Day 2,948 – PSA Results

My slight sense of optimism that I gained after my last consistent PSA result was shattered at four o’clock this morning when I hopped online in a fit of insomnia to check my PSA test results from this week. I’m back on the upward climb again with a PSA of 0.13 ng/ml.

PSA 20181203 clean

My spiffy spreadsheet predicted a value of 0.129 ng/ml, so it wasn’t unexpected. Just my hope for a more stable PSA went out the window.

Obviously, I’ve got some serious thinking to do in the weeks ahead.

The predictive part of my spreadsheet shows the increase will continue at a rate of about 0.011 ng/ml every four months. In April, I would be at 0.140 and in August at 0.151. Is that rate slow enough to delay any decision about salvage radiation therapy a while longer? I don’t know.

Do I get involved with the imaging trial at UCLA to see if we can determine where the cancer is before undergoing salvage radiation therapy? I don’t know.

Or do I just say screw it and start the salvage radiation therapy in early 2019? I don’t know.

Stay tuned for the answers. That, or for pictures of ostriches with their heads buried in the sand.

9 thoughts on “Day 2,948 – PSA Results

  1. Ken G

    Dan, I’m real sorry to hear about the rise, Even though, as you said it was not unexpected. Forgive me if I’m being repetitive I don’t know if I’ve mentioned it before but when I was debating whether to do salvage radiation and HORMONE therapy, I spoke with the radiation oncologist who both advised to act at .07 , once a clear trend was established, saying that recent studies show that earlier is better.

    I feel your angst, at the thought of radiating a spot not knowing if that’s really the trouble spot. I had the same angst. In the end I decided I didn’t want to have to look back and say should’ve would’ve could’ve

    FWIW, my list of 40 radiation treatments was on November 16th. My last shot of Lupron was November 20th. The side effects of hormone therapy, or annoying at worst. I’ve gained about 5 pounds, and I get the hot flashes and sweats, but they are mild short and manageable.
    And the side effects of the radiation treatments were zero, zero, Nada. Maybe they are still to come, but right now I’m down south for the winter and enjoying every day, especially knowing I don’t have to do a PSA test until April or May.

    Maybe my experience will help you in your struggle to make a decision I hope so, but I don’t have to tell you it’s a very personal decision that only you can make. Best of luck whatever you decide

    Ken.

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  2. Clark Fishback

    Bummer about the increase of your PSA. I had the same thing happen a year ago. It slowly started to creep up 4 years after surgery so a month before 5 years out I opted for radiation . I did salvage radiation and hormone therapy over the holidays last year. 33 days of radiation was not too bad. You get a warm blanket and any music you like while the machine does its thing. The hormone therapy sucks unless you already have no testosterone! I guess the ugly part is anticipating the next PSA in February. I always get edgy before I go in.

    I don’t know about you, but after the recurrence I pretty much think about it sometime during every day. And I am truly a glass is half full guy. It just pops into my mind.

    I wish you good luck on your next round!!

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    1. Hi Clark,

      Thanks for sharing your experience. I definitely relate to the anxiety before each PSA test—it’s just part of the deal, I guess. I also hear you about cancer popping into your thoughts daily. It’s been the same for me, although I’ve gotten to the point where I do my level best not to dwell on it. It seems to be working for the last 4 months; these results will likely change that for a while to come.

      Dan

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  3. It’s clear you still have a good attitude, which is really helpful. The decision you’re facing has no clear best choice. Ultimately, I think you’re going to forced make it based on your gut feel.

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  4. The consideration that argues for the imaging trial first is that you may find out where it is. If you go with “blind” irradiation, will they be able to tell early on if they got it, presumably by dropping PSA?

    Liked by 1 person

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