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PSA "undetectable" for amost a year: Continue to monitor
Prostate Cancer | Last Active: 4 hours ago | Replies (70)Comment receiving replies
@jc76 Certainly, nothing you read here is a substitute for the advice of your doctors. This is about sharing your own story, which may well be entirely unique to you.
But it is true that if you read the literature and talk to experts there are many different opinions. In my case, I had a biopsy in 2023 that showed a single positive core with Gleason 6. My urologist felt this was a case for active surveillance, which I agreed with, based on my reading in the literature (I am a PhD biochemist/immunologist). Nevertheless, my PSA kept rising. At my next biopsy in 2025, they found 3 positive cores, one Gleason 8 and one Gleason 4+3. Quite a change! This obviously required action.
I immediately made contact with a Center of Excellence in New York City. Our hospital here is a good academic medical center, but not a COE for cancer. They were ready to do surgery, but before my scheduled date I had an appointment with my Urologist here. He insisted that a PSMA-PET scan was necessary before deciding on surgery.
While I had no objection to having a scan, they scheduled it for a month away. Then I would have had to wait for a follow-up appointment, then wait for surgery. I felt that time was of the essence, as having an aggressive tumor sitting there as a potential source of metastasis did not appeal.
The folks in NYC saw no reason to do a pre-operative PET scan. That made sense to me and I went down for the operation. More than a year later, my PSA is undetectable, <0.02. This makes it very unlikely that the PET scan would have shown anything beyond the primary site.
So, doctors can disagree and we as patients have to make the choice we feel is best for us.
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@optimistic @soli
I hope you the best in your future journey and your continued success in your PSA tests.
What I am reading here from many is the differences in medical care. I can only pass on my experience with my experiences. I went to two different COEs and got excellent research, excellent care and medical advise. I cannot comment on the quality of care someone else got just compare it to my own.
I do know we are not suppose to come to Mayo Community Connect in lieu of professional medical doctors care and medical advise. No one on MCC should try to diagnose others and/or give specific medical advice. No one other than your medical doctors have you full medical and mental health history. We are to stay with our own personal journey with P.C. and what you learned that helped you make decisions and your outcomes.
I constantly suggest seeking second opinion because I did that myself and it helped me. I also promote the Decipher test because I had the Decipher test and drastically changed my treatment plan. I think important to stick with your research, doctor recommendations, specific tests you had and why, your diagnosis from your medical experts, treatments that you have personal experience with.
If you disagree with your doctors do more research from COEs. Then if you still need more (and I am one to promote doing it anyway) consider second opinions from C.OE.s.
Even though I was at a C.O.E. I did a second opinion from another C.O.E. who gave me tons more research information to help me decide and the two books that every one (Dr. Walsh) talks about as being excellent.
Good luck and seems you did exactly what was best for you but your journey and level of care and expertise was drastically different than mine.