Has anyone had PC that is very aggressive and a very low low PSA?

Posted by sam60 @sam60, Jul 13, 2023

My cancer is now chemical reoccurring after five years of ADH and Zytiga. My PSA rose to .5 and we did a PSMA scan, which came back with only a tiny uptake in one rib, and my scapula too small to even radiate my oncologist thinks that my cancer is of a type that is very aggressive. I have Glisan nine but very low PSA I’ve never had a PSA over five. has anyone had a cancer like this or know of anyone?

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PSA 5.3 Gleason 9
Bio reoccurrence 90 days post Radical Prostatectomy

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PSA went to 9.8 as PC met to L2 lumbar Li was radiated 2 years ago On Xtandi now and Xgeva Psa 1.7

feel good at 78 Radiation done in 2017

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PSA 0.62
PSMA Showed stage 4 metastatic most metastases to left shoulder area. Oncologist dx of neuroendocrine differentiation. Will be doing my 5th. of 6th. Chemotherapy of Docetaxel and Carboplatin this morning. Also on Lupron and Nubeqa.

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@brownsf

Sounds like your doctor felt something suspicious during the DRE which led to the biopsy. And, like me, you were very lucky that a 4+4 Gleason cancer was discovered and you’re doing OK.

I would say the DRE plus PSA together are the gold standard. Most of the time, Prostate cancer is first detected by a PSA test and the DRE may be negative. But for a small but significant number of men like us, the PSA is relatively low but the DRE is positive.

Many so-called experts have come out against the DRE and even against the PSA for reasons I can’t understand. Neither test is expensive, presents risks, has side effects or is costly. Their main argument-they can lead to more invasive tests which may not be necessary. This could happen…but today there are other relatively non invasive tests which can help eliminate false positives before a biopsy is needed, so the argument that an elevated PSA or suspicious DRE leads straight to the operating room just doesn’t make sense.

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DRE relies on human interpretation. Machines are so much better than humans in most cases now.

Get an MRI.

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i am 65, just diagnosed with gleason 4+5. cancer spread to pelvic lymph nodes and a little higher. starting eligard and zytiga next week. radiation team on tap. my psa has never been over 3.68, which was last may. 3.5 this week at Mayo. i am elated to hear that treatment can work for 5 years.

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@rgillis

i am 65, just diagnosed with gleason 4+5. cancer spread to pelvic lymph nodes and a little higher. starting eligard and zytiga next week. radiation team on tap. my psa has never been over 3.68, which was last may. 3.5 this week at Mayo. i am elated to hear that treatment can work for 5 years.

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Yes stay as positive as you can. Lots of up’s and down’s . Let me know how it’s going. Also what Mayo had to say about low PSA with high grade cancer.
🙏❤️

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@sam60

Yes stay as positive as you can. Lots of up’s and down’s . Let me know how it’s going. Also what Mayo had to say about low PSA with high grade cancer.
🙏❤️

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I can tell you. You can have a very low or even undetectable PSA and still have aggressive cancer show up on PET scan. Although rare it does happen that’s why yearly scans are so important with a high grade cancer especially when you have had multiple reoccurrences and treatments as I regardless what your PSA is. I have a neuroendocrine type of the disease most likely caused from my multiple reoccurrences and treatments. PSA was 0.62 when it showed up.

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