Arrived at the onco's office to find we were being joined by the community support worker - didn't even know this existed!
Onco is concerned and was a bit cross that he hadn't been told about the August result; a problem I guess of seeing uro and onco in 3 monthly rotation. We discussed my theory that the rise could be down to John cheating and eating bacon and mince every time my back is turned. Mr B's reaction was very interesting - he said "yes, I suppose the healthy diet could have kept the PSA artificially low" which is the opposite way round to what I would have expected - that eating these hormone laden foods might artifically raise the score!
We have a plan - thank God for plans:-
- John eats less red meat and more garlic, even if I am not there to nag him
- repeat PSA in Feb and if it has risen to 0.12 - 0.15 or above, we assume the cancer is back
- in which case J will have a choline PET scan
- if there is an identifiable hot spot, more RT would be the first option - Mr P feels that if there is still some cancer it is not in the area already irradiated
- in the meantime, our hospital is trialling a new nuclear tracer for PET scans which is more precise than choline and has a much longer half life which makes it more accessible - the shorthand name is FACBC. John will have one of these scans when the trial launches around Christmas / New Year
- if there is a hot spot on the FACBC scan, refer to step 4 above
So not the best day ever but I have a new theory. In a normal man (with a prostate and no cancer) 10% of PSA is produced in the adrenal glands. Adrenal glands can work overtime when a person is in a state of tension or danger. Some of you know that a dreadful family circumstance has put John in a perpetual state of 'fight or flight' since February - so what if high stress / anxiety can raise PSA levels? I am on a mission now - my initial searches are indicating that research has concluded stress does not affect PSA but I have a small collection of papers that I need to read in detail just in case.
If it turns out that stress can increase PSA production, Julie's score would be high enough to consider having an RP!