To test or not

The standard NHS approach is supposed to be 6 monthly until the 5 year mark and then annual tests thereafter. But in cases where there has been a need for adjuvant or salvage treatment, the checks tend to stay more frequent so John is still on 3 monthly 7 years post op. In Bri's case the specialist gave him the option this time - annual test unless he wanted to have an interim check. 

Some will continue with the annual test under their consultant but will have additional PSAs in between times via an agreeable GP. Some consultants can't wait to get rid of patients back into the GP system - I am thinking of members here who never saw their surgeon again after the post-op check up and have only had tests and follow ups at their local practice.

Edited by member 10 Nov 2016 at 21:34  | Reason: Not specified

That's shocking :-(

Phoned the consultants secretary who was now able to give me the PSA results.

The result is 0.02 so it is up on the last test but still obviously very low. I am aware of the technical issues at such low levels but it does give you a "oh" moment when you hear it's higher than it has been for the last three years where it had progressively dropped.

Oh well let's see what the test in March says

Bri

Hi Bri,

There is something I have never really understood, but I am sure there are some on this website who know the answers, hence my post.

In your case, you had RP, so logically any residual PSA can only be attributed to 3 possibilities, perhaps some health prostate cells were left in the margin when the scalpel cut out your prostate, or ditto some PCa cells were left in the margin, or prior to RP there had been some minimal spread of PCa and this is growing elsewhere in your body.

In my case I had RT, so residual PSA can be attributed to 3 similar possibilities, healthy prostate cells in what is left of the radiated prostate are growing back to life, or PCa cells within the radiated prostate are growing, or likewise some PCa cells had spread prior to RT.

Now in an untreated man, a PSA of 3, 4 or even 5 would be seen as perfectly normal and healthy.

So how come we worry about such low numbers, your PSA of 0.01 or even 0.02 is very low, lets assume that the surgeon managed to remove 99% of your prostate tissue, the residual 1% left behind might be assumed to generate PSA of 0.05 even were it perfectly healthy?

As a youth I cut my hand quite badly with a saw, what was once a vivid scar is now hardly noticeable, over time, measured in years, my body has gradually replaced the scar tissue with, for want of a better word, 'hand tissue'.  Isn't something similar happening to our prostates, or what is left of them?

Personally I would be reluctant to go back on HT or any other form of treatment until my PSA was rising quite steadily way past the range considered healthy.

But as I said, I have never really understood why the doctors are so concerned about such low PSA numbers, I guess someone can tell me?

:)

Dave  

Edited by member 11 Nov 2016 at 20:13  | Reason: Not specified

There is a difference between the point at which you and your medics accept that there is still some cancer floating about, and the point at which you go back onto treatment. The 0.2 refers only to men with no prostate; I think for men that have had EBRT / brachy etc it is 2 but I am not certain of that.

Have a look at Topgun's profile - his cancer came back about 5 years after RT and he successfully used intermittent HT for many many years. I can't remember what trigger point he used in the early days but the details will be there for you to read.