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Anyone get PSA Test Angst days before that post-treatment PSA test?
Anyone else get this the days or week before that post-treatment PSA test? When I had my kidney cancer, I spent a year waiting for "the other shoe to drop" and while not as severe this time (likely desensitized from the very bleak 12 months after my last cancer), I sort of feel the same. Just short of a year past RARP and each PSA test feels like I'm in Vegas rolling dice and I'm a bit on pins and needles until I get it over with and they tell me "undetectable".
I'm sure I'm not alone. Again, I have to remind myself about who continues to come to these forums, so when I read the regular accounts from guys who had my same Gleason and got RARP two to five years ago who are back because the PSA jumped it just causes my heart to miss a beat - even though I realize there are probably 100X as many guys out there who will never see it rear its ugly head again.
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I call the first year of "every 3-months" PSA testing - and every 6-months for subsequent years - the "black raven" sitting on my shoulder that I carry with me everywhere." I know it is there...it routinely pecks on my head/neck reminding me that it is going to be there forever, and then one day, if after my PSA starts to rise, it is going to say: "I'm baaack, and I am going to kill you now...slowly...miserably....and painfully." I see why women with breast cancer call themselves "survivors" but that they also say that they (still) "have" breast cancer. They had the mastectomy and radiation or other therapy, but they know that it will eventually come back to kill them. That is no way to live..for any of us.
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1 ReactionAlways. When I have those “moments” I try to focus on something that’s a distraction. My next test is April. 👍🤞🙏
My angst comes after getting the results of the PSA days before I see the Urologist. I know I don't HAVE to look, but I can't resist. I just confirmed my RARP failure this week. It's been 18 months since the surgery and every time I've gotten tested my PSA is higher. I went from 0.13 to 0.25 in three months. A week later it is 0.29. My angst is heightened because my Urologist doesn't seem to care that its rising. In the end, I think knowledge is power as long as you don't give it power over you.
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1 Reaction@larrypt3b
It sounds like you need to go to a different doctor. Maybe you can present the below information to your doctor so they are aware of what the standards are. Your doctor is ignoring the standard of care. Here’s what the American Society of a clinical oncologist has to say About rising PSA after surgery.
From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL: Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%). Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.
0.2–0.5 ng/mL: Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.
0.5–1.0 ng/mL: Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.
This article discusses the above;
https://ascopost.com/news/march-2023/psa-level-at-time-of-salvage-radiation-therapy-after-radical-prostatectomy-and-risk-of-all-cause-mortality/