1. < Prostate Cancer

What should the psa be?

Posted by majed @majed, 3 days ago

My husband started docetaxel and zoladex on 3/4
His psa on 3/4 was 43
What is the goal psa?

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northoftheborder | @northoftheborder | 1 day ago
In reply to @kujhawk1978 "Language, terms and definitions are powerful. Early in my journey i confused undetectable with no prostate..." + (show)
@kujhawk1978

Language, terms and definitions are powerful.

Early in my journey i confused undetectable with no prostate cancer.

I think over time I've adjusted to understand it simply means that it is not that the results mean here are no PCa cells, simply for that equipment and that assay, below the level of reporting, it cannot detect PCa cells which may be present, the infamous "sleeping" ones.

I, and you, know folks who treat very early one using USPSA. That is their choice, and they are comfortable with their approach and decisions doing so.

I have seen the other end of the spectrum, people and their medical team don't pull the trigger until PSA 10 or greater. again, they and their medical team are comfortable with that approach and decision.

Certainly, increasing PSA over several labs using USPA portends recurrence. The questions is, what do you do with the clinical data. As I've said before, my medical team and I use .5 as the trigger, image, then go from there. I'm high risk as you know, GS 8. GG4, 18 months to BCR, rapids PSADT and PSAV, so we treat "early."

Someone with say GG3, a GS 3+4, a PSADT >12 months...may decide to wait longer than I do, and likely they and their medical team are making a good decision.

Kevin

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Absolutely. Especially if you have early stage cancer with no metastases and a low risk profile (e.g. 3+4), there's no need to drive your PSA down to undetectable, at least in many cases. As long as it stays stable from test to test, it's probably fine. (As always, not a physician, etc etc).

They're learning a lot about not overtreating early-stage cancer (you don't need a sledgehammer to swat a fly), and not undertreating advanced-stage cancer (in the past, they treated stage-4 mainly palliatively; now, they often hit it early and hard with doublet or triplet treatment).

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