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Thread: I知 back

  1. #1
    Regular User
    Join Date
    Dec 2013
    Posts
    49

    I知 back

    After 5 years of 0.0 I知 back at .02

    Crappola
    Blood test 10.0
    DRE and Biopsy
    3 0f 12 cores 3+3
    AS 2 Years with blood every 3 months, stable at 10.1
    2nd Biopsy 9 of 12 cores 3+3
    RARP 11/26/13 by Dr. S Conely
    Catheter out in 7 days
    Pathology 3+4
    1 light pad at 1 week past catheter
    Continence at 3 weeks no pads
    PSA undetectable at 7 weeks
    At 13 Months Erections both with and without meds, its all coming together .
    July 2019 psa detected at.2
    Sept psa .2
    Oct psa .2
    Nov ct negative
    Nov Pet negative
    Nov Radiologist consult

  2. #2
    Senior User
    Join Date
    Nov 2016
    Posts
    317
    Lab didn't change did it?
    Age at Dx 57
    PCa History: Father, Uncles, Grandfathers

    Oct 2016 Biopsy 12 core: Adenocarcinoma, Gleason 4+3=7 Grade Group 3) w/PNI
    Left Lateral Base: Suspicious
    Left Lateral Mid: PIN
    Left Base: 4+3=7 (60% pattern 4) Core involvement 30% (5mm)
    Right Base: Suspicious
    Right Apex: 3+3=6 Core involvement 60% (7mm) discontinous
    Right Lateral Mid: 3+3=6 Core involvement 10% (1mm)
    Right Lateral Apex: 3+3=6 Core involvement 10% (1mm)

    Jan 2017 DaVinci - Dr. Grant Taylor - Pathology = pT2c or pT3a; Gleason 4+3=7; Weight: 42g

    Jun 2019 AMS800 installed - Dr. David Rapp - Jul 2019 activated

    ED: Light to moderate

    (Note: All PSA tests prior to Jun19 were done by LabCore)
    PSA_TESTS

    Apr 2016=5.1
    Jul 2016=4.7
    Aug 2016=5.13

    ----Surgery----

    Mar17<0.01
    Jul17<0.01
    Oct17<0.01
    Jan18<0.01
    May18<0.01
    Nov18<0.01
    Jan19<0.01
    Jun19<0.02

  3. #3
    Quote Originally Posted by PeterG View Post
    After 5 years of 0.0 I’m back at .02

    Crappola

    A single reading of .02 isn't considered to biochemical recurrence. I don't think the doctor is going to recommend further treatment at this point in time, particularly since its 5 years after surgery, a relatively long time and also a good sign

    Good luck with this, and BTW "Crapola" is spelled with just one "p"
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2. PSA test 1/2018 2.2 (after 7 months of proscar) PSA test 7/2018 2.3, PSA test 7/2019 2.0


    DOB 1956, in Pittsburgh, USA

  4. #4
    Quote Originally Posted by PeterG View Post
    After 5 years of 0.0 I’m back at .02

    Crappola
    Unless you mistyped, 0.0 does not mean you were never 0.02.
    YOB 1957

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

    3/6/19. Pathology - Grade Group 4 Intraductal Carcinoma
    T3aNO, 1 mm EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.

    7 Nodes, SV, SM, PNI, and BNI were negative.

    LVI and Cribriform pattern present.

    Decipher .86 High Risk.

    Post Surgery PSA
    3/25/19 .03. (<1 month)
    4/25/19 <.03. (2 months)
    5/25/19 <.02. (3 months)
    9/10/2019. <.02. (6 months)
    11/27/2019. <.02. T<3. (9 months)

    3 Part Modality Treatment

    2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic,

    ADT - started 6/19, end date 6/21.

    ART - Completed 9/26/19. (78 Gy, yes, I glow in the dark)

  5. #5
    Quote Originally Posted by PeterG View Post
    After 5 years of 0.0 I’m back at .02

    Crappola
    Welcome Back PeterG! IMO, you have returned only to visit The Forum and NOT for treatment.

    Question: For the past 5 years, was your PSA = 0.0 or 0.00? Your latest PSA was reported to 2 decimal places

    Be sure that your most recent PSA value was analyzed by the the The Same Lab using The Same PSA Methodology as your prior results. Be sure to obtain a copy of The Original Lab Report each time. This will list both the Lab and Methodology used.

    PSA results can be wrong. Most commonly, incorrect results are due to transcribing/recording errors. Always rule out error 1st!

    At this point, there is NO reason for alarm or concern. Your PSA is clinically 0! Thus you remain a member in good standing in "Club Zero!!!

    Discuss this result with your URO MD and let us know when he/she recommends to repeat. My "guess" is sometime in the next 3-4 months.

    Meanwhile, relax, stay calm and don't be concerned by your latest value!

    FWIW, in my case by rounding off to 2 decimal places, my uPSA has never been < 0.02 in the past 7 years.

    Good luck & Keep us updated!

    MF
    Last edited by Michael F; 07-21-2019 at 12:53 AM.
    PSA: Oct '09 = 1.91, Oct '11 = 2.79, Dec '11 = 2.98 (PSA, Free = 0.39ng/ml, % PSA Free = 13%)
    Referred to URO MD
    Jan '12: DRE = Positive: "Left induration"
    Jan '12: Biopsy = 6 of 12 Cores were Positive: 1 = G7 (3+4) and 5 = Gleason 6
    Referred to URO Surgeon
    March '12: Robotic RP: Left: PM + EPE. MD waited in surgery for preliminary Path Report then excised substantial left adjacent tissue(s) down to negative margins and placed 2 Ti clips for SR guidance, if needed in future.
    Pathology: Gleason (3+4) pT3a pNO pMX pRO c tertiary pattern 5 / Prostate Size = 32 grams / Tumor = Bilateral: 20% / PNI: present
    3 month Post Op standard PSA = <0.1 ng/ml
    1st uPSA at 7 months Post Op = 0.018 ng/ml
    uPSA remains "stable" at 91 Months Post Op: Mean = 0.022 (22x uPSAs: Range 0.017 - 0.032) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

  6. #6
    It's freaky to see .02 after years of zero's. I know from experience, and i was only 2 years out of surgery when i got my first .02. But at this point, its a big nothingburger. Especially since if it took 6 years for this to happen, even if it is real, its not very aggressive
    Diagnosed at age 64 (in November, 2014), PSA 4.3
    Nov 2014 BX 3 of 12 cores positive original pathology G8. Johns Hopkins second opinion, G6
    Surgery with Dr Ash Tewari Jan 6, 2015
    Post surgical pathology, stage T2c, bilateral disease, upstaged to G7(3+4)
    5% of Prostate involved in Tumor. Organ confined, Margins, SV, lymph nodes (9) all negative, PNI positive
    PSA <.02 until (uh-oh), 2/17 .02. Then 5/17-.033, 8/17-.033, 11/17-.046, 4/18-.060, 6/18-.068, 7/18- .082, 8/18-. 078.
    Decipher score low risk, .37
    ADT/Firmagon started August 2018. SRT SEPT 2018. Finished SRT November 2018, Finished ADT Feb 2019
    T=7, PSA <.05, 5/19 T=48 PSA <.05, 10/19 T=97 PSA=<.05

  7. #7
    Hopefully it was a lab error.. Maybe list your full final path so that our FBs can assist more. Any adverse findings?

  8. #8
    When I changed from my surgeon for my PSA tests at 6 month intervals to my GP, I didn't think to mention that I should be getting the 'post treatment' PSA assay, and my '<.1 read as .02 a couple of times. I mentioned this to the doc and I've been back to <.1, so did you change docs or testing labs/assays?
    DOB: 8/1963--Great-Grandfather/Uncle had PC
    9/13 PSA 4.85, 2/14 PSA 6.7, TRUS Bx 12 core-neg, 6/14 PSA 4.8, 12/14 PSA 5.9, PCA3: 38, 1/15 PSA 5.4 (switched docs to JH), 3/15 PSA 5.8/fPSA 17.4/PHI 28.4, 3/15 3T MRI/Fusion-Guided Bx @ Johns Hopkins, 2/14 cores pos, bilateral, <5% involvement, Gleason 6, Open RP: 8/10/2015 w/ Dr. Carter @ JH

    Final Pathology:
    LN-, SV-, Margins-, EPE-
    Tumor Extent: Moderate, organ confined
    Gleason upstaged to 3+4=7 (2% pattern 4)
    Additional Findings: HGPIN
    pT2 NO
    PSA 11/2015 <.1, 05/2016 <.1, 09/2016 .02 & 3/2017 .02 (different assays), 09/2017 <.1, 03/2018 <.1, 10/2018 <.1, 4/2019 <.1, 11/2019 <.1

  9. #9
    Senior User mostth's Avatar
    Join Date
    Feb 2019
    Posts
    132
    Maybe I am not good at math but .02 I believe is a heck of a lot better than <0.1. You should not worry.
    DOB 9/6/59
    1/21/19 PSA 7.5.
    Bx 2/8/19
    G7 (4+3), 60% pattern 4
    Reffered to Mayo Clinic Rochester, MN
    RALP 4/3/19 Igor Frank
    Adenocarcinoma G8 (4+4)
    Mass (3 x 1.5 x 1.2 cm)
    Tumor involves both seminal vesicles.
    Extraprostatic soft tissues, SM, EPE, BNI, LNI (24): neg., SVI+
    pT3b pN0 Mx
    7/19 3mo PSA 0.74
    7/24 retest PSA 0.78
    8/14 3 mo. Lupron inj.
    9/10 Start radiation 38 doses
    10/31 Radiation complete
    11/5 2nd 3 mo Lupron inj.

  10. #10
    Moderator Top User HighlanderCFH's Avatar
    Join Date
    Nov 2011
    Posts
    7,281
    Yup. Remember what many of us are saying -- as a 0.02, you are STILL at 0.0.
    July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
    Local uro DRE revealed significant BPH, no lumps.
    PCa Dx Aug. 2011 age of 61.
    Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
    Gleason 3+3=6. CT abdomen, bone scan negative.
    DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
    Surgeon was Dr. Matthew Tollefson, who I highly recommend.
    Final pathology shows tumor confined to prostate.
    5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
    1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
    mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
    doctor says this is insignificant.
    Prostate 98 grams, tumor 2 grams.
    Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
    Eight annual post-op exams 2012 through 2019: PSA <0.1
    Semi-firm erections without "training wheels," usable erections with 100mg Sildenafil.
    NOTE: ED caused by BPH, not the surgery.

 

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