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ross62 10-13-2011 06:28 AM

PSA reading of 222.5
Hi All Got Psa Reading Of Over 200 Today , have no usual symtoms
Lost 20kgs In Less Than A 3 month.
GP Says 1000% Chance Its Cancer Anyone Similar Is This
Number Possible.
Have Also Had Pain In Left Leg And Back.
Any Replies Greatly Appreciated

Cheers Roscoe

Baptista 10-13-2011 04:06 PM

Re: PSA reading of 222.5

I never heard of a PSA that high being related to other than prostate cancer. The alarming aspect is that you have symptoms of pain (leg and back), which if found to be related to the cancer it would diagnose you in an advanced stage T4. PSA=222.5 is not new. There have been many guys reporting PSAs in the thousands mark.

You definitely are in need of finding more details about the problem with more tests and image studies. Only a biopsy will rule cancer and will give you info on its aggressivity.
Nevertheless, there are successful treatments to control cancer in advanced cases with high PSAs. Do not be anxious but act the soonest.

Welcome to the board.
Wishing you good luck on your journey.

Baptista ;)

IADT3since2000 10-14-2011 09:10 PM

Re: PSA reading of 222.5
Hi Roscoe,

I'll join Baptista in welcoming you to the Board, and I'll add some thoughts in green. Baptista already covered some important points.

[QUOTE=ross62;4860646]Hi All Got Psa Reading Of Over 200 Today , have no usual symtoms
Lost 20kgs In Less Than A 3 month.
GP Says 1000% Chance Its Cancer Anyone Similar Is This
Number Possible.[/QUOTE]

[COLOR="DarkGreen"]I had the same reaction when I got my first ever PSA; it was 113.6, which was a shock as I thought 10 was the top number possible. Odds are high that the GP will turn out to be right, but it isn't open and shut. Infection has been known to drive a PSA to over 200, though it is rare. Also, a month ago one of Canada's leading surgeons, Dr. Klotz, told an audience about a man who was an avid biker, and his PSA was over 1,000. All of that very high PSA was due to the biking, and his PSA returned to normal when he ceased riding his bike![/COLOR]

[QUOTE]Have Also Had Pain In Left Leg And Back.
Any Replies Greatly Appreciated

Cheers Roscoe[/QUOTE]

[COLOR="darkgreen"]The high PSA, combined with the pain in leg and back and the weight loss are concerns. Do you have an explanation for the weight loss?

As Baptista said, there are approaches that are likely to help no matter what your circumstances.

Take care,

Jim :wave:[/COLOR]

bartonse 10-18-2011 10:39 AM

Re: PSA reading of 222.5
My father in-law-was diagnosed with prostate cancer in July with a PSA level of 320. He's having regular estrogen hormone injections as the cancer had spread to his bones but so far so good!

He's been told it's not curable, but it can be treated in various ways so he's feeling positive and seems to be feeling better already!

ross62 10-18-2011 01:50 PM

Re: PSA reading of 222.5
Hi All was unable to reply sooner as i have been away,thanks for the replies
have had scans now and they show multiple nods in my stomach .
don;t now size or number yet, have changed diet drastacly ,
and am keeping fingers crossed .
cheers roscoe

ross62 11-27-2011 07:16 PM

Re: PSA reading of 222.5
Had Biopsy and have a gleason score of 9, have started hormone treatment and have no bad side effects yet,fingers crossed the psa goes down

cheers roscoe

Baptista 11-28-2011 03:41 PM

Re: PSA reading of 222.5
[QUOTE=ross62;4885893]Had Biopsy and have a gleason score of 9, have started hormone treatment and have no bad side effects yet,fingers crossed the psa goes down

cheers roscoe[/QUOTE]


I am glad to know you started a treatment. Gleason 9 is for high risk cases and for aggressive type of cancer. You may now investigate about any other treatment that could be beneficial with the HT to handle your case.

Can you share more details on your diagnosis?
How many needles were taken in the biopsy?
What scans have you done? Bone scintigraphy? MRI?
Which drugs are you taking in the hormonal treatment?

Many guys here can help you understanding the facts in your journey but you need to share more info.

I hope that HT will arrest your PSA down and that the pain subsides.

The best to you.
Baptista ;)

IADT3since2000 11-29-2011 06:52 PM

Re: PSA reading of 222.5
Hi again Roscoe,

I too am glad you are under treatment.

Baptista asked some key questions, and I'll add a couple of other thoughts. We are not medical professionals, but over time we pick up what is typical and what is not. The stomach is an unusual place for metastases from prostate cancer. (I'm assuming that metastases is what you meant by nodes. Right?) Is there evidence that prostate cancer is in those "nodes"? Could it be something else? It's clear from the biopsy that you have prostate cancer, but you might have something else too. Your weight loss is a concern, though to someone who is not a medical professional, like me, it is plausible that a stomach problem could explain the weight loss.

just get a sense that there is more in your case that needs explaining to make sure the treatment is right. Is it possible for you to get another opinion, from an expert?

Take care,

Jim :wave:

ross62 11-29-2011 07:22 PM

Re: PSA reading of 222.5
Hi I Will Try and Get The Information Down Now ,
Dre Examination Gland Hard And Obviously malignant.
CT scan on The 17/10/11 Revealed pelvic lymphadenopathy
Whole body bone scan Revealed possible metastases in the Thoracic Spine And Right Hip Region.
(1-12) Prostatic Trus Biopsies; (CONCLUSION)
Gleason Score 9 (Major 4 + Minor 5) with tumor involving left base,left 2, left 3, left 5, left 5, left transition zone, right 3, right 5 and right transition zone:
Tumour is bilateral and involves 25% of tissue received (tumor present in 9 of 12 biopsy sites).
Awaiting Results from CTscan and xrays Of Spine And Hips.

Have been taking Androcur 100mg tablets for a week ,at the two week mark I have a Injection of Lucrin 30mg (4 month) then 2 more weeks of androcur and retest PSA.

Biopsy Microscopic Description
left base --- 60% GS 4+5=9
left 2 --- 70% GS 4+5=9
left 3 --- 80% GS 4+5=9
left 4 --- 10% GS 5+4=9
left 5 --- 30% GS 5+4=9
left transition zone --- 60% GS 5+4=9
right 3 --- <5% 4+4=8
right 5 --- <5% 3+3=6
right transition zone ---5% 4+4=8
The remaining 3 specimens consist entirely of benign prostatic glands and stroma.

Thats all the test results i think .
Cheers Roscoe

Baptista 11-30-2011 02:34 PM

Re: PSA reading of 222.5
Ross62 (Roscoe)

The info you share indicates you as a stage IV patient :( probably systemic. This is an advanced status in prostate cancer which requires an aggressive treatment.
Most probably, your doctor will try to arrest the cancer with hormonal treatment firstly and then follow with chemotherapy.

The protocol with an antiandrogen (Androcur) plus an LHRH agonist (Lucrin) will lower the PSA but it may not be enough to arrest the cancer into submission, if you stop taking the antiandrogen at the one month mark. In advanced cases it is common to have the patient on [B]constant[/B] double blockade. Some doctors still add a 5-alfa reductase inhibitor for a total blockade protocol.

The aim is to avoid feeding the cancer with testosterone (cancer survives on it). The LHRH agonist will cause the testes to stop producing testosterone (chemo castration) and the antiandrogen will avoid the testosterone from attaching to cancerous cells receptors (their mouths). The 5-ARI will interfere with the production of dihydrotestosterone which is a more powerful form of testosterone.

You will require adding a bisphosphonate drug like Zometa to treat the existing lesions in bone (induce osteoblast). The hormonal treatment will weaken the bone to a certain extent which may influence cancer to further metastasize.
There is a newer drug named Xgeva (denosumab) which has successfully treated cancer in bone and at the same time, alleviated pain. Your may inquire with your doctor about the drug, because it can be taken together with the other drugs. He may be thinking in radiation to the lesion at the thoracic spine.

Diet and fitness (physical exercises) play a big role in the treatment of side effects from drugs. I recommend you to get a copy of the following book which deals with systemic cases similar to yours;
“Beating Prostate Cancer: Hormonal Therapy & Diet” by Dr. Charles “Snuffy” Myers

You can read about the drugs details typing their names in a net search engine. You can also search about hormonal therapy and its side effects typing the sentence in this forum or in the net.

I wish you success in your journey.

Baptista ;)

ross62 11-30-2011 03:33 PM

Re: PSA reading of 222.5
Thanks for the info baptista
should get results for scans that zero in on problem areas ,and the urologist will discuss treatments then.
I am just glad that something is happening now
thanks again to everyone for this site it makes alot
clearer to me.


IADT3since2000 11-30-2011 04:17 PM

Re: PSA reading of 222.5
Hi Roscoe,

I've just read your latest post and Baptista's thorough reply that covers important points. I want to emphasize his point that the antiandrogen be maintained throughout the hormonal blockade process; the medical oncologists I have followed as experts for years are convinced that is most important for an advanced patient.

They also believe that the 5-ARI drug, mentioned by Baptista, should be part of the program. By preventing almost all of the conversion of any remaining testosterone (some is produced outside the testes) to DHT, the 5-ARI drug accomplishes a key role: it prevents DHT from pushing aside the antiandrogen. DHT is much better at binding to the cancer cell androgen receptors (the "mouths") than the drug; therefore, if there is significant DHT in your system, the cancer cells will still be fueled. On the other hand, if the DHT level is sharply reduced, the antiandrogen drug can do its job of blocking the cell's mouth so testosterone cannot fuel the cancer. I have been on a 5-ARI drug (first Proscar, then its generic version finasteride, and recently Avodart) from September 2000 until the present. My only therapy for a challenging case has been androgen deprivation, which shifted in the first year from single (Lupron, probably like your Lucrin), to double (added Casodex, similar to your Androcur), to triple (added Proscar). I have also been on a mild bone density drug (bisphosphonates for me) for most of the time. My case is challenging, but considerably less so than your case is. I have done very well.

I too believe that adding Zometa, a drug given by infusion, should be seriously considered both to protect bone density and to help slow down, stabilize or even reverse bone metastases. As Baptista mentioned, there are some more recent alternatives that may offer equal benefit and lower risk of side effects. Another alternative is transdermal (through the skin) estrogen patches.

I'm glad your urologist has at least used partial double blockade. However, urologists are essentially surgeons, and they are usually not as familiar as are medical oncologists with the best use of drugs for prostate cancer. You might want to get another opinion from a medical oncologist, especially one who treats a lot of prostate cancer. I was with a good urologist initially, but it became clear to both of us that he just was not familiar with the issues for a challenging case that needed deft use of drugs. One problem is that urologists sometimes think they are experts with drugs when they really are not. (On the other hand, you would not want a medical oncologist performing surgery on you.)

In addition to the excellent book mentioned by Baptista, another excellent book that covers key tactics for avoiding or minimizing side effects is "Invasion of the Prostate Snatchers" by Ralph Blum and Dr. Mark Scholz.

I'm still puzzled by the problems noted in your stomach area.

Take care,

Jim :)

ross62 12-14-2011 02:24 PM

Re: PSA reading of 222.5
Hi All Back Again ,had lucrin shot 100mg ,suffering pain from shoulder to elbow, getting worse ,
changing doctor and may get rid of uroligist,
I have one question, does the bone scans by ct scan show bone density or is this another test, starting to think the uroligist only cares about the cancer and nothing else, seeing a new gp next week and will ask to see a oncoligist , keeping active seems to stop alot off the tirednees but usually need a nanna nap for One Or Two Hours

zebra57 01-07-2012 01:10 PM

Re: PSA reading of 222.5
To have bone density checked, you will need a DXA scan. It's a quick, easy test. Definitely indicated while you are on the hormone blockade. The ideal test will be with you laying on a table while the scan is done. Don't let someone get away with doing a quickie scan on your wrist or heel bone. Those won't be enough to see how your spine and hip are doing.

Hope you are able to find the specialists you need.

ross62 02-08-2012 12:56 PM

Re: PSA reading of 222.5
Hi Jim my stomach problem is vasalvagus episodes, two months of hormone therapy and PSA Has Gone From 222 To 13 Very Happy and Relaxed .

Cheers Roscoe

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