Next Wednesday, I will be meeting with my oncologist and having my first PSA test since last December. We usually spend a full hour or more together on these visits. This time, I will be tested in his own lab, which will produce instant results instead of having to wait 2-3 days. With one minor exception, all of my PSA tests, from 2002 to December, were done at the exact same lab. I like the consistency of that. I am not sure what level this test will show, but in my case, a reading at .xx will be more than good enough, considering that my last reading was at 14.0.
I can still say, with an honest heart, I have zero anxiety about the test, or the visit. I got over PSA anxiety a long, long time ago. In my case, with the rapid failure of both my surgery and SRT, the number only has one place to go, and that is up. I accept this reality, and whatever it is, is what it is.
I am hoping he will reccomend a new scan of some type. In December, they were talking about doing an advanced level PET scan, to look for mets, but in the end, we mutally agreed to put it off. My concern, is how much more the areas of pain have advanced in my body in those 4 months. Before, it was always right hip, and right leg above the knee. Now its my entire lower back (about 2-3" below my shoulder blades), and on some days, the same high level of pain is developing in my left hip and left leg.
The only surprise or hope in the PSA number is how much it rose since December. My doctor has said, that in cases like mine, the hope is that the rapid rise I have experienced in the past year, will start to level off, and the increases will be less. He said that there isn't always consistent doubling of PSA once BCR has occured for the second time.
Before, the pain in general was diagnosed as being "cancer pain" from severe nerve damage caused by the faulty SRT that I underwent. Made sense to me at the time. But my SRT ended in November of 2009. The worse of this pain began in earnest around October of 2010, and has progressively gotten worse.
I am pretty sure he will increase the Fentanyl patch dose again. This will be the 3rd increase if he does. Changing the patches every 48 hours vs. the traditonal 72 hours has helped a lot, but the area of pain has increased so much since the last increase, it's becoming less and less effective.
I use to think the hip pain was the worse thing, but now that my back is so wracked with pain, there are times there is no possible way I can get comfortable, not even lying down in bed holding perfectly still, that I can escape the pain, which at its worse, is at level 7 to 9 at times. I am still using Loratab as the break through pain med, and on the bad days, its taking as much as 8 pills per day (the max) to control the pain to be bearable. On the good days, my total intake is about 5 pills. There has to be some other explanation for such severe pain, thus, hoping the right kind of scan may shed some light. Mets would be an obvious answer, and sure hoping to stay clear of them, but with the PSA at 14, 4 months ago, its very possible met(s) could be starting to rear its ugly head, thus causing the worse of the pain. I hope not.
I will report back, after I have this visit and PSA test. Anyone is welcome to place their bets on where the PSA will be at, lol. My guess, is that it will be between 16 and 18, hoping it won't be higher.
This weekend, wife and I are going to Charleston for 3 days, to visit my daughter and SIL, and go walk along the beaches there. It will be a nice break and diversion for us, as Friday is our 38th anniversery, and this weekend is Easter weekend, so we are really looking forward. I love living by the mountains, but always miss the ocean. Also give me a chance to see how my new car pays off for comfort (being in any car does a number on my back after an hour). My Lincoln MKS has both heated and air conditioned seats, so hoping it will ease some of the back pain. Least it was a good excuse to buy a nice car, lol.
David in SC
Post Edited (Purgatory) : 4/4/2012 7:17:54 PM (GMT-6)