G9 - 6 years out - PSA Results

Redwing57 said...
If you've had your prostate removed, the "Phoenix" criterion for recurrence is at 0.2. The comment above to wait for 2.0 is only for those still with a prostate, having had radiation as a primary therapy.

The trend is more important than the value. A growth process generally doubles on a logarithmic trend, so if you plot your PSA levels vs time on a log plot it would be a straight-ish upward line. If that's happening, then it's likely to be growth and just a matter of waiting until you think it appropriate to do other analyses or treatments, along with your doctor's guidance.

Finally, I jumped in since you're also a G9. The G9 tumors, specifically the Type 5 cells, don't make much PSA. So comparing your PSA to that of, say, a G7 3+4 is misleading. Those put out much more PSA per gram of tumor tissue than a G9 does, like 3 or 4 times as much depending on the mix of Type 3,4, or 5 cells. If they're recurring at 0.2, then yours could be recurring at almost 1/4 of that. This factor is greatly neglected by urologists, since for better or worse there just aren't that many of us G9 cases. [Edit: this may be somewhat arguable, and is not discussed much today, but that's my ever-so-humble understanding. Here's a link to a post from some time back talking about this concept.]

All of which is to say I am in favor of an earlier and more aggressive response if the trend is supportive of any kind of growth process, even at a lower level. But that's just me....

George_ said...
Redwing,

Grillmaster wrote: "RALP: 7/2013, 2 yrs Trelstar, 39 IMRT" so he had surgery and adjuvant or salvage radiation. After that you do not need to act if the PSA value gets above 0.2 ng/ml. All you will do is start with ADT and you can start with that at a PSA value of 2.0 ng/ml. This is even a very low PSA value to start with ADT in my opinion. Your URO may have a different opinion but this is overtreatment, I think.

George