Re: PSA Clarification

[Guest guest]

Tammy

Sorry that you have had to join us. There are 2 new members who have dads who have recently been diagnosed who have just joined us. We are here to support you with info and we also try to empathise at this traumatic time.

Let's look at this steadily.

Your dad has a battle on his hands with such a high PSA to start with and having secondaries already.

Now the good news. The hormone manipulation therapy has worked better than expected, with a very low nadir (bottom figure).

Much depends on for how long this treatment works. What we tend to do in the prostate cancer field (patients and medics) is to go for the treatments with least side effects first. There are other treatments - eg using 2 or 3 hormone manipulation drugs at the same time.

It would be good to know if Dad was given a Gleason score. This is a score out of 10 and gives a concept of the agressiveness of the cancer.

As long as the hormone treatment works it will reduce the growth of cancer cells and may cause the death of some normal cancer cells, though the stem cells from which other normal cells can develop after a dormant period, will not be killed off.

I think that the best way of describing this is that the drugs have put the cancer to sleep. The length of time that the treatment is effective varies immensely. It can be months or 10s of years. I have to say I know men who were diagnosed with similar stats who were or are still alive 10 years later so there is lots of hope about.

Just a quick word on how these drugs work.

It is likely that the drug is Lupron or Zoledex implants. This first causes an over production of testosterone by the testes, then they shut down. Testosterone is seen as a growth promoter for prostate cancer cells. Some men's bodies learn how to make testosterone by the pituitary glands. Hence the use of drugs like Bicultamide to lock with the molecules of testosterone and stop it being avaiable as a growth promoter.

Next it is import to say that if dad is any pain, this needs to be dealt with for his comfort.

Let us know if we can support you more. Also if you need to sound off, we'll understand why!

Best wishes

PSA Clarification

My Dad was diagnosed back in Sept of this year with stage 4 Prostate cancer that has spread to his bones. His PSA level was then 450.He has since been on hormone therapy. He just got his new PSA count results last week and they dropped to 0.45First reaction was elated joy and tears of relief.Now, after stepping back and thinking about this, I am confused....To me, PSA # (Prostate Specific Antigen) would mean that that is only the cancer cell count for his prostate...is this correct?If so, what about the cancer in his bones? Will this continue to spread or has this gone dormant as well?Any advice you can give would be greatly appreciated at this time as I am new to this site.Thanks to all!-Tammy

[Guest guest]

Tammy,

has given you an excellent explanation of your Dad’s

position. Although he has a serious diagnosis which will require management –

hopefully for many years – the good news is the speed and level to which

the PSA dropped.

All the best,

Terry

Herbert in Melbourne, Australia

Diagnosed ‘96: Age

54: Stage T2b: PSA 7.2: Gleason 3+3=6: No treatment. November '06 PSA 31.4

My site is at www.yananow.net

As a

physician, I am painfully aware that most of the decisions we make with regard

to prostate cancer are made with inadequate data: Dr

“Snuffy” Myers.

From: ProstateCancerSupport

[mailto:ProstateCancerSupport ]

On Behalf Of Tammy

Sent: Thursday, 30 November 2006

5:11 AM

To: ProstateCancerSupport

Subject: PSA Clarification

My Dad was diagnosed back in Sept of this year with

stage 4 Prostate

cancer that has spread to his bones. His PSA level was then 450.

He has since been on hormone therapy. He just got his new PSA count

results last week and they dropped to 0.45

First reaction was elated joy and tears of relief.

Now, after stepping back and thinking about this, I am confused....

To me, PSA # (Prostate Specific Antigen) would mean that that is only

the cancer cell count for his prostate...is this correct?

If so, what about the cancer in his bones? Will this continue to

spread or has this gone dormant as well?

Any advice you can give would be greatly appreciated at this time as I

am new to this site.

Thanks to all!

-Tammy

[Guest guest]

<snip>

> To me, PSA # (Prostate Specific Antigen) would mean that that is

> only the cancer cell count for his prostate...is this correct?

> If so, what about the cancer in his bones?

I'm not sure if this part of Tammy's question was answered in the

replies so far. I had a similar question about post operative PSA:

If the cancer has spread outside the prostate, how can we detect it

with a PSA test? Here is what I was told: Prostate cancer cells

retain their identity even after infiltrating a non-prostate

structure such as bone or another gland. So, even though my prostate

is gone, we can still detect, through a PSA test, traces of cancer

that originated from it and set up shop elsewhere. Therefore, and

please correct me if I'm wrong, Tammy's Dad's bone cancer is really

prostate cancer in the bone and PSA# accounts for prostate AND bone

cancer, assuming the bone cancer came from the prostate and not some

independent source. So, there's little to worry that prostrate cancer

is under control while bone cancer is growing undetected. I think

that was her concern.

Best regards,

Tony Higgins

[Guest guest]

Tammy,My response is marked with '>>>'. Just to level set, I am 43, have Stage 4 as well and have been managing it for almost two years.My initial numbers in Feb 2005 were:PSA 219Gleason 7-8Bone Mets covering spine, pelvis, thigh, small area in ribs.One set of lymph nodes shodl involvement as well.Within 6 weeks of starting Lupron/Casodex PSA dropped to 2.1, eventually falling to .35 after 5 months.I add all this jsut let you know where my responses are coming from.~~~~~~~~~~~~~~~~~~~~My Dad was diagnosed back in Sept of this year with stage 4 Prostate cancer that has spread to his bones. His PSA level was then 450.

He has since been on hormone therapy. He just got his new PSA count results last week and they dropped to 0.45

First reaction was elated joy and tears of relief. >> First, be joyful that his body reacted so quickly! As you may have read or been told, and I hate to even write this, what you dad I and I have is not curable. When Prostate Cancer reaches this stage it is only treatable or manageable. Sorry, I know it's hard to hear that, believe me at 43 it still brings tears to my eyes when I write it.That being said I'll agree with other responses you have already recieved, it can be managed and in some cases 10 years or more. It won't be easy, there will be set backs but you and your dad need to remain postive. 10 months after diagnosis my PSA started to climb and my Oncologist was ready to start Chemo. Before doing so I had updated bone and CT scans and guess what? My spine was almost clear, lymph nodes

were clear and all other mets showed decrease in size and no new areas were found.Now, after stepping back and thinking about this, I am confused....

To me, PSA # (Prostate Specific Antigen) would mean that that is only the cancer cell count for his prostate...is this correct?

If so, what about the cancer in his bones? Will this continue to spread or has this gone dormant as well?>>> No, what this means is the number of PC cells circulating in his blood stream has decreased. The bone mets are basically tumors. The only way to measure them is via a bone scan. What I was told is this, the longer the PSA number is kept down, the more impact is will have on the mets. In order to sustain the mets need to be fed new prostate cancer cells. In some areas the lack of new cells will dminish the met completely, in other area it may just halt any new growth in the area. Testosterone blocker (Lurpon etc.) can work for many years but at some point it will fail. The prostate cancer cells will find another vehichle to circulate. At this point there are a few other options: different types of blockade drugs (though I have not read any cases where this has worked? Not

to say that it hasn't). Also the doctor may, as in my case, try a combintation of Ketoconozal and Hydrocortizone. My number had climbed back to 83 in September and before trying chemo we decided to try this combination. It has worked, my PSA number dropped in October and November to 51 and 43 respectivley. High yes, but it beats the hell out of chemo. For guys like your dad and me chemo is the last option. Currently the standard treatment is Taxotere and Predisone. It is usually administered once every three weeks. The predisone, an oral pill, is usually taken daily during treatments. The three week cycle is repeated for 8-10 treatments. This again is not a cure but another stop gap to try to get the PSA number (number of cells in the blood stream) down again. I could add more but I think I answered your questions, in face I might have given you more information than you wanted? In the midst

of all this chaos, don't lose HOPE! Let me know if you have more questions and feel free to contact me directly. I don;t know it all by any means but I do know quite a bit about advanced cases. Emerson

[Guest guest]

My psa was at 505.9 when I finally was allowed to come in to clinic in March

of 2003.

There was a lot of spinal damage. But I am still alive and with the help of

physical therapy I was able to learn to walk again. I was trated with beam

radiation as well as Casodex and Lupon anti androgens.

The tough answer is that there is no way to tell how much time is left or

how much suffering will occur. You just have to keep going, consider the

options and side effects and do what you can to enjoy your time here.

on 3/3/07 11:17 PM, amy_jakey at amy_jakey@... wrote:

> ,

> I am new here. My Dad has stage 4 Prostate cancer, it is in his

> bones, and he has spots on his lungs, ribs, kidneys. His most recent

> PSA was over 300.

> My step Mom tries to explain to us as treatment goes along, but I

> really want the hard truth. How much time? What kind of suffering?

> What will happen along the way to his body? I know this all sounds

> harsh, and I am sorry for that. I just need to understand these

> things, but no one wants to tell me. I need to know so I can

> prepare...for me and my two young children.

> Thank you.