PSA

Hello Worriedwife 

As far as I was aware the criteria for further action was:

* A rise of +2.00 above your nadir reading.

* 3 Consecutive rises in a row within 6 months.

These are the figures Prostate Cancer UK advise. (I checked them earlier last week for very personal reasons )

So 0.21 - 10/24

     0.27 -  02/25

Me - I would say that's PSA bounce but I think the oncologist will go for another PSA test in May, just to be sure.

If it's any consolation it's nowhere near as big a rise as mine. Keep the positive waves going and I think he will be fine.

Kind Regards - Brian.

Thanks, Brian. So, he’s had 2 of his 3 chances with 2 rises in a row albeit Ithink we should allow for the bounce after coming off HT (wishful thinking here!) As you so rightly said - ‘the journey continues…..’ I think you may be right - another test in 3 months  I hate this perpetual uncertainty, do you?

Hi WW

I think after HT is over PSA is always going to go up a bit,  .21 is not high and as you have said it has gone up .06 to .27. still very low.

The next one may mean a bit more and suppose if PSA no 4 (after HT finished) is up again then re think it but wouldn't be too worried at the moment, easy to say I know.

Fingers crossed for the next PSA

All the best

Steve 

Good evening WW. I had a memory of what the definition of a bounce was and can only find an old article which defines it as an increase of 0.2, 0.4 .....over 6 months with a subsequent decrease.

https://pmc.ncbi.nlm.nih.gov/articles/PMC5075994/#:~:text=This%20phenomenon%20called%20a%20PSA,after%20brachytherapy%20than%20after%20EBRT.

There is also a meta analysis which gives a bit more information on the bounce which shows that the size of it is over what your husband is experiencing at the moment.

https://pmc.ncbi.nlm.nih.gov/articles/PMC7465291/

Your husband has shown an initial increase which I think is more to do with coming off HT but the second increase is relatively small. Also the PSA can fluctuate slightly so at the moment it is too early to think that it is a recurrence. 

Thank you for the reassurance, Steve. Yes, for me it’s the fear of him having to go back on to ht. he really struggled with it with each and every passing month, week, day seeming to be worse. I feel I lost him in the midst  ( and mist!) of it all . He aged dreadfully. I suppose we will get to know more when we see the oncologist the week after next. He doesn’t seem bothered so I’m not showing my anxiety to him. 

Thank you AH. I have to admit that I found the papers difficult to understand - I am neither mathematician nor scientist! But, I do recognise and value your own skills and so will take on board your words ! His increase has been 0.24 over 9 months so perhaps we are in difficult territory? 

I think  too early to be worrying about going back on HT although I understand the concern obviously.

Possibly after HT finishes it can creep up for a while (and it is only creeping).

So long as no large increase, for now that's probably the main thing

All the best 

Steve 

Hello Worriedwife 

I know how you are concerned for your husband and quite right too as he had a bad time of it - but I think he will be fine - I think the oncologist will go for a retest in 3 months and he will be fine.

Worriedwife said:

I hate this perpetual uncertainty, do you?

At the start 182 (my PSA on diagnosis) was just a number to me - as time has gone on - my knowledge has increased and working Community wide now - I have accepted that I have been "lucky" with 3 years HT/RT. For the last couple of years I have said to Lorraine "this ride isn't over". Having had a "close shave" at the very start of my journey I don't worry anymore (Lorraine does it for me!!).

Enjoy the weekend and relax.

Kind Regards - Brian.  

I don't think so. The rise is at the lower end of determining whether there is a recurrence. A bounce, if it occurs, is usually between 12 and 24 months after recieving radiotherapy. An increase in PSA can occur as a result of coming off the hormone therapy so different responses can occur at different times but they could also coincide. I would ask for another PSA in 3 months to see if the level is stabilising or give a better idea of the rate of increase which can be used as a predictive tool. The radiotherapy will still be working so it is a balancing act to try and determine the difference between stabilisation and recurrence and to avoid over-treatment.