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Old 11-15-2012, 12:20 AM   #1
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Psa velocity

I am 58 and was diagnosed with a somewhat enlarged prostrate when I was 44 years old. I have seen the same urologist once a year for the past 14years. My psa was always a 0.1 until 2011 when it went up to 0.2
I attributed this to my going off the medicine "propecia" which I was taking for hair loss. My understanding is that it lowers psa readings somewhat.
I've just had my 2012 visit and my psa is now 0.3
The nurse sad the the doctor reviewed the results and Said they were fine.
However everything I've read indicates that a 100% increase two years in a row is not ignorable. Prior to the 0.2 result in 2011 I began working out 5 days a week on an exercise bike which I just learned could influence results. Notwithstanding the bike thing any info or guidance on these numbers would be appreciated.

 
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Old 11-15-2012, 01:05 AM   #2
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Re: Psa velocity

Your PSA is ridiculously low. PSA velocity is meaningless on such low numbers.Congratulations!

- Allen

 
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Old 11-15-2012, 09:32 AM   #3
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Re: Psa velocity

Thank you. I've been disturbed with these numbers and now I feel better. I was all set to call the nurse and "politely" suggest the Doctor wasn't paying attention. I've read many of your other responses on this forum and your knowledge appears to be quite extensive. I never knew my numbers were considered "ridiculously" low even when increased 50 to 100 %. Lastly, do you have an opinion on riding a stationary bike riding and how it may effect psa levels?

 
Old 11-15-2012, 10:05 AM   #4
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Re: Psa velocity

I saw a study that showed an increase after vigorous bike riding -- stationary bikes are a smoother ride. Unless there is some other reason, like a positive DRE or unexplained urinary symptoms, urologists would not be concerned for anything under a PSA of 2.5

 
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Old 11-15-2012, 04:41 PM   #5
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Re: Psa velocity

Move the decimal point one place to the right and you might have a little concern. Move it two places to the right and you're in deep trouble. As it sits take a deep breath, calm down and have a drink of your choice.

 
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Old 12-11-2012, 03:13 AM   #6
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Re: Psa velocity

i just had my test back psa ultra and for 6 years it was less then .001 and it changed to .015 ..i will wait for another test in 90 days to make sure

i am in high risk with gleason 9 and psa of 55 before rp and hormone therapy
but my testasteraone is still almost zero ...so i do not understand how psa is changing

 
Old 12-11-2012, 09:19 AM   #7
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Re: Psa velocity

Hi mrpkpatel,
You might want to start a new thread so others might be more likely to see it.

When your PSA rises in spite of low testosterone, it is called "castrate resistance." It means the cancer no longer needs testosterone to grow. At this point, the cancer may start feeding on Casodex if you are still taking that, so it may be wise to stop taking that. That alone may improve your PSA.

You are fortunate that two great new drugs have recently been approved that can greatly enhance your hormone therapy. You didn't mention whether any distant metastases have been detected, but if so, you are eligible for either Zytiga or Xtandi. They will keep the cancer hormone-responsive for a while.

You are also eligible to get Jevtana, a chemotherapy that seems to work much better than Taxotere.

The other ingredient you might want to try is an immunotherapy called Provenge. If it were me, I'd want to attack the cancer from all those directions at once.

To prevent distant metastases, you can take Zometa or Xgeva. Alpharadin, now available for expanded use, can be used if you already have bone mets. The FDA just approved a great new drug called Cometriq a couple of weeks ago for thyroid cancer, but that makes it available off label for prostate cancer too. Getting it paid for may be problematic. It is probably the most promising new drug out there. There are also lots of great new drugs in clinical trial that you can get into.

I hope you are under the care of a good oncologist who is willing to explore these possibilities with you.

- Allen

 
Old 12-11-2012, 09:24 AM   #8
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Re: Psa velocity

Hi mrpkpatel,
You might want to start a new thread so others might be more likely to see it.

When your PSA rises in spite of low testosterone, it is called "castrate resistance." It means the cancer no longer needs testosterone to grow. At this point, the cancer may start feeding on Casodex if you are still taking that, so it may be wise to stop taking that. That alone may improve your PSA.

You are fortunate that two great new drugs have recently been approved that can greatly enhance your hormone therapy. You didn't mention whether any distant metastases have been detected, but if so, you are eligible for either Zytiga or Xtandi. They will keep the cancer hormone-responsive for a while.

You are also eligible to get Jevtana, a chemotherapy that seems to work much better than Taxotere.

The other ingredient you might want to try is an immunotherapy called Provenge. If it were me, I'd want to attack the cancer from all those directions at once.

To prevent distant metastases, you can take Zometa or Xgeva. Alpharadin, now available for expanded use, can be used if you already have bone mets. The FDA just approved a great new drug called Cometriq a couple of weeks ago for thyroid cancer, but that makes it available off label for prostate cancer too. Getting it paid for may be problematic. It is probably the most promising new drug out there. There are also lots of great new drugs in clinical trial that you can get into.

I hope you are under the care of a good oncologist who is willing to explore these possibilities with you.

- Allen

 
Old 12-11-2012, 11:38 AM   #9
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Re: Psa velocity

iam off casodex for almost 4 years now....i will take other points and discuss with my oncologist...thanks

 
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