I have been reading this forum for six years and have decided to take the plunge as a poster. The impetus to do so is my first detectable PSA reading of .02 at 75 months (early December, 2014) and another of .03 at 77 months (this week). I have read so many studies my head is spinning and I am not sure I know much more than when I started. Since many of you seem to be able to take complicated concepts and simplify them I hoped you could keep me going down a logical path.
My oncologist (the same one who did the surgery) said he wasn't too worried about
the results because I have been less than or equal to .01 for so long. He thought there was a strong chance the readings were just some healthy prostate tissue left behind that has grown and that the likelihood of a recurrence was less than 10%. Even if there was a recurrence he felt that it would likely be an indolent form of the cancer. The Sloan Kettering nomogram suggests about
a 3%-9% chance of recurrence, depending what numbers I use for Gleason score and months before rising PSA. I'll be taking another PSA test in four months. He said the key to further decisions is what my PSADT is and that he may need a few more readings before making that determination.
So, here are my questions.
1. Is there any literature out there specifically on recurrence rates for people who show slight PSA elevations after this long a period after surgery?
2. Some of my prior readings were <.01, others =.01. Is there a difference? And if there is a difference, then have I actually been undetectable until recently or does a score of .01 say something other than undetectable? I've been using the same lab for every reading.
3. My post surgery Gleason grade was listed as 3+3 tertiary 4. What is the consensus these days - is my Gleason grade 3+4 or more of a 3+3 and a half?
4. I haven't been able to pin down what happens if the cancer can't be killed. Does everyone with a recurrence where radiation fails eventually metastasize if something else doesn't kill them first?
5. Besides calming down (which I have read as advice on here a lot and I know is good advice) what else should I be doing to get more informed about
Sorry for the length of the post. Thanks for reading. Any comments would be highly appreciated.
age 66, no other significant health issues besides this
biopsy 6/08, 1 of 12 cores positive, 5.8 PSA
Da Vinci 9/08 at KU Medical Center
pathology report: Gleason 3+3 tertiary 4, positive margins at bladder neck, pT2c, PIN, peneurial invasion
PSA of <.01 12/08, .01 3/09, <.01 6/09, <.01 7/09, .01 10/09, .01 4/10, .01 9/10, .01 3/11, .01 10/11, <.01, 11/12, .01 11/13, .02 12/14, .03 1/15
Post Edited (bucky24) : 1/30/2015 9:16:01 AM (GMT-7)