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Increasing PSA post Treatment

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User
Posted 29 Feb 2024 at 09:47

In late 2018 I was diagnosed with Prostate Cancer Gleeson 6 Stage T1c, the biopsy result was one 2mm focus of atypical fused gland plus 4 cores showing marked BPH from a total of 14 needle biopsies. Prostate size was estimated at 65cc.

In March 2019 I completed 39 sessions of External Beam radiation with no other treatment.

My PSA came down to 1.09 on the 4.12.20 from 14 prior to the start of treatment.

Since then my PSA results are:

15.6.21     1.25

7.12.21      1.47

8.6.22        1.45

10.1.23      1.72

12.7.23       1.69

23.2.24      1.97

There is an obvious upward trend but on two occasions the was no rise in 6 months, I understand there is neither 3 consecutive increases nor a rise of +2 ng/ml above nadir.

I think I also have unusually high testosterone for a 73 year old at 941 ng/dl or 32.66 nmol

Has anyone any knowledge or experience of similar increases and in particular does it look as though I am heading for biochemical failure.

 

Geoff 

User
Posted 29 Feb 2024 at 22:56

Well by the textbook you don't have recurrence. You also have a large prostate, BPH, high testosterone and you are 73. You have plenty of reasons to have a high PSA without it being cancer. 

The rise is in steps of 0.25 once per year. The growth is not accelerating. If it were established cancer I think you would have a clear doubling time rather than a haphazard slow rise.

I presume you have been discharged from the supervision of your oncologist, if that is the case, as soon as the PSA rises above 3.1 get referred back. It is possible that this is a brand new prostate cancer. On current form it will be another four years before you will reach this level.

If one can measure anxiety on a scale of 0 to 10, then I think your current statistics warrant a score of 1 or 2.

Keep monitoring things and keep posting to this thread with new results.

 

Dave

User
Posted 29 Feb 2024 at 21:57

BUMP!

Can any of you RT lad's or lasses help?

User
Posted 01 Mar 2024 at 08:05

Not in the same situation but my PSA sometimes went up and down without any treatment. Whenever I ask the medics for a reason the short answer is usually "we don't know, but it happens". All my tests are listed at the beginning of my profile,all done in the same lab.

Thanks Chris 

 

User
Posted 01 Mar 2024 at 11:07

Yes I did notice the rises alternate between 0.0 and 0.25 every six months. Us humans always look for patterns in data, that is what science is all about. We then come up with a theory to explain it. 

Any data also has errors or noise these are random but for short periods may cause a pattern which we spot. We then try and explain it with a theory, but sometimes there is no explanation.

I did think, is there some activity you do in the last half of the year that increases PSA? but some theories are a little too far fetched.

At the moment the best fit line for your PSAs is +0.25 ng/dL per year, with errors of ±0.125. Very importantly that line is straight it is not accelerating, cancer has an accelerating line. It may be after more results we will spot a pattern of acceleration, until then don't worry. Keep getting tested so you can spot a pattern early if one develops.

 

Dave

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User
Posted 29 Feb 2024 at 10:45

Hi Geoff.

I had surgery so I'm afraid I can't help. However I just wanted to welcome you to the forum. There are many here that will be able to help with your question.

User
Posted 29 Feb 2024 at 21:57

BUMP!

Can any of you RT lad's or lasses help?

User
Posted 29 Feb 2024 at 22:56

Well by the textbook you don't have recurrence. You also have a large prostate, BPH, high testosterone and you are 73. You have plenty of reasons to have a high PSA without it being cancer. 

The rise is in steps of 0.25 once per year. The growth is not accelerating. If it were established cancer I think you would have a clear doubling time rather than a haphazard slow rise.

I presume you have been discharged from the supervision of your oncologist, if that is the case, as soon as the PSA rises above 3.1 get referred back. It is possible that this is a brand new prostate cancer. On current form it will be another four years before you will reach this level.

If one can measure anxiety on a scale of 0 to 10, then I think your current statistics warrant a score of 1 or 2.

Keep monitoring things and keep posting to this thread with new results.

 

Dave

User
Posted 01 Mar 2024 at 07:16

Thanks Dave, I could not understand why the PSA results showed no increase after 6 months then go up again on the next test (twice), that was the main reason for the post to see if any one else had this type of experience. At first I was hoping it was a bounce but too long after treatment now.

 

Geoff 

User
Posted 01 Mar 2024 at 08:05

Not in the same situation but my PSA sometimes went up and down without any treatment. Whenever I ask the medics for a reason the short answer is usually "we don't know, but it happens". All my tests are listed at the beginning of my profile,all done in the same lab.

Thanks Chris 

 

User
Posted 01 Mar 2024 at 11:07

Yes I did notice the rises alternate between 0.0 and 0.25 every six months. Us humans always look for patterns in data, that is what science is all about. We then come up with a theory to explain it. 

Any data also has errors or noise these are random but for short periods may cause a pattern which we spot. We then try and explain it with a theory, but sometimes there is no explanation.

I did think, is there some activity you do in the last half of the year that increases PSA? but some theories are a little too far fetched.

At the moment the best fit line for your PSAs is +0.25 ng/dL per year, with errors of ±0.125. Very importantly that line is straight it is not accelerating, cancer has an accelerating line. It may be after more results we will spot a pattern of acceleration, until then don't worry. Keep getting tested so you can spot a pattern early if one develops.

 

Dave

 
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