate post-RP. I have the utmost respect for Dr Delprado's experience, my only concern is that Dr Delprado does do all of Dr Stricker's patients post op and there is a tiny niggling paranoid part of me that wants an independent opinion. If I did a second review of the prostate here in Australia, would you have the name of an alternate specialist pathologist?

An
 Hello An,
Good to hear from you. about 8 months after my op ( after learning a lot more about the disease) I had a couple of nagging doubts about the desirability of additional treatment given the post op pathology. I arranged a consultation with Dr Joseph Bucci (radiation) and Dr Paul De Souza (medical oncologist) both at St George public hospital Cancer Care Centre.
 
 
I had no problem arranging the appointment and it was all fully covered by Medicare. St Vincents Private have their own in house pathology and that is who did the original report. Dr Bucci arranged to have the post op specimen examined by another pathologist. That was also covered by Medicare. Dr Bucci sent the specimen to Douglas Hanley Moir and it was Delprado who did the second report. He downgraded the St Vincents Gleason report as well as commenting on the cell grade in the EPE region (grade 3) which was not done in the original. As for the Ultrasensitive PSA,  I have that done at the Tumour Marker Unit of the bio-chemistry department at RPA. It is fully covered by Medicare. That is where the lab for Sydney South West pathology is located. I simply downloaded a pathology request form, took it to my GP and had him fill it out. I asked that he specify "Ultrasensitive PSA" and under the clinical notes section he puts "progress post prostatectomy" to make sure everybody knew what was going on. There are some details here:
 
 
You can download the request form here under "Pathology Request Form":
 
 
Hope that helps some,
Bill
 
 

Post Edited (BillyMac) : 9/23/2010 3:47:34 PM (GMT-6)


An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted Yesterday 8:47 PM (GMT -6)   
That helps heaps Bill.

Thank you!

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted Today 12:32 AM (GMT -6)   
An,
I've only just realized those links did not do what I thought they would. If you open the link and put in ultrasensitive PSA in the "search by test name" then click on 'Total PSA" the details I meant to come up, will. If you also click on "Lab Forms" in the original page and hit "Pathology Request Form" the request form will come up.
Bill

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 4276
   Posted Today 6:09 AM (GMT -6)   

Bill, I vote for the "different tech" angle.  And, re the other thread...shock is good...LOL.  In my opinion you were right...

Tudpock (Jim)


Age 62 (64 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Procedure went great, catheter out before I went home, only minor discomfort. Everything continues to function normally as of 9/10/10. 6 month PSA 1.4, 1 year PSA at 1.0. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 10/8/2010 12:01 AM (GMT -6)   
Bill,

So we used the form and went to the RPA for the first post op PSA at 6 weeks.
The results were good but not great – 0.02.

Of course I am happy that my husband is under 0.1 but we were hoping that it was going to be undetectable on ultrasensitive – that would really have helped us relax a bit – and we did expect an undetectable because my husband’s 3+4 pathology was with negative margins. But as people have pointed out here, we are in the zero club and that’s what we should really try to focus on.

In any case I think I may have the answer for your question. I phoned up the scientist in the lab and asked them several questions on detection levels and accuracy of the test (for some reason the scientist thought I was a doctor) but what was really interesting was when I brought up the issue of calibration. He was surprised that I asked because he said just in the last few weeks he has had some peculiar questions about the tests with one doctor from Wagga reporting 5 separate patients who previously had undetectable (<0.01) coming up with 0.01. He suspects that one of the two machines that he uses for PSA are not working perfectly and he trying to pull together evidence to prove that there is a problem on that machine. This may explain your problem and it does throw some doubt on the 0.02 reading.

Regards,
An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.
Post RP PSA, Sep10 – 0.02

mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 10/8/2010 2:35 PM (GMT -6)   

Hey Bill,

That's still a good number. Maybe it was just the lab or the tech. May the rest be as good or lower.

All the best,

Mike


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 10/8/2010 4:52 PM (GMT -6)   
Hello An,
That's a pleasing result you have there. Six weeks is an early test though so don't be surprised to see it go down a little more. PSA has other sources as well which can vary from person to person so given his negative margins and the reputation of his doctor this may also be another reason for the very minute reading. These other glands can and do produce trace amounts of PSA which vary from man to man. They are not affected by the operation. I think that what is important when using the ultra sensitive test is to see it as an early marker rather than an absolute value. Our PSA at this level may move about a bit but if there was residual tumour it would over time, show a definite and persistent increasing reading, even at very low values. If a very low reading should move up and then back down (which as we have seen here is not uncommon) I think you would be safe in assuming things other than tumour are in play. A growing tumour would not begin producing less PSA. The tests during the first year following the operation has the greatest amount of stress ........ after this you become more relaxed. To put your mind at rest there is an interesting article on the other sources of PSA here.

www.andrologyjournal.org/cgi/rapidpdf/jandrol.107.002576v1.pdf?ck=nck
(page 3)

Many thanks for the update on the testing at RPA ....... that is very interesting. It is no wonder he thought you were a doctor........I'll wager not many patients ring up asking the head scientist about how well their equipment is calibrated. If the scientist was a gentleman named Terrence Foo, I spoke with him in my early days and he was sure one very helpful man.
Take care and continued good health to your man,
Bill

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 10/8/2010 5:28 PM (GMT -6)   
AN - reminder from other postings - undetectable is < 0.10 .... NOT <0.01 ......
your Paul is undetectable - at least his PSA is .... (0.02 is GREAT !!!!!)

sincerely,
BRONSON
Age: 55 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB
Sept 23, 2010 -0.05 - again -hoorah !

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1152
   Posted 10/12/2010 1:51 AM (GMT -6)   
Thank you Bill and Bronson,

Decided to take a chill pill and not think of PC for a little while. But I'm back now.

The accuracy of the reading is dependent on the assay used and the 3rd generation DMC test that Bill and I do is very sensitive - this may or may not be the test that other people use and therefore may not be comparable.

See Table 5 in http://www.prostate-cancer.org/education/preclin/McDermed_Using_PSA_Intelligently2.html

where the third generation DMC test provides a post-RP nadir which can be related to the probability of biochemical recurrance. For a reading of <0.01 this is 4%, for a reading of 0.02 it is 16% and for >0.04 it is 89%.

However, on reflection I can make the following observations about my husbands level of 0.02:
1. The surgeon did say that he did a particularly careful nerve sparing procedure due to my husbands (and my) age and the biopsy and MRI reports which showed an a very tiny bit of cancer. Maybe he left more tissue behind than he normally would causing a trace PSA to register.
2. The actual test is maybe reporting a higher PSA than normal - evidenced by 6 other people using the same lab within the last month or two moving from <0.01 to 0.01 
3. Maybe my husband is one of these people who secrete a small amount of non-prostate PSA
4. Maybe, he hasn't reached a nadir at 6 weeks post RP

There is an 84% chance that the reason for the 0.02 is 1, 2 or 3 of the above. That is something to celebrate!! And there is a chance that he has not even reached this nadir yet so the probabilities are even better.
We should be able to work this out shortly with his next PSA test in three months.

Regards,
An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.
Post RP PSA, Sep10 – 0.02

Post Edited (An38) : 10/12/2010 1:25:31 AM (GMT-6)


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/14/2010 12:15 AM (GMT -6)   
December has rolled around and it was test time again last week. Result came in at <0.01 again. This is at 40 months post surgery so I am well pleased. The previous result was a 0.01 which looks like it may have been a lab blip (thanks to An38 for the possible explanation). I am still gobsmacked at the varied course this disease can take. My prostate was 32 grams (32cc) measuring 50x45x35mm. Within the right lobe, there was a 20x20x20mm tumour, 80% grade 4 cells (Gleason 8). On the left was a separate tumour, somewhat smaller in size, comprised of mainly grade 4 and grade 3 cells (Gleason 7). The right side tumour extended through the capsule 1.5mm (focal EPE) and reached the surgical margin which was was disrupted (i.e. messed up a bit on removal). The pathologist made a judgement call that the surgical margin was negative despite this disruption. The left side tumour was confined and clear of the margins. Looking back I can remember noticing a slowly increasing loss of ejaculate in the couple of years prior to diagnosis ------ at the time I assumed this was due to getting older but now I think it may be that the ol' walnut was falling to bits. I have always been half expecting that given these stats my PSA would begin to reappear-------- I still have my backup plan on hand----you just never know what's around the corner. Is ignorance bliss sometimes? Knowing what I know now, if I had just had the op and received that pathology I would elect to have immediate follow-up radiation. If only everything was black and white shakehead
Bill

Post Edited (BillyMac) : 12/14/2010 2:57:29 AM (GMT-7)


creed_three
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Date Joined Jan 2007
Total Posts : 762
   Posted 12/14/2010 12:38 AM (GMT -6)   
Hey Bill,
You are braver than us having a PSA so close to the holidays. After 3 years of trauma we have given up the Christmas PSA test! However this is an excellent result and we are really glad to see it is all good for you. Have a great holiday season if you have holidays. cheers, Lana & CJ

An38
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Date Joined Mar 2010
Total Posts : 1152
   Posted 12/14/2010 1:18 AM (GMT -6)   
Hey Bill,

Fanstastic news, I am so pleased for you. What a Christmas present!

It seems that the machine is now working, so this time Paul's 0.03 is really a 0.03.

Regards,
An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg (margins, seminal vesicles, extraprostatic extension). Multifocal, with main involvement in the fibro-muscular zone.
Post RP PSA,
Lab 1: Sep10 – 0.02|Nov10 – 0.03
Lab 2: Nov 10 - 0.01

Radical
Veteran Member


Date Joined Mar 2009
Total Posts : 739
   Posted 12/14/2010 2:06 AM (GMT -6)   
Hey Billy, great news mate, and what a bloody relief for you, fantastic x-mas present.

AUSSIE-AUSSIE-AUSSIE-OI-OI-OI-......................LOL......................Kev. yeah
Age 52yrs [Gold Coast Qld, Australia]
6 out of 8 cores positive 3 X 60% / 3 X 10%
PSA 4 Gleason Score 3+4=7 Stage T1c
RP 24/12/08 Dr Philip Stricker [Sydney]
Upgrade Gleason Score 4+3=7 Gleason Differential 60%/40%
Stage T2c Three small foci total volume <10%
Margin status- Focal Involvement
Nil - EPE
ED- okay with Meds.
PSA at 2 yrs, no change remains 0.03
"Everyday in Every-way I Get Better'

Piano
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Date Joined Apr 2008
Total Posts : 847
   Posted 12/14/2010 2:53 AM (GMT -6)   
Billy -- congratulations on the little '<' this time. My experience is that even medical people are cavalier with it, and it's quite likely that whoever wrote down the result last time forgot to put it in.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 12/14/2010 10:08 AM (GMT -6)   
Billy, that's great news. Congrats.
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh, next in Feb.
ED-total-Bimix 30cc

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 12/14/2010 3:12 PM (GMT -6)   
Thank you one and all. I find though I am getting a little complacent ------- the diet has slipped somewhat and the exercise regime is now slack. Time for some serious New Year resolutions ....... not just yet though. tongue
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