PSA Rising

…whatever that means…

Every man—with or without a prostate—would like a PSA of zero or close to zero. For many prostate cancer survivors (like me) there can be a gradual PSA increase over the years. I have had regular PSA testing for the past 10 years. For more than eight of those years my PSA has stayed about the same; somewhere around four. This was before, during, and after treatment (there were brief dips after surgery and radiation). Zero would have been better but I can live with four. I have lived with four.

Then, in a 12-month period, my PSA started to rise. I switched medications. It kept right on inching up. Five wasn't so bad but in a couple months it was eight. A few months later it was 12, then 13, and finally (I hope) 14. It seems to be stabilized for the moment. Why does this happen? How does this happen? What does it mean? Nobody seems to know. It just happens. What I do know is that the next generation of medications will be a lot more spendy (spendy is a well-known medical term) and with no guarantees.

There doesn't seem to be a consensus about when a PSA number is “high” or “of concern” or “critical.” PSA numbers can range from zero to 2,000 or more. Lower is better, of course, but how high is high? As long as I wake up every morning (not early), walk to the bathroom by myself, visit friends, walk to the mailbox (and back), and drink a glass or two of wine I’ll consider my numbers to be in the “normal range.”

axman

Maybe the PSA saves lives after all - NCI study

Federal Government Reverses Course,Now Sees Benefit of PSA Testing...
NCI Admits its Previous Prostate Cancer Study was ‘Contaminated’ Following the Release of New Data that Shows PSA Test Saves Lives

The nation’s leading authority on cancer has thrown out its own study on prostate cancer screening, now saying that PSA testing reduces the prostate cancer death rate by nearly 50 percent.

In its July 13th bulletin, the National Cancer Institute says findings from the Göteborg Randomized Population-Based Prostate Cancer Screening Trial - a study NCI partially funded in Sweden - shows “PSA screening substantially improves cancer-specific survival without the extent of over-diagnosisand overtreatment.” The Swedish study showed testing reduces the prostate cancer mortality rate by 44 percent. That prompted NCI to admit there was a “significant amount of contamination” in its earlier Prostate, Lung, Colorectal, and Ovarian study (PLCO), which suggested there was no mortality benefit with the PSA test.“Careless mistakes like this may be costing men their lives. You can’t publish that there is no value in getting tested if you don’t have the right data to back that claim up,” said Skip Lockwood, ZERO’s CEO.

“Admitting you were wrong is the first step - the American Cancer Society has yet to swallow its pride and come clean – so now NCI needs to take action to make things right,” said Lockwood.
In the bulletin, NCI says the PLCO data was contaminated because of “men in the trial who had already undergone screening with a PSA test, which a number of researchers have said may preclude the trial from ever demonstrating a cancer-specific survival improvement.” Regarding its new data from the Swedish study, NCI goes on to quote Dr. Eric Klein of the Glickman Urological and Kidney Institute who says the “data suggesting that a baseline PSA in men in their 40s and subsequent PSA velocity (the rate of increase in PSA levels) can predict both lifetime risk of developing cancer and potentially lethal cancers.”