Talk me down from the ledge!

OK, I have been on this forum since my diagnosis. I have probably read every post and all the replies dating back 10 years or so over that time. I have also replied to many posts offering my personal experiences to others. I know what the responses to my question will be, BUT I have to ask it anyway. I need some kind of reassurance.

I just go my 18 month post-op uPSA results today. I want to say that I lost my '<', but I'm not sure it matters with results being calibrated low. All of my prior uPSA's have been <.006. Today, I got .007. I have been using the same lab (Labcorp) since day 1. So, here it is.....should I be concerned?

There is nothing like the sinking feeling of not seeing that '<' for the first time. I know a lot of you guys out here would kill for a reading like that, but, for me, no '<' is freaking me out. Not the holiday gift I wanted.

Anyway, I guess I'll just wait the 3 months and test again to see if any trend is starting. I will not sleep well tonight.

J


--------------------------------------------------------------------------------------------------------------------

Age at Dx: 54 (DOB: 01/28/62)

08/31/15 PSA 2.5;
01/01/16 Urinary Frequency;
02/05/16 DRE Pos;
02/22/16 Biopsy;
02/26/16 Dx: 7-12 positive; (5) 3+3=6; (1) 3+4=7; (1) 4+3=7; T2B;
03/11/16 Bone Scan Neg;
03/23/16 CT Scan Neg;
03/31/16 Surgery Consult UPENN;
04/08/16 RT Consult/2nd Op Fox Chase CC upgrade to 4+4;
04/14/16 3TMRI "organ confined", EPE-, SV-, LN-;
06/01/16 DaVinci @ UPENN (Dr. D. Lee);
06/08/16 Catheter Out;
06/08/16 Post-Op Path: EPE+, Marg +, SV-, LN-, G7(4+3) (G4 80% - G3 20%), tumor vol 25%, T3a;
07/01/16 Start 5mg Daily Cialis, 20mg once a week on Friday's;
07/06/16 Decipher 0.56 (Average Risk), 5 Year Metastasis 7.6%, 10 Year PCa Specific Mortality 6.9%;
08/01/16 Penile rehab started (Pump);
08/31/16 uPSA <.006;
12/01/16 uPSA <.014 (? same lab);
01/30/17 Decipher GRID PORTOS: [Avg ADT Response (21%), Avg Docetaxel Sensitivity (56%),
Lower RT Response (45%), Avg Dasatinib sensitivity (38%), High Genomic Gleason Grade (81%),
High Metastasis Risk (70%), High Tumor Cell Proliferation (82%), Avg AR Activity (56%)];
03/01/17 uPSA <.006;
06/01/17 uPSA <.006;
09/01/17 uPSA <.006;
12/01/17 uPSA .007;

I agree with TA.

Also, since it is a rise you can request a retest sooner than another 3 months.
Have one done in 2 weeks.

Jay, seriously. And for me of all people, to say that, it has to be nothing.
I'm doing the same test I drop the third digit, so at my last 3 m0nth test, when I went from .033 to .046, I really went from .03 to .04.

So you went from .00 all the way up to .00!.

Some of us are gonna recur. Nothing we can do about that. But even if you are one of those, you are so far away from having to do something, that it's not worth thinking about right now.

Now get off the ledge bro.

JayMot said...
OK, I have been on this forum since my diagnosis. I have probably read every post and all the replies dating back 10 years or so over that time. I have also replied to many posts offering my personal experiences to others. I know what the responses to my question will be, BUT I have to ask it anyway. I need some kind of reassurance.

I just go my 18 month post-op uPSA results today. I want to say that I lost my '<', but I'm not sure it matters with results being calibrated low. All of my prior uPSA's have been <.006. Today, I got .007. I have been using the same lab (Labcorp) since day 1. So, here it is.....should I be concerned?

There is nothing like the sinking feeling of not seeing that '<' for the first time. I know a lot of you guys out here would kill for a reading like that, but, for me, no '<' is freaking me out. Not the holiday gift I wanted.

Anyway, I guess I'll just wait the 3 months and test again to see if any trend is starting. I will not sleep well tonight.

J


--------------------------------------------------------------------------------------------------------------------

Age at Dx: 54 (DOB: 01/28/62)

08/31/15 PSA 2.5;
01/01/16 Urinary Frequency;
02/05/16 DRE Pos;
02/22/16 Biopsy;
02/26/16 Dx: 7-12 positive; (5) 3+3=6; (1) 3+4=7; (1) 4+3=7; T2B;
03/11/16 Bone Scan Neg;
03/23/16 CT Scan Neg;
03/31/16 Surgery Consult UPENN;
04/08/16 RT Consult/2nd Op Fox Chase CC upgrade to 4+4;
04/14/16 3TMRI "organ confined", EPE-, SV-, LN-;
06/01/16 DaVinci @ UPENN (Dr. D. Lee);
06/08/16 Catheter Out;
06/08/16 Post-Op Path: EPE+, Marg +, SV-, LN-, G7(4+3) (G4 80% - G3 20%), tumor vol 25%, T3a;
07/01/16 Start 5mg Daily Cialis, 20mg once a week on Friday's;
07/06/16 Decipher 0.56 (Average Risk), 5 Year Metastasis 7.6%, 10 Year PCa Specific Mortality 6.9%;
08/01/16 Penile rehab started (Pump);
08/31/16 uPSA <.006;
12/01/16 uPSA <.014 (? same lab);
01/30/17 Decipher GRID PORTOS: [Avg ADT Response (21%), Avg Docetaxel Sensitivity (56%),
Lower RT Response (45%), Avg Dasatinib sensitivity (38%), High Genomic Gleason Grade (81%),
High Metastasis Risk (70%), High Tumor Cell Proliferation (82%), Avg AR Activity (56%)];
03/01/17 uPSA <.006;
06/01/17 uPSA <.006;
09/01/17 uPSA <.006;
12/01/17 uPSA .007;

Well, if you should be concerned, then I am doomed. Since I lost my < something like 2 1/2 years ago, and that meant I was .01, 1.5 times higher than you are now, and I have since doubled to .02, 3 times higher than you are now. PLUS I AM HIGH RISK, ( I can't see my own signature as I type, so how long ago was that? a year? 9 months? EDIT: OK, just looked, took me 18 months to double after losing my <, so almost a year ago) Anyway, I have not so far been too concerned about it, though I seem to be slowly working my way towards that .03, which some folks say that means I am sooner or later going to BCR. So maybe I will want to do something about that before I actually do BCR. But I will think about that later. If I were you, I would not totally panic quite yet. There is always time for that later.

Post Edited (BillyBob@388) : 12/5/2017 6:14:20 PM (GMT-7)

Pratoman said...
Jay, seriously. And for me of all people, to say that, it has to be nothing..

Very true, Pratoman! Ken, if you are saying not to worry yet, it must really be so!

In our minds......the difference between having a "<" sign and not having a "<" sign is the difference between having cancer and not having cancer. It's ridiculous. I'm with TA. Two digit readings at least gives one a break. Three digit readings is asking for a hard life.

I believe this small change is what Doctors refer to as "noise" and little concern. Sincerely hope that is your situation.

I can empathize with the fear of any increase in PSA results, either after initial treatment, or after subsequent treatments.

Last month my own PSA rose from 1.4 to 1.7, approximately one year after being on Xtandi. Things could be starting to change, although I don't have any new symptoms or imaging results as evidence. I am grateful for my lack of symptoms, and relatively stable scans, to date. I realize that eventually I will have to touch base with my medical advisors and decide upon another type of treatment.

Tall Allen mentioned a while back that people can be more resilient and adaptable than they think, given some time to adjust to things. I have personally found that to be the case in the four years since my initial diagnosis, and a pretty wild PSA "roller coaster" ride, so far (see Below).

I attend some face-to-face cancer support & prostate cancer support groups each month. I've found them to be helpful for getting these kind of feelings out into the open, and sharing them in a mutually supportive setting, in addition to posting on-line to places like this.

I encourage you to Live Well in the present moment, and to take care of yourself as a whole person in relation to others and everything else in this wonderful world. It's good for you. Of course, keep tabs on the medical "details", and things you and your doctors need to do there, but also make room for some time to just "be", and for keeping the totality of your life in balance. You will know it when it is happening.

Charles

JayMot,

I have used Labcorp forever. There have been times where Labcorp records .006 or .015 without the < only to find out that it was an error on their side because subsequent readings had the <....Hang in there...

Jerry L

Hi,
Any PSA < or = to 0.03 is Ok.
If it was like < 0.05 and doubled 2 times within each 3 months intervals, or it increase to >0.2, than it is time for radiation therapy.
If this happened after a year of RRP than the prognosis is better than if it happened within few months after surgery.
Don't worry your readings are so far very good!

My PSA is <.1 twice now. Is the 1/10th/.1 minimum test ok to be using or is the 1/100 / .01minimum PSA test better to use. I thought no action was taken till .2 PSA

oldbeek said...
My PSA is <.1 twice now. Is the 1/10th/.1 minimum test ok to be using or is the 1/100 / .01minimum PSA test better to use. I thought no action was taken till .2 PSA

There have been a lot of threads on this theme for post RP testing. What I've gathered is that anything <.03 is not prognostic because up to .03 could be caused by non-PCa sources within one's body; 0.2 was the classical bell to start salvage therapy, but many ROs and even some Uros now would take action at 0.1 or upon any upward trend in three consecutive PSAs. Also, many ROs recommend adjuvant therapy for high-risk patients (G8+, pT3a+) with aggravating factors like EPE, even without any uptick in PSA.
I welcome correction by Tall Allen and others, and apologize ahead of time for any errors.

EPE focal means that your extraprostatic extension penetrated by a very small amount beyond the prostate capsule. It is a small risk factor. Your GS 4+3 tumor is another risk factor, although not a big one. If it were me, I'd want to see my uPSA in 30 days. If it's undetectable on a uPSA, I would feel a lot more comfortable waiting 6 months.