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Last PSA Number Before Cancer Diagnosis?

Posted by mikeg73 @mikeg73, Aug 23 10:27am

Would anyone mind sharing their last PSA number before they were diagnosed with prostate cancer?

It seems like PSA of 4.0 is the typical point where many are referred to Urologist. I'm wondering are most people getting diagnosed within the 4 - 10 PSA range.

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jeff Marchi | @jeffmarc | Sep 2 2:53pm
In reply to @melvinw "My PSA hit 4.8 when my PCP referred me to a urologist who performed a biopsy...." + (show)
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My PSA hit 4.8 when my PCP referred me to a urologist who performed a biopsy. Cancer in two cores, Gleason 6. Surveillance recommended. A few months later I went for a second opinion and a second biopsy. More cancer was found that was Gleason 7 (3+4). Now a candidate for treatment. Most significant to me (and the urologist) was my very linear PSA velocity from several years of testing (see attached plot). As the second urologist said, 'we can treat now, or wait, but I guarantee you will be back for treatment within a year'. I opted for a robotic radical prostatectomy with him ASAP. No regrets, although ten years later I now have recurrent cancer with PSA of 0.1 and a palpable lesion in the prostatic fossa, and no evidence of metastatic disease on PET or MRI scans. Starting EBRT of prostate bed and pelvic lymphs nodes in mid September.

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It doesn’t matter if most of Your Gleason Score was 3+4, what was the highest Gleason score they found? That is the only one that counts and your treatment depends on that score not what most of them were.

The chance of reoccurrence is based on that higher score, And you definitely have had reoccurrence if they found a palpable lesion in the prostatic fossa. I had radiation when my PSA hit .2 3 1/2 years after surgery but they didn’t see any metastasis yet.

The PSMA pet scan can’t see lesions smaller than 2 1/2 mm and According to a UCSF radiologist even 5 mm is hard to see. Your radiologist is definitely telling you that sooner is better. It doesn’t make sense to let it grow for another year because it can spread.

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melvinw | @melvinw | Sep 2 4:19pm

3+4 was the highest Gleason score. Yes, correct it’s the highest score that counts.

Yes, despite my last PSA (June) being at 0.1, the presence of the small lesion (also confirmed by DRE) is compelling reason to treat now. I’ll do one more PSA test just before starting treatment.

Yes, micromets could be present that are below scanning detection. Discussed that thoroughly with my new urologist who specializes in advanced prostate cancer. For now, I’ll take the absence of evidence as good news, fully aware that things could change.

It’s a real balancing act—on one hand you don’t want to delay treatment for a confirmed presence of PCa, but on the other hand, it’s really critical to be informed as possible about treatment options, probabilities, and the recommendations from your care team. Seeking a second opinion is a good idea, but that also adds to the delay.

My urologist, radiation oncologist and me are all in agreement—treat now.

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sahallock1947 | @sahallock1947 | Sep 3 10:26am

I have a question, has anyone who’s been on eligard and xtandi developed kidney problems, and if so, what have you done about it?

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jeff Marchi | @jeffmarc | Sep 3 11:37am
In reply to @sahallock1947 "I have a question, has anyone who’s been on eligard and xtandi developed kidney problems, and..." + (show)
Profile picture for sahallock1947 @sahallock1947

I have a question, has anyone who’s been on eligard and xtandi developed kidney problems, and if so, what have you done about it?

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The standard blood tests I get every month check for liver and kidney problems because they are occasionally occurring with people on those drugs.

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