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recurrent psa 0.2

User
Posted 12 Jun 2022 at 16:59
With a name like wellyeknaa, I already knew that you were from the land of milk & honey. I am a Wallsend girl.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 12 Jun 2022 at 17:28
pure belta,im a howdon lad exiled in chopwell,which has led to interesting discussions with the newcastle freeman hospital where my consultant is based, as my bloods are monitored in gateshead with an ultra sensitive psa test.

.i had maybe 10 incrementally increasing psa test results before breaching the 0.1 level which is deemed detectable in newcastle...but fair play to consultant at the level 0.083 he recognised slowly rising psa...12 months later and here i am at 0.21...i wonder if those incremental changes couldve been a guide to future action.?

.anyhow thanks again.your advice is invaluable, keep yer feet still, unless your dancing, joe

User
Posted 12 Jun 2022 at 20:08
Okay so technically I am also a Howdonian - Lesbury Avenue - although we moved to Essex when I was young and I ended up in Leeds. Doesn't stop me from loving my football team 😍 and we have a grandchild in Holystone.

How did you know that John & I dance?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 12 Jun 2022 at 20:45
dont all geordies learn to dance to their daddies when their boat comes in?.hope you and john all the best,im so much more informed than i was,and thats down to you and all the other kind posters.thank you from a windsor drive gadgie.
User
Posted 12 Jun 2022 at 21:30
🤣🚢🐟
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 13 Jun 2022 at 09:24
https://www.cancer.gov/news-events/cancer-currents-blog/2021/decipher-test-prostate-cancer-hormone-therapy#:~:text=A%20large%20study%20has%20confirmed%20that%20a%20genetic,choose%20the%20most%20appropriate%20treatment%2C%20the%20researchers%20concluded.

a paper which indicates a genetic test can determine how likely recurrent prostate cancer is to metatize.

this looks interesting.anybody got any views on if, or when ,genetic testing to determine desirability of use of hormone therapy in addition to salvage radiotherapy for recurrent cancer is available in nhs? is it worth raising with oncologist or is it prohibitively expensive for nhs?

anyhow, keep yer feet still ,unless you're dancing

User
Posted 13 Jun 2022 at 16:03

I did a nomogram some time ago and hormones plus RT was significantly better than just RT. 

Watching the YouTube channel being bandied about on here, with my Gleason of 4+4 Dr Scholz talks of two lots of hormones and chemo to start off with, if the patient can take it.  They also emphasise that the chemo used for PCa, taxere I think it was, is no-where near as toxic as that for other cancers.  I'm just arming myself with background information and reality will strike at some point in the coming months. 

My psa is rising faster than yours but was just beneath 0.1 at the last check.  I reckon it will be over 0.1 now.  A psma scan is said to be only 30% accurate at psa 0.2 and so is it worth it and do I want to know but I think with my Gleason it'll be worth paying for it if necessary.   At your age they should be more likely to throw the book at it.  I don't know what your Gleason is, it isn't in your profile.

User
Posted 13 Jun 2022 at 20:01
good luck peter,my gleason is 4+4 also,it was 5 years before i reached 0.2,hope your psa flatlines.joe
User
Posted 16 Jun 2022 at 12:38
consultation led me to being referred to oncologist but told my case is not urgent so may be some time before an appointment,i decided to wait until psa reaches 0.4 (,was told salvage radio therapy at this point not greatly advantageous and main advantage to ease anxiety of patient) .im to have a pmsa scan if when psa reaches 0.4,next psa test in 2 months..thank you for all the advice,wishing everyone a splendid summer. joe.
User
Posted 17 Jun 2022 at 20:53

I'm in a similar situation to many of the posts above with a climb from 0 to 0.2 in just under two years since my Op. I have an oncology appointment next week to discuss go forward.

I'm curious to know how effective RT can be if the cancer cells can not be picked up by a scan at 0.2

Is it just a case of 'carpet bombing' the area as opposed to a guided missile after a scan gives better location info?

Having escaped serious side effects from the op I'd be loathe to risk RT collateral damage.

Appreciate any thoughts

User
Posted 17 Jun 2022 at 21:00
Oncos make these decisions based on many years of data. Statistically, if a man has undetectable PSA post-op and then it climbs fairly steadily, this is a strong indicator that there are cancer cells left in the prostate bed so salvage RT is likely to be successful. if the man has detectable PSA immediately post-op, there are already cancer cells elsewhere in the body so salvage RT to the prostate bed is probably not useful. If he has undetectable PSA for a while but then a sudden and sharp rise, it is likely that there is a significant cluster of active cancer cells either in the pelvic region or further afield - a scan may help determine whether whole pelvis RT is worth trying.

The other bit of information that helps an onco to make this decision is your post-op pathology; if you had positive margins then salvage RT is probably a good bet.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Jun 2022 at 22:18

Originally Posted by: Online Community Member
I'm curious to know how effective RT can be if the cancer cells can not be picked up by a scan at 0.2

Basically, treatment earlier when there are fewer cancer cells is more likely to be effective than waiting until later. Whereas scans are not good at picking up small numbers of cancer cells. There is a risk waiting until the cancer is bigger and visible on a scan means RT might not work as effectively. LynEyre summarises the issues extremely well.

User
Posted 17 Jun 2022 at 22:44

Not sure how well respected this guy is but the following elaborates on the problems of recurrence. I posted earlier in this thread and my oncologists educated guess based on data didn't work out for me.

https://youtu.be/Q2joD360_pI

Thanks Chris 

 

User
Posted 04 Jul 2022 at 10:43

Hi Joe,

My psa started to rise within months of my RALP which was 3 and a half years ago. I was monitored after that with my psa continuing to rise slowly, my consultant happy to wait until my psa had risen to 1.0 as a petscan would then pinpoint the problem more clearly.

I've since had HT which has dropped my psa to undectable, the petscan has shown no spread out of the prostate bed and I've just started RT to hopefully zap the baddies lurking there!!

 

Good luck with your treatment, whenever that maybe

 

Rob

User
Posted 25 Jul 2022 at 06:13
hi, just an update.ive an oncologist appointment 9th august with my urologist recommending i wait unti psa reaches 0.4 then have a pet pmsa scan.im hoping to have an updated psa test before then to track trajectory of psa..im worried about any time lag which may occur but as has been said by lyn life can only be lived forward.as they say in these parts, Howay

,thanks and best wishes to all.

User
Posted 03 Aug 2022 at 15:24
well ive just had some unexpected good news..i dont understand why but my psa has shrunk to 0.183,not sure what to say to oncologist now,can anybody explain what may have happened? im baffled.

anyhow i wish you all the best,will update after my oncology appointment.joe

User
Posted 03 Aug 2022 at 15:59
It doesn't make much difference - it is still too high for a man with no prostate. It may just be the difference between a PSA taken in the morning and the afternoon, or could it have been tested at a different lab?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 03 Aug 2022 at 16:46
thanks lyn,i didnt know psa could fluctuate during the day ,as it happens my blood test was at 9am ,.so its not as if my biochemical recurrence is in retreat,ah well canny thought for a while...hope youre having a canny summer..joe

User
Posted 03 Aug 2022 at 22:14

If you're happy to wait to 0.4 then it maybe means it will take a little longer which sounds good, although wait for the Onco's opinion.

 I'll be arriving at 9am at my next test.  What did you have for breakfast.

 

User
Posted 03 Aug 2022 at 23:14

I have asked medics and research staff about the timing of blood tests and testing. My last few blood tests were all done in the trials room and were in the lab within a few minutes. The pattern was a slow increase.

Previous tests were done at a phlebotomy department of a regional health centre they all went to the same lab as my trials tests. I would have my blood taken any time between 9.0am and 12.30, the blood sat in the health centre until 13.00 when it was taken to my hospital to be tested. My previous test results have frequently  fluctuated. Does the PSA decrease in the time between taking the blood and testing it. 

None of the medical staff seem to be able to confirm whether there has been any research into variations in results linked to testing timings. 

I came to the conclusion we are more interested in our results than the medical staff that treat us.

Thanks Chris 

 
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