Which PSA value is REMISSION?

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Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 5/27/2011 4:51 AM (GMT -6)   

Fellow Survivors

I have a doubt  confused   that only you could help me to dissipate with your acknowledgement.

 

Which PSA value is considered as REMISSION?

 

We read about threshold marks or mile-stones or triggers in the process of treatments but remission is only considered by oncologists. Dr. Myers uses PSA<0.01 as remission level in HT patients, whether Dr. Strum considers a PSA<0.05 as remission on his HT patients.   nono  

Many friends use the sentence, “… he is on remission…” with a meaning that the cancer progress reversed and doesn’t exist anymore.

 

What is right?

 

Thanks

Baptista  :-)


Age: 50 at Dx on May/2000; PSA=22.4;
6x cores biopsy positive; Gleason score (2+3=5)
RP in Aug/2000, PSA=24.2
Negative S-vesicles & lymph node (9); capsular penetration
Voluminous Adenocarcinoma, well-differentiated, Gs (3+2=5); pT3apN0
Post-op lowest PSA=0.18 on Oct/2000; Classified as Micro Metastasis
Jan/2001 PSA=0.26 Biochemical recurrence
AS (Watchful W.) until PSA=3.80 on Oct/2006; MRI & Bone scan negative
Nov/2006 SRT (3D IMRT; 68Gy / 37 fractions)
Feb/2008 lowest nPSA=0.05
May/2009 PSA=0.26 Biochemical recurrence
Oct/2010 PSA=0.95 (doubling at 9.6 months)
Nov/2010 ADT Cyproterone 100mg/day + Eligard 45mg 6-month depot
Asymptomatic, never incontinent, ED since RP

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 5/27/2011 5:09 AM (GMT -6)   
Baptista:
undetectable PSA is <0.01
zero cub membership is PSA <0.01
zero club memberhsip = remission

-each doctor / urologist / surgeon may interpret numbers different - you can easily say - anything less than 0.01 is right.

I am in remission.

hugs,
BRONSON

p.s. the cancer still exists - it is just undetectable right now ....
Age:55 -gay with spouse of 14 years, Steve -Peterborough, Ontario, Canada
PSA:10/06/09 3.86
Biopsy:10/16/09- 2 of 12 cancerous, 5% involvement -Gleason 7 (3+4)
Radical Prostatectomy:11/18/09
Pathology:pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA:04/08/10 -0.05 -Zero Club
PSA:09/23/10 -0.05 -Zero Club
PSA:03/24/11 -0.02 -Zero Club
PSA:03/24/12- TBA

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4849
   Posted 5/27/2011 5:42 AM (GMT -6)   
I always look at the numbers like currency.
 
.01 = one penny and that you are cancer poor
.05 = is pretty darn poor too
3.00 = a trip the URO

BB_Fan
Veteran Member


Date Joined Jan 2010
Total Posts : 1011
   Posted 5/27/2011 6:03 AM (GMT -6)   
To me remission is the point where PSA stabilizes and no longer is advancing. I read the story of a man who went the SRT and HT. After his PSA rose to around .45 and had ceased to increase from that point. Maybe he was maintaining that level with diet and suppliments. Who know. But to me he is in remission.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic RP March 2009
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes - tumor volume 9%, nerves spared, no negitive side effects.
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT .01, < .01

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 5/27/2011 7:09 AM (GMT -6)   
Bronson, think you goofed, brother. Undectable and zero club admission is <.10, not <.01 as you stated.
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 margin
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, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

HD_Rider
Regular Member


Date Joined Apr 2011
Total Posts : 416
   Posted 5/27/2011 7:38 AM (GMT -6)   
So, now this topic has me wondering:  Once you have PCa, will you always have PCa?  I mean, is there really no such thing as a cure for PCa, only various means of controlling it?
John (HD_Rider)
Age: 49
PSA: 3.5, 6/07
PSA: 4.5, 3/11
Biopsy, 12 cores: 04/13/11
Dx: 04/19/11
Gleason: 3 cores at 3+3=6 and one core at 3+4=7 (primarily on right side with <5% on left side)
DaVinci: scheduled for 06/09/11, hoping and praying for the best

Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1267
   Posted 5/27/2011 7:54 AM (GMT -6)   
HD_Rider,

My totally medically uneducated take on this is that "cure" means you die of something else, and during your life PCa isn't an issue --- i.e. you're not spending time, effort, energy, money, on treatment.

When your PSA is <0.01, or <0.02, or whatever, and stays there, year after year after year, you are in remission. The cancer has gone away in the sense that it is not increasing, or causing you any issues. Only an autopsy of the most picky sort would ever tell you if you were cured in the sense of the cancer being totally gone.

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, 2009 less than 0.02
PSA on Jan 8, 2010  less than 0.02
PSA on April 9, 2010 less than 0.02 
PSA on July 9, 2010 (one year) less than 0.02
  

Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2361
   Posted 5/27/2011 10:14 AM (GMT -6)   
Undetectable means that the PSA value is below what the testing instrument can measure, for example <0.1 ng/mL, <0.05 ng/mL, <0.01 ng/mL, <0.001 ng/mL. Most prostate cancer experts consider <0.1 ng/mL to be, for all intents and purposes, a zero.

An advantage of surgical removal of the prostate is that the pathologist can examine the entire prostate, its margins, the seminal vesicles, and any lymph nodes removed. If the cancer hasn't penetrated the capsule or gotten into the seminal vesicles or lymph nodes, you're cancer free and are extraordinarily likely to remain so until your death from another cause.
Age 62
PSA quadrupled in one year (0.6 to 2.6)
DRE negative Retested at 3 months
1 of 12 biopsies positive (< 5%) G6
open surgery June 2006, age 57
Bilateral nerve-sparing
Organ-confined to small area, downgraded to G5
Prostate weight 34 grams
PSAs < 0.1

livinadream
Veteran Member


Date Joined Apr 2008
Total Posts : 1382
   Posted 5/28/2011 11:12 AM (GMT -6)   
this is one of those topics that the answer is as varied as cancer itself. I have heard the recurrent PCa is when the level reaches .2 however I see people that are well below that thinking they are having a relapse. For me I am looking for doubling time. My PSA has risen consistently over the last year and I suspect that June 30th it will be over the 1 mark.
I have no right answer other than to keep a close eye and be prudent in your decisions. Cancer is our enemy so we have to treat it as such

peace and love
Dale

Baptista
Regular Member


Date Joined Aug 2010
Total Posts : 84
   Posted 5/28/2011 7:32 PM (GMT -6)   

Thanks guys for the answers. I like your sincere comments.

“Keep a close eye and be prudent in your decisions” may be the best translation for “Remission”. A number is just another “marker” which does not reflect the whole spectrum of one guys’ status. Remission could be taken with the meaning as absence of symptoms which indicates a successful treatment.

Hope all of us become “pennyless and pretty darn poor” as Steve comments above.

 

The best to you.

Baptista  smilewinkgrin


Age: 50 at Dx on May/2000; PSA=22.4;
6x cores biopsy positive; Gleason score (2+3=5)
RP in Aug/2000, PSA=24.2
Negative S-vesicles & lymph node (9); capsular penetration
Voluminous Adenocarcinoma, well-differentiated, Gs (3+2=5); pT3apN0
Post-op lowest PSA=0.18 on Oct/2000; Classified as Micro Metastasis
Jan/2001 PSA=0.26 Biochemical recurrence
AS (Watchful W.) until PSA=3.80 on Oct/2006; MRI & Bone scan negative
Nov/2006 SRT (3D IMRT; 68Gy / 37 fractions)
Feb/2008 lowest nPSA=0.05
May/2009 PSA=0.26 Biochemical recurrence
Oct/2010 PSA=0.95 (doubling at 9.6 months)
Nov/2010 ADT Cyproterone 100mg/day + Eligard 45mg 6-month depot
Asymptomatic, never incontinent, ED since RP

sterd82
Regular Member


Date Joined Sep 2006
Total Posts : 187
   Posted 5/28/2011 11:50 PM (GMT -6)   
Just to add....guess I don't think about "remission"....I just think about any "next steps". I've 5 years since diagnosis, so things have maybe changed a bit. After surgery, my PSA rose. WHen it rose above .2, the "next step" was radiation.

My PSA was <.1 until a year ago...it's been right at .1 three times in a row. My oncologist told me stories of PSA rising to low dectable leves, then just staying put. For now, at .1 the "next step" is to get it checked again in six months.

Since I've had all the local treatments I can get, if my PSA starts moving up again, the "next step" would be hormone therapy. But they usually don't start that up until your PSA hits maybe 10 or higher.

In the mean time, my other "next step" is not to worry about it, take came of myself and my family, and live a good life.
Sterd 82
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