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Will PSA ever hit 0 or close to it?
I think you "regular" guys on here, know my husband's story.
Stage 4 diagnosis in Feb. Gleason 8 and 9s, PSA was close to 300!
Firmagon and Zytiga and prednisone and chemo over the summer.
PSA is still trending down but it's 0.33 now, last month it was 0.37, before that 0.44 and maybe before that 1 something then 2 something and so on, but the last few months it's slowed down drastically and we're worried that it's bad news, that it will never hit close to 0 (undetectable), I try to be positive that it's still going DOWN! but I've read online that if it's not 0 by 6-9 months, it's not a good future outcome.....I also read that Firmagon IS better than Lupron in these cases. So he'll stick with that for now, unless it's insanely $$ next year as our insurance won't cover it.
Anyways, I don't want replies about the Lupron, just what your thoughts are on the PSA levels.
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I cannot ad anything to this because I had a radical Prosectomy and never used any other medication or methods to decrease my PSA but post op my PSA was less than .005 which my Urologist classified as undetectable. I have tried to stay current in this group to give support where I can and maybe learn something so if anyone that I meet has questions I can at least make an educated response but when I see grown men acting like children it is a deterrent for me to hang around anymore. I hope everyone has the success they are looking for in the fight with this cancer but I’m out. Enjoy your pissing contest
Mine hit .0000, but eased up to like .oo1 after 2 years.
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1 Reaction@q95oldies
I do not understand how PSA can ever be zero since it is produced at some level by other body organs beside the testicles.
@pesquallie
Yeah maybe my husband's will never be that low because he never got surgery to take out the prostate as it was everywhere when diagnosed.
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1 ReactionNot sure. Just what the Oncologist told me.
Not sure this adds anything.
Your question, "does PSA reach 0?"
No...
Depending on which test, which assay and which lab., it may be reported to one, tow or three decimal points.
Generally, for single decimal point it is reported at < .1. Does that mean it's zero? No! It could be .03 but the test, assay, measuring equipment and the medical facility does not detect or report to two or three decimal points?
Why not use the USPSA? The discussion generally centers around the medical usefulness of doing so. Some subscribe that an USPSA may just cause unnecessary anxiety and at levels of for example .02 or .03, no action is required by the patient or his medical team.
Others take a different view and say that USPSA may provide early indication of activity and inform a treatment decision .
I kind of use a hybrid of the two...
In my case, my medical team uses USPSA, two decimal places, but interestingly, our decision criteria says we don't act until we have three or more consecutive PSA increases and, or, PSA between .5-1.
We have those criteria to ensure we have a definitive trend vice an aberration and increase our chances of imaging showing where the activity is and thus enhancing the clinical data used in making our treatment decision.
We do not feel that letting the PSA rise to .5-1 entails any risk in my PCa getting out of control..
There is more and more in the literature about rapid responders , guys whose PSA drops to "undetectable" in the first 6-9 months. The literature says these patients are candidates to come off treatment and generally see longer progression free survival while off treatment. What "undetectable" may not mean is "cured." I am not sure we are yet at the point of advanced PCa being curable. We are changing the treatment landscape to where it may be possible to manage advanced PCa as a chronic disease and use criteria like overall survival, progression free survival...sadly, we know that for some 35k men here in the USA , they die of PCa, not with it.
My medical team knows their task is to make me part of the "with" group. My radiologist off handily made a comment that if I die of a heart attack, the task is complete. A little morbid perhaps but as I pondered her comment, I said yeah...
What is "undetectable?" Depends on the test, assay, measuring equipment and the institution's policies. I am comfortable in saying that in my 12 years undetectable has never been "zero "
The downward trend you cite is encouraging.
Kevin
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1 Reaction@kujhawk1978
I have to agree - it all depends of many factors : type of a treatment, type of PC (aggressive vs slow growing), stage as well as of the goals and strategy for possible future treatment choices and steps.
Some new studies even show prognostic values of the first USPSA test after RP.
In my husband's particular case with aggressive features such as cribriform and IDC and gleason 9, USPSA makes more sense than regular one. For him value of 0.05 might mean a need for heighten alert since his treatment could start at 0.1.
All in all, it is not universal thing and depending of the case, hospital and a patient it can be used and measured different ways.
And at the end - PSA is not produced only by a prostate gland, in very small amounts it is produced by salivary glands, mammary tissue, periurethral glands etc. , so it never is actually a real "0".
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