Discussion about PSA holding at .10

Hawk · Experienced user Joined: 22 Nov 2006 Posts: 82

Replicant, earlier in a post, you wrote

"I've read in several places (journal articles) that there is a certain percentage of men who will progress to 0.1 after RP and then not progress further. I can't find the articles right now, but on Google books I did find it in a textbook co-authored by Peter Scardino: "

If the link you found has useful information can you post it?

As you can see from my profile below, I am very interested in anyone that has any info on this topic. For instance I wonder if that level would be expected to be present soon after surgery where my PSA was below.1 for almost 4 years (at least at the time of the blood draws)

I am also curious if there is any explanation for why the PSA would register but not climb. I have never heard of PSA climbing to any level and just stopping. My Medical Oncologist at MSKCC never mentioned this possibility.

I feel I need to be very well educated on this topic because my next test could be .11 Then what would I do?, wait or radiate. (I promise not to start posting in rhymes) Smile

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History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2 - 8.1 - 8.7 Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06 - May .09 - Jun .10 - Aug .10 - Nov .15 SRT

johnw100

The view by Dr Scardino I have seen is in the context of a rising PSA from remaining bits of benign tissue. The PSA usually rises slowly and peaks at a low level about 1.

"If the PSA reaches a level of .2 or more and continues to rise steadily it's reasonable to assume that there has beena regrowth of prostate tissue, which could be benign or malignant. Properly done, radical prostatectomy should remove the entire gland. There should be no benign tissue left in the patient. Unfortunately that does not always happen."

Hawk · Experienced user Joined: 22 Nov 2006 Posts: 82

Thanks for the reply JohnW.

It is hard to imagine benign prostate being left in enough quantity to cause a PSA reading of .1 or .2. I know men with an entire gland that only have a .2 reading. I guess some could be left behind when they spare nerves

I cannot imagine me waiting until .2 for radiation. If my PSA (listed in profile below) bumps up to .14 or higher I am going into the toaster Smile

If it is less than that then I will agonize over what to do unless I learn more than I know now.

Regards

Hawk

PS: John, In your post, I think you wrote a 1 where you meant .1
You might want to edit that for other new guys that scan the forum.
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History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2 - 8.1 - 8.7 Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06 - May .09 - Jun .10 - Aug .10 - Nov .15 SRT

chas036

I would consider getting radiation now rather than waiting. From what i have read, the chances of killing all the remaining cancer cells that were left behind after surgery is much greater when salvage radiation is given as soon as possible than waiting until later.

Since you were diagnosed with an agressive cancer at Gealson 8, it is even more important that you do something quickly rather than wait. I would suggest that you find an oncologist that is experienced in prostate cancer and discuss this with him. I know a lot of docs say not to do anything until your psa reaches .2, but why wait. Once your psa gets above .1, you know pretty well that you have some cancer cells that were missed with the surgery, so why wait and give them a chance to escape out of the prostate bed.
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Biospy 4/2007 - 2/12 <%5 Cancer Gleason 6
RP 9/25/2007 Uni Rochester, NY
Gleason 6, Negative Margins

Hawk · Experienced user Joined: 22 Nov 2006 Posts: 82

Charles,

I feel somewhat the same but....

I have been to a Medical Oncologist and a Harvard Grad. Radiation Oncologist, both from Memorial Sloan-Kettering Cancer Center in Manhattan, and both specializing in PCa. Not to mention I had a consultation with my local Radiation Oncologist. 2 of the 3 suggested I wait (both radiologists). It has already been 4 1/2 years since surgery. The 2 that suggested I wait have the opinion of "what if the prostate cancer has not returned?" . They also reason that the studies of earlier is better suggest it far better to do salvage radiation at .2 the it is at 1.0. Some say you should clearly start before .60 but I am .10

They say there are no studies of results of radiating people at my low level because it is the lowest detectable level there is if you get the NON-sensitive 2 decimal PSA tests.
_________________
History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2 - 8.1 - 8.7 Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06 - May .09 - Jun .10 - Aug .10 - Nov .15 SRT

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