Thanks Lyn. You are a star. The second paper seems to be the most comprehensive/and qualified. The key paragraph.
”Initially, PSA expression was reported to be exclusive to the epithelial cells of the prostate gland, but later it was found that low levels of PSA are also present in other tissues and biologic fluids. PSA immunoreactivity has been detected in the mammary glands, salivary glands, pancreas, breast milk, thyroid gland, placenta, amniotic fluid and semen, as well as in various malignant tis- sues. By RT-PCR, PSA encoding transcripts have been de tected in the endometrium, trachea, thyroid gland, salivary gland, pancreas, placenta and uterus, and low levels have also been detected in the pituitary gland, testis and peripheral leuko- cytes. Some of the cited findings are contradictory and were in most cases obtained by the use of a single method. Extrapros- tatic expression of hK2 has not been studied extensively; never- theless low levels of immunoreactivity have been found in saliva, amniotic fluid, mammary gland and breast milk, and transcripts encoding hK2 have been observed in the prostate, thyroid gland, endometrium and pituitary gland.”
Cant see the Adrenal gland mentioned anywhere and the paper looks like it is discussing where PSA is secreted (e.g. Fluids) and where it comes from. But I will be asking more questions and refer to this at my next meeting.
Fresh
Base jumping without a parachute should be frowned at, never criticised. Fresh |
User
Good evening, everyone. My hospital uses the super sensitive machine and I will outline my experience.
January 2017 - first post prostatectomy PSA test result - 0.014
March 2017 - 0.015
May 2017 - 0.019
June 2017 - 0.014
September 2017 - 0.02
January 2018 - 0.023
Oncologist recommended radiotherapy. She said rising PSA indicated that cancer cells were present but she couldn’t say exactly where. So I paid for a PSMA scan and it found remaining cancer cells.
If I had been in a hospital which didn’t use the super sensitive machine, my PSA might still be less than 0.2 and my cancer would have possibly continued to grow.
I know the debate about super sensitive testing evokes strong views, but based on my personal circumstances and experience, I’m glad of it.
Ulsterman
User
The references to adrenal gland are on p295 - 2 different studies observed the same pattern, although both were small scale projects (in one case, there were only 2 patients I think?)
Certainly, PSA is recorded in other cancers but it does also seem to be widely accepted that very low levels of PSA can be measured in healthy people. It was our urologist who mentioned the adrenal gland, when we were agonising about the rise from <0.1 to 0.1 Now, with a range of tests at 0.09 - 0.11 we are comfortable to believe that J just produces a high level of healthy PSA until it is proven otherwise.
I am sure your specialists will be thrilled the next time they see you. It is a shame isn't it that not all specialists have the same approach - John's uro and onco both seem happy to engage in discussions with me about research, emerging trends, perceptions ... I have asked him about people's situations on here sometimes (Trevor Booth and Si_ness) which he finds quite bemusing, I think.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
|
User
Originally Posted by: Online Community MemberGood evening, everyone. My hospital uses the super sensitive machine and I will outline my experience.
January 2017 - first post prostatectomy PSA test result - 0.014
March 2017 - 0.015
May 2017 - 0.019
June 2017 - 0.014
September 2017 - 0.02
January 2018 - 0.023
Oncologist recommended radiotherapy. She said rising PSA indicated that cancer cells were present but she couldn’t say exactly where. So I paid for a PSMA scan and it found remaining cancer cells.
If I had been in a hospital which didn’t use the super sensitive machine, my PSA might still be less than 0.2 and my cancer would have possibly continued to grow.
I know the debate about super sensitive testing evokes strong views, but based on my personal circumstances and experience, I’m glad of it.
Ulsterman
Yes but you were in a slightly different situation and I suspect the onco took other factors into account like your upgrade to T3b, positive margins, PNI, extracapsular invasion and your young age ... the odds were that you were always going to end up with salvage treatment and some oncos would have gone for adjuvant treatment as soon as they saw the pathology report. In that context, your usPSA results were perhaps only part of the bigger picture?
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
|
User
Lyn
I totally agree that other individual circumstances will have been taken into account by my oncologist. The point is, though, that had I been in a hospital which didn’t use the super sensitive test, I might still be classed as undetectable when cancer was very much there And could have been treated. For what it’s worth, I did ask my oncologist for adjuvant radiotherapy but she isn’t a fan of ‘unnecessary’ treatments and wanted evidence that I needed further treatment. She got that evidence earlier because of the sensitive test.
Ulsterman
User
Originally Posted by: Online Community MemberLyn
I totally agree that other individual circumstances will have been taken into account by my oncologist. The point is, though, that had I been in a hospital which didn’t use the super sensitive test, I might still be classed as undetectable when cancer was very much there And could have been treated. For what it’s worth, I did ask my oncologist for adjuvant radiotherapy but she isn’t a fan of ‘unnecessary’ treatments and wanted evidence that I needed further treatment. She got that evidence earlier because of the sensitive test.
Ulsterman
Ulsterman you are a classic example of why supersensitive is a good idea. Some oncos believe anyone with a T3 should have ajuvant therapy even though they know this will overtreat 50% of patients. Use of supersensitive allows you take some time and still catch and treat any recurrence early as research seems to indicate you can safely wait until 0.1 before starting RT. The impressive thing about your case is that they were able to find and target the recurrence too.
PS I know what Lynne is going to say now!
Edited by member 13 Sep 2018 at 07:23
| Reason: Not specified
User
Francij1
Please remember, the cancer cells were found by a self-funded PSMA scan. With such low PSA, it was a gamble, but it did get results.
And we all love Lyn whose knowledge, research and experience has helped countless people, but I’m still glad I’m in a super sensitive testing hospital😊
Ulsterman