1. < Prostate Cancer

Seeking an opinion

Posted by stew80 @stew80, May 30 1:19pm

I had a PSA test in March. It was 12.3. Two weeks later it was 8.6. Three months after that (yesterday) it was 9.5. The free PSA is 1.10. The free percentage is 12%. Recent DRE found no irregularities although the prostate is moderately enlarged. Symptoms are slow to start and a weak stream. Slight burning sensation but urine test is fine. I had a TURP 10 years ago. I have a Urologist appointment next week and I'm wondering what the next steps might be. I am concerned. Could this be benign or is it probable cancer? I'm 83 years old.

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northoftheborder | @northoftheborder | Jun 1 2:03pm
In reply to @robertmizek "Respectfully, the 15 year life expectancy numbers are not a one size fits all deal for..." + (show)
@robertmizek

Respectfully, the 15 year life expectancy numbers are not a one size fits all deal for everyone with prostate cancer. The study out of England does not take into account high risk / aggressive cancer and/or Gleason 8/9 scores. If I did nothing my odds of living 5 more years at age 69 would only be 50%.

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«Respectfully, the 15 year life expectancy numbers are not a one size fits all deal for everyone with prostate cancer.»

That's a good reminder. Almost all studies use "overall survival" (OS) as their measure, since it's hard to tell exactly what eventually kills someone. I expect that OS understates actual life expectancy for younger people, and overstates it for older ones (e.g. if you're already 95, you're probably not going to make 110 regardless of how your prostate cancer progresses, but please prove me wrong!).

However, the biggest issue is that all studies are backwards looking, often using data that they started collecting 10–20 years ago (even if the study came out recently), and so much has changed in Prostate Cancer treatments and best-practices in the last 5–6 years that perhaps all of the numbers are inapplicable now. We're the new sample population, and new studies like IRONMAN will some day tell us what's happening to us today.

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1 reply
stew80 | @stew80 | Jun 1 4:56pm
In reply to @mikewo "I was 73 with a PSA of 2.9 and a Gleason of 4 -3 and 3..." + (show)
@mikewo

I was 73 with a PSA of 2.9 and a Gleason of 4 -3 and 3 -4 with a very large prostate (120gms). I elected 5 radiation treatments at Mayo Phoenix. Two weeks after my treatment a study out of England came out with results that said if you did nothing, had radiation, or a proctectomy your life expectancy was 15 years with any choice. You are 83 add in 15 years puts you at 98. How long are you planning to live?

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I guess I need to find out the level of aggressiveness, but for some, this is an interesting study. I was looking at 15 years more, God-willing. Maybe snatch the century mark. 🙂

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mikewo | @mikewo | Jun 1 7:54pm
In reply to @robertmizek "Respectfully, the 15 year life expectancy numbers are not a one size fits all deal for..." + (show)
@robertmizek

Respectfully, the 15 year life expectancy numbers are not a one size fits all deal for everyone with prostate cancer. The study out of England does not take into account high risk / aggressive cancer and/or Gleason 8/9 scores. If I did nothing my odds of living 5 more years at age 69 would only be 50%.

Jump to this post

I have no regrets on my choice as after a year and three months my PSA is still undetectable. I was 73 he is 83 you are 69. Age makes a huge difference in one's outlook. If I get 15 years, it puts me at 89. My sister works in a nursing home and tells me all the time you don't want to go to one. That one core out of the four they found in my 7mm lesion made me do something about it. If it had only been 3 -4's I would have just watched as the MRI showed it was not near the capsule. My PDA had varied over the last five years from 2.3 to 2.9 and I had a 2.9 at year three before. The only thing that alerted me was a very low free PSA of 15 which started my investigation.

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kujhawk1978 | @kujhawk1978 | Jun 2 7:14am
In reply to @northoftheborder "«Respectfully, the 15 year life expectancy numbers are not a one size fits all deal for..." + (show)
@northoftheborder

«Respectfully, the 15 year life expectancy numbers are not a one size fits all deal for everyone with prostate cancer.»

That's a good reminder. Almost all studies use "overall survival" (OS) as their measure, since it's hard to tell exactly what eventually kills someone. I expect that OS understates actual life expectancy for younger people, and overstates it for older ones (e.g. if you're already 95, you're probably not going to make 110 regardless of how your prostate cancer progresses, but please prove me wrong!).

However, the biggest issue is that all studies are backwards looking, often using data that they started collecting 10–20 years ago (even if the study came out recently), and so much has changed in Prostate Cancer treatments and best-practices in the last 5–6 years that perhaps all of the numbers are inapplicable now. We're the new sample population, and new studies like IRONMAN will some day tell us what's happening to us today.

Jump to this post

One of my rules..."

Consider the age of any treatment statistics. New advances quickly make them obsolete. I am careful about applying statistics to my situation. I am an individual, not a statistic.

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grandpun | @grandpun | Jun 3 8:48am

All good comments above.
I was 75 at time of RALP and now 77 and negligible PSA. Most all my immediate ancestors lived to 90+ and very cognitive so I think I have a shot at that. But I don't want PC to kill me - I understand that PC in the bone can be terrible. So if I get another PSA warning I'll still take another try to stop it again.

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windrider354 | @windrider354 | Jun 3 10:58am

PSA shouldn’t bounce that much. What lab are you using?

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stew80 | @stew80 | Jun 3 11:07am

Same lab. I wondered about that, too.

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