Note that this is my first OT post ever – I like the 911 Forum much
better. I feel I should add and reinforce here (thanks pwd911s.)
I am a 7-year survivor of my second round with the disease. First
time I opted for radiation therapy. It was pitched to me as
being “less intrusive” by (naturally) a radiation oncologist. Not
only did it not work but damaged other structures.
I had regular 6-month PAS tests and all of a sudden my PSA was
53 and increasing 2.3% of reading per week. I lit in and did my
homework this time. I consulted with all the top Urologic
Oncologists in the country. I read all their papers. I interviewed
them (some weren’t used to that but tough.) Yes, including
Walsh.
After much testing to attempt to determine if there was
metastastic disease (see if it had spread) I opted for Radical
Prostatectomy (surgery.) That worked as hoped and my PSA is
still undetectable (<0.01) after almost seven years. I have no
adverse effects from the surgery.
I am convinced that had I opted for surgery in the first place I
would not have had the very substantial risk of dying form the
disease. Docs will (naturally) espouse the treatment they know
best; surgeons surgery, radiation oncologists radiation therapy,
etc. They are also loathe to bad mouth other therapies. I got to
know the euphemistic phrase “It is up to you to determine the
best therapy for you” as meaning I should follow someone’s
advice. The only way you can make the best decision is armed
with as many facts as possible. Gone are the days where you
nod your head and follow any single person’s advice.
The key is educating yourself. Read the professional papers, talk
to those involved (patients, researchers, docs, etc.) This is a
rapidly changing field and today’s accepted practice may be
changed tomorrow.
Tabs, tcar, joeaska, leader and others are right on with their advice.
The internet is full of worthless junk and just plain bad information.
Be careful. Choose your sources with care. Question everything.
OK, my 2c.
Regular PSA tests are your best advance warning system to
date. These are usually covered by your health plan. I
recommend to my friends (any age) to have quarterly PSA tests.
If your insurance won’t cover that many, they are only $35 if you
beat the bushes. When you don’t have any indication of
prostate cancer you should be collecting this long-term baseline
data. A single elevated PSA measurement is not conclusive. It is
the trend that is indicative of a problem or not.
Lets say you have periodic PSA tests and these are the results:
1.3, 0.4, 1.2, 1.8, 0.3, 1.2, 0.8, 0.4, and 1.3. A little 5th grade
math will tell you the average (mean) is 0.94. If you graph this,
you can see the trend.
IMAGE PSA01
Even if your first test had been 5.0, the mean would still be 1.35.
Looking at the trend you can see that 5.0 would be what the
statisticians call an “outlier” and should be disregarded.
IMAGE PSA02
This is where you should develop consistency prior to PSA tests.
The 5.0 could be due to a 5K bike tour the previous weekend,
great sex the night before, stress, or many other possible
reasons. Don’t believe one test.
IMAGE PSA03
For example you are collecting the results of several years of PSA
tests and all of a sudden you have a PSA 6.0! Not to worry.
Perhaps a few extra tests (“x” marks) will confirm that was an
outlier or the tech misread the result 0.6 as 6.0. A few extra
tests are worth the peace of mind.
IMAGE PSA04
Lets take the example where you had been collecting data 1-20
and you started getting measurements as indicated by the “o”
marks. Note that there isn’t a measurement higher than
previous outliers. It isn’t the absolute number, it is the trend.
When you graph the results, you can clearly see the trend.
Needless to say somewhere about points 23-26 I would start
testing much more often.
Note that 23 is the first point where it is above the new arbitrary
PSA 2.0 number and half the old 4.0 arbitrary number.
IMAGE PSA05
When we track our Porsches, we meticulously graph lap times,
tire pressures, oil temperature, etc. We should do no less with PSA.
Every man dies with Prostate Cancer; no one should die from it.
Best,
Grady