Tag: PSA Test

Day 2,343–A Struggle

On By DanIn Emotional Aspects, Prostate Cancer15 Comments

I’m surprised by how much getting my PSA results 30 hours ago affected me yesterday and today. It’s been a real struggle.

Anger. That’s the word of the last 24 hours. I just want to scream, “Would you make up your fucking mind already?!?! Either come back and let’s battle this cancer shit head-on, or get the fuck out of my life once and for all!!” (Told you I’m pissed.) It’s the uncertainty that comes with each test result that’s getting to me. And the fact that this will happen every four months for the foreseeable future is growing really tiresome.

Logic tells the data-driven part of me that I’m okay—that I’m still considered to be cancer-free for now. It’s probably because I am so data-driven that I’m getting so angered and frustrated. Cancer doesn’t always follow a logical path; it doesn’t always fit neatly into cells in a spreadsheet. I need be better at accepting that fact. (You would have thought that I would have learned this after 6+ years of dealing with this.)

Cancer sucks.

Sorry if I offended with my language, but when I started this blog, it was intended to be a raw sharing of thoughts and emotions, and it’s something that I needed to do today, otherwise my head would explode. Really.

And, no, I’m not wishing for the cancer to come back. I’m grateful that I’m still here and able to whine about it. Truly. I guess frayed nerves, anger, and frustration are small prices to pay for longevity.

 

 

Month 77–The Results

On By DanIn Prostate Cancer1 Comment

The results are in. My latest PSA is 0.08 ng/ml, up from 0.06 ng/ml in December. That’s exactly where the trendline on my geeky spreadsheet graph told me it would be, so I’m not entirely surprised. Not pleased, but not surprised.

What does all of this mean? Who knows. On the good news side, I’m still well below the historically accepted 0.2 ng/ml cancer recurrence threshold. But I’m at the point now where I can no longer convince myself that these elevated PSA readings were just a byproduct of the change in PSA test methodology in March 2015. I’m sensing that something real is afoot here, and it doesn’t bode well.

My appointment with the doctor isn’t until 9 May 2017, so I’ll have plenty of time to think about this in advance and have a battery of questions ready for him. We’ll see if we’ll stick to the four-month test cycle or if he wants to increase the frequency. If we stick to the four-month cycle, my trendline would predict the next PSA to be between 0.09 and 0.1 ng/ml.

The last time we met, the doctor wasn’t willing to act until we got closer to the 0.2 ng/ml threshold. I’ll see if this result changes his opinion or if he’s been more accepting of some of the more recent research on prostate cancer recurrence. (You may recall from some of my earlier posts that several studies using the new ultra-sensitive PSA test showed that crossing the 0.03 ng/ml threshold was predictive of cancer recurrence and that intervention with salvage therapies sooner rather than later was more effective.)

I’m not going to pretend that this isn’t troublesome for me, because it is. But I also know that it’s still too early to go into full panic mode. If we stick to the four-month test schedule and August’s results come in at 0.07 or above, that will be one more data point to reinforce the notion that the cancer is, in fact, on its way back. At least in my mind. If it comes in less than that, I’ll be both happy and frustrated because of the continued uncertainty as to what’s really happening.

The journey—with its sometimes insufferable waiting—continues.

 

Day 2,339–PSA Test Time

On By DanIn Prostate Cancer2 Comments

It’s that time again. Another four months have elapsed and I just had my blood drawn for the next lap on the PSA roller coaster.

Actually, the anxiety leading into this test has been pretty much non-existent. Not that there isn’t any concern; it’s just that I haven’t let it control me. Why get all worked up about something you don’t know the answer to, right?

I should have my results by my next monthly update on 11 April. Stay tuned.

Month 76 – Status Quo

On By DanIn Prostate CancerLeave a comment

The last month has been a pretty busy month with relatives visiting from out of town and giving them the grand tour of San Diego County. There were also some transitions at work that have left us short-handed until we find a replacement for an employee who moved on to pursue his career elsewhere. Translation: Little time to think about pesky cancer.

But it’s approaching the four-month mark for my next PSA test, so those thoughts will be creeping to the front of my brain soon enough. I’ve scheduled my next PSA blood draw for 6 April 2017.

Till next month (with the latest PSA results in hand, hopefully)…

 

Day 2,241–Doctor’s Visit

On By DanIn Prostate Cancer7 Comments

My visit to the doctor this afternoon to review my latest PSA results (0.06 ng/ml) went just as I expected it would:

  1. There’s no definitive explanation for the elevated PSA yet.
  2. The elevated PSA seems to be stable, so no need to panic about recurrence.
  3. Retesting in four-month cycles will continue for the foreseeable future.

I’m okay with all of that. I seem to have turned the corner where I’ll always be concerned about my PSA, but I’m not going to let it control my life. It’s too consuming.

He reminded me of how slowly PSA can change and that we shouldn’t even begin to think about any intervention unless the PSA starts creeping up into the 0.15–0.18 range. That’s fine by me. If we get to that point, I’m going to be much more deliberate in selecting what, if any, salvage therapy would be appropriate given where I’m at in life and the potentially debilitating side effects that impact quality of life.

So I’ll call that visit a positive end to 2016. Let’s hope for a happy, healthy 2017!

Day 2,212 – PSA Results

On By DanIn Prostate Cancer11 Comments

My latest PSA test on 28 November came back at 0.06 ng/ml, up slightly from the 0.05 ng/ml back on 1 August.

That could just be the difference between a new moon and a full moon or simple instrument error. It’s a concern, but certainly nothing to panic over at the moment.

I’m glad to see that I’m consistently hovering in that 0.04–0.08 range, although, if I were to lay a trendline over the data, it would certainly be moving in an upward direction towards that recurrence threshold.

The one nagging thing that hangs over my head is those recent studies that showed PSA at 0.03 ng/ml can be predictive of recurrence. I’ll press the doctor on that again at my appointment on 29 December.

Lastly, I’ve accepted the fact that this will be my new reality: Testing, waiting, and wondering every four months. Not the path I hoped to be on six years out, but it is what it is.

Thanks to everyone for your thoughts, support, and prayers.

psa-tracker-20161130

 

Day 2,210 – PSA Test Time

On By DanIn Emotional Aspects, Prostate Cancer9 Comments

Time to buckle up for the next ride on the PSAnxiety roller coaster. I had my blood drawn this morning for my next PSA test. Now we wait, typically three days before seeing the results online.

On the good news front, I’ve been completely unemotional leading up to this PSA test. I’m not sure why, but it’s been a refreshing change from the last PSA tests.

My appointment with my doctor is on 29 December, and I’ll post my results as soon as I have them (and geekily update my spiffy little PSA chart).

Six Years

On By DanIn Prostate Cancer2 Comments

Six years ago today, I was told I had prostate cancer. Guess what? It’s six years later and I’m still alive and kickin’. Woo-hoo!

PSA Trend 20160803Of course, the cancer storm clouds may be brewing as I head into my next PSA test in a few weeks. Who knows what crazy result it will yield. Remember, in the last 15 months, we’ve gone from undetectable to 0.05 to 0.04 to 0.08 to 0.05. Any bets on the results this time around??

My schedule in early December is quite hectic, so I’ll likely go for the blood draw during the week of 28 November. As usual, I’ll wait three days to get the results online, and then my appointment with the urologist is on 29 December.

Stay tuned. In the meantime, here’s wishing everyone a Happy Thanksgiving with family and friends!

Month 70 – Sharing Awareness

On By DanIn Prostate Cancer4 Comments

We’re about half-way through Prostate Cancer Awareness Month and it seems as there’s been some progress in getting the word out. More organizations seem to be helping to increase awareness than in the past, and that’s a good thing.

I’ll have to admit that my own approach to PCAM has changed slightly. I’m more inclined to tell people to educate themselves before making the decision to test.

Those of us who have been dealing with prostate cancer understand how complex, convoluted, conflicting, and confusing it can be. If you’ve never entertained the notion that you can get prostate cancer, you probably haven’t paid much attention to the raging debates in the field. DRE or no DRE? PSA test or no PSA test? Over-treatment versus under-treatment? Active surveillance versus treatment? That’s why it’s so important to educate yourself before being tested.

One of my former managers always said, “If you can’t stand the answer, don’t ask the question.” Your decision to get screened for prostate cancer is exactly that: your decision. You have to be comfortable with either path you take, and the best way to make that decision is by being educated. Please take a few moments this month—Prostate Cancer Awareness Month—to learn more about prostate cancer and how it can affect you. You can start with my Resources page.

I finally made my family and friends aware of my detectable PSA shortly after my visit with my urologist in August. There was concern from those who responded but, on the whole, the reaction was good. I knew that sitting on this for a year would cause some deserved criticism, too, but they seemed to understand my rationale.

It’s a relief to have it out in the open now. As one of my readers wrote on his own blog, “A burden shared is a burden halved.” Yep. It is. (Sorry, I can’t find the quote again to give credit where credit is due!)

On the whole, I’ve been able to push aside the emotions and thoughts that the cancer may be returning, and it feels good to be reengaged in the world. The next PSA test is in December.

Now if I can just get used to the fact that it’s dark when my alarm goes off in the morning… It wasn’t that long ago that the sun shining through my east-facing bedroom window woke me up and not the alarm. Autumn and shorter days are here! (In San Diego, shorter days are about the only indicator of it being autumn.)

Month 69 – On Reflection

On By DanIn Emotional Aspects, Prostate Cancer, RecurrenceLeave a comment

It’s been a week since my last PSA results came in—it seems like eons ago—and I really have been able to just ignore them for pretty much the entire time. That’s good.

With the yo-yo movement in my PSA over the last 4 tests, I can’t conclude much of anything aside from the fact that there will be more PSA testing in my future.

PSA Trend 20160803

The engineer in me reflected on the last year of testing looking for some logical explanation.

I do remember that a year ago, just before the September test, I made the mistake of having an orgasm within 24 hours of the test. I thought that may have explained in the increase from undetectable to 0.05 ng/ml. But then the doctor threw in the possibility of the new ultra sensitive PSA test skewing the results. Two variables that weren’t present for the previous undetectable test.

For the December and April tests, I eliminated one variable by abstaining from orgasms for a nearly a week before the blood draw. The doctor asked me to abstain for two weeks for the August test, and I did.

If the next PSA test 3–4 months from now stays in the 0.05–0.08 range, I’ll be more inclined to think that this is a result in the change to the ultra sensitive test and nothing more. (Part of me wants to go to another lab for an independent test and see what it produces, but that will just introduce one more variable when we’re trying to eliminate them.)

At 0.05–0.08 ng/ml, I’m still well below the widely accepted biochemical recurrence threshold of 0.2 ng/ml. That generally makes me breathe a sigh of relief, and I think that I can come to terms with living with those numbers if that’s all it is.

But a UCLA study published in May 2015 showed that, under certain conditions, the ultra sensitive PSA threshold of 0.03 ng/ml was a good predictor of recurrence.  Yes, it was a small (247 patients) retrospective study, but that little fact has stuck in the back of my mind and gives me concern. (I wrote in more detail about it in my Day 1,768 post.)

There was also a Johns Hopkins study published in February 2016 that also indicated that low PSA levels measured by an ultra-sensitive PSA test were predictors of recurrence.

So I’m going to just wait until the doctor appointment on 23 August and see what she has to say about all this. It will be interesting—maybe even entertaining.