Are there any studies or evidence of how much PSA levels and PC correlate after the prostate is removed? My PSA level has been steady at 8 (eight). for 10 months (19 months after radical prostatectomy.) I have a PSA test monthly. No cancer symptoms at this time. The only studies I've seen are with respect to doubling times (going from 0.2 to a 0.4 causes alarm). Does a constant PSA mean that my PC is not growing/spreading or does it mean that my alternative supplements are keeping it down. (Or none of the above). I haven't seen anyone on this board in a similar situation. (Might have just missed it)
It may be a mistake taking supplements to lower your PSA as this may mask a disease progression. Loma Linda is the closest treatment facility to you although there are several in Los Angles. I would call somebody immediately if it was me.
The Following User Says Thank You to harpman For This Useful Post: 04chris (03-10-2011)
Are there any studies or evidence that a supplement can mask a PSA reading? My limited understanding is that once the prostate is removed a PSA reading can only be effected by how much PC is in the body. Not sure how they are correlated. If the PC cells double will the PSA double -- or maybe there is some kind of exponential relationship? Like I said, I have a very limited understanding of this subject/relationship.
A rise to PSA 0.2 is after prostate cancer surgery is considered to indicate a failure. If your PSA is 8 after surgery that is a very serious situation. I can't believe that your doctor hasn't rushed you to a radiation treatment facility.
If you have cancer and you take supplements to lower your PSA that is not a cure. It does not stop the progression of the disease and if you delay salvage therapy because you PSA went down from a higher level to one that is still extreme for someone having surgery recently then you may lose the chance to be cured.
Dale, the only other reason that your PSA would be detectable after a prostatectomy besides cancer, is if some prostate tissue was left behind. Since your PSA has been 8 for so long, do you think that maybe this might be due to that? Either that, or very slow growing cancer. Have you had an ultra-sensitive PSA test done. ie 8.02, 8.12, 8.22 etc. which would show slow cancer growth? Since the number is quite high, this might also be the case.
Thanks for the reply. I might have mislead in my statement that my PSA is level at 8. Actually it bounces around some (e.g., down to 6 back up to 10 now it's down to 8) It peaked at 25 about 13 months ago (6 months after RP) and has gone down since then to an average of around 8. I'd love to think there is some residual prostate tissue causing these strange results and the PC is gone -- most likely wishful thinking. I'd still like to find out the mathematical correlation between PSA and PC cancer cell count. This info might not exist.
Thanks again -- I'll hope for a big chunk of remaining prostate tissue pumping out PSA
A normal prostate would give you a PSA below 2.5 unless you were much older or had some other problem such as enlargement or infection. The doctor told me that maybe I had a piece of prostate tissue remaining after my recurrence at 0.08.
I agree with Rhonda that something must have been left behind. Chunks of tissue can be left at the apex or around the neurovascular bundles if you had nerve-sparing surgery. And I agree with Harpman that there may be an infection (have you had a urinalysis lately?), and that salvage radiation may be a possibility. I have never seen a supplement have that big an effect on PSA that high. I agree that your case is unusual and if it were me, I would see a doctor at one of the top multi-disciplinary treatment centers. I guess the closest of the top 10 treatment centers to where you live would be at UCLA. Perhaps they can perform a DCE-MRI or one of the advanced imaging techniques to help figure out what's going on.
Thanks everyone for the info.
I have not had radiation or hormone therapy. I've been taking about 19 different 'alternative' supplements -- sort of a shotgun approach. I'm hoping that a couple of the supplements will work (at least slow things down). The pomegranite studies look very promising (I'm taking a bunch of pomegranite powder in a very yuky smoothie each day). I will have a bone scan shortly. Depending on the results of this test I'll look into advanced imaging.
I would suggest that you stop all supplements and see a Radiation Therapist immediately because you may be in a life threatening position and may be wasting precious time. Don't wait until your situation is hopeless.
None of us are doctors here, and that certainly includes me - no enrolled medical education ever. Please keep that in mind when reading a few thoughts on your most recent post, quoted in part here.
Originally Posted by 04chris
... I've been taking about 19 different 'alternative' supplements -- sort of a shotgun approach. I'm hoping that a couple of the supplements will work (at least slow things down). The pomegranite studies look very promising .... I will have a bone scan shortly. Depending on the results of this test I'll look into advanced imaging.
First - about the supplements: I'm convinced that supplements can have a dramatic effect on prostate cancer, and some research is supporting that, while not conclusively proving it yet. In the first (UCLA)pomegranate study, the average PSA doubling time went from 15 months to 54 months at the two year point; moreover, PSA levels actually fell for some of the men! I think it is possible that you are getting that kind of benefit. I read that harpman thought you should stop all supplements. My own layman's opinion is that the odds favor continuing them, but harpman might be right.
Second - as other responders have indicated, that high PSA level after your RP is worrisome. It's possible the supplements are not actually doing enough. I'm very glad you will be getting a bone scan, even though the odds are extremely good that it will not show anything, based on your PSA level. That could be because existing bone mets do not yet occupy enough bone - around 10% - to show up on the scan.
There is a newly available scan that is outstanding for catching spread in lymph nodes. It is known as feraheme, and it is being done by Sand Lake Imaging in Orlando, Florida. It involves technology closely similar to the Combidex scan that was available in the Netherlands until about a year or two ago. (I learned more about this scan at the recent IMPaCT conference, though the scan was not developed under the DoD program.) However, until now only two doctors - Michael Dattoli (Sarasota, FL) and Charles "Snuffy" Myers (Free Union, VA, outside Charlottesville) - have been authorized to send patients to the facility. That restriction was done to make sure the process was providing sound results and to provide rigorous data for a study to be published. I'm not sure if more doctors may now send patients. Drs. Mark Scholz and Richard Lam who practice not too far from you at Marina del Rey (around LA) may now be sending patients too. My impression is that the Sand Lake approach would pick up spread to the nodes even if the PSA was as low as yours is now, or even lower.
If I remember correctly, a rapid rise in PSA after a prostatectomy can indicate a local recurrence in the area of the prostate bed, rather than a recurrence at a distant metastatic site. As for some healthy prostate tissue being left and accounting for the PSA, I've never heard of such a high PSA being associated with that. (On the other hand, in the past two weeks I learned of a man whose surgeon had really botched the job, leaving half the prostate. That would not happen if you had an experienced surgeon.)
There is a definate relationship between psa and size of the tumor. You can find these mathamatical relationships in "Primer on Prostate Cancer" by Dr Stephen Strum. Given this relationship there should be very little psa after surgery and any benign prostate tissue would have to be exceptionally large to generate a psa of 25 or even 8. (.066 X prostate size is cc). Your high psa indicates a large amount of cancer somewhere. With that high of a psa it would unusual to have it locally in the bed so a radiologist would not be the best person to diagnois where the psa is coming from.
This is a very unusual case and needs a top notch medical detective to help understand what is really going on. If you are in the LA area I would definately see Dr Mark Scholz in Marina Del Rey as he is most likely the best doctor to figure this unusual case out.