Timestamps for this video: 0:40 What does a sudden spike in PSA usually signify? 2:58 How are lab errors usually detected? 5:08 Which physical activities can affect PSA levels? 6:25 Is it advisable to get a PSA recheck before opting for a PSMA scan? 7:40 What degree of PSA spike usually indicates a lab error? 8:14 How long should a patient wait in between PSA readings? 8:48 How long should a patient wait after a high PSA reading before getting a PSMA scan? 9:41 Is there a kind of PSA test that is the most accurate or advisable? 10:42 Are ultra-sensitive tests the standard in modern PSA testing? 11:17 How can you tell the difference in PSA test readings? 11:39 Are other assays more useful than the PSA test for post-treatment monitoring? 12:42 Alex's conclusions
Stage four castrate resistant metastatic prostate cancer. Been through all the hormonal treatments and they held my psa around 10 for ten months. The meds failed and my psa jumped to 98 then 300. Started pluvicto 16 weeks ago after first treatment psa was 390 after second treatment went to 598. I’m currently in the hospital because of leg weakness and pain and psa has spiked to 1622. I have third pluvicto next week but may not be able to get it because my blood counts and platelets have dropped considerably. Hope this helps people who are struggling with this issue praying for all of us ❤
The last point made in this video is spot on! I'm well beyond three years of prostate removal and still doing excellent. I'm anxious just thinking about the "what ifs"
I agree with you about the last part of the post. My mental state is SO fragile when it comes to my PSA. Because when my numbers started rising in March of 2021, my pcp AND urologist were very nonchalant about the PSA and its importance to my health. “ come back in 3 months “ they said… well… when I was greated with a PSA of 38, and it jumped to 68 2 weeks later… So, yeah, the PSA discussion is definitely a trigger… but I am very grateful for the support you give us.
After 10 years my PSA had been slowly creeping up. March 2020 0.52, Feb 2022 0.76, Feb 2023 1.38, March 2024 3.29. Then they decided to give me a scan. It had spread up my lymph nodes around my aorta nearly to my oesophagus and to one of my ribs as well. I can't help feeling that they should have started looking sooner then maybe more could have been done to zap it in it's infancy. Now it's advanced and I know it is not going to be a good ending. So it's hormone injections and Enzalutamide for the time being until that doesn't work.
Most helpful video, the balance your video’s provide is most reassuring. Thank you for the time you all commit to making these presentations. Best regards
The grey area is when PSA is rising but still below the level where pet psma detects where it now is. So do you let cancer grow larger in order to find out where it is (although it may also be elsewhere, but smaller, or during that waiting it may establish elsewhere as well) or do you do abandon pet psma and do whole pelvic radiation, plus ADT and hope the diffuse treatment is effective. Or do you start adt for a while, up-regulate psma expression, then do a pet psma scan. Is there a standard of care for this scenario.
Spot on when it comes to pretreatment bumps or rises in PSA caused by exercise. If you engage in a sport where the legs move in a way that puts pressure on the prostate (kicking in swimming, kicking in Karate, etc.) you can get a substantial spike in your pretreatment PSA.
This is SO currently relevant about PSA interpretation of PSA lab data. This is a OVERLOOKED consideration of the confusing PSA fluctuation data that happens. Prostate Cancer is a devious form of Cancer... That even the Expert Doctors do not understand.
I started with Labcorp for first few tests and then when I went to Emory University Hospital to see a new urologist they have their own lab. I got a number waaay lower than anything previous. I think samples got switched or something. Went back to Labcorp now 3.5 years. Love Emory, l have had many procedures there, just recently Inspire implant for moderate obstructive sleep apnea. Everything went perfectly now still getting used to the tongue stimulation. Right now l have low blood platelets 110 versus lowest normal being 150 and pretty much no other blood issues or symptoms of low blood platelets. 3 tests over last 5 months all low, never before that. B12 is fine. Abdominal CT scan with contrast was unremarkable with no suggested follow up. Now bone marrow biopsy in 2 days. I read radiation can cause this, that was 2 years ago to the day practically. 35 grey in 5 sessions mri- linac. I have a great doctor, one of the best hematologists in Atlanta.
We have many support groups! Find one that feels right for you: pcri.org/supportgroups ancan.org/prostate-cancer/ zerocancer.org/help-and-support malecare.org/support-groups/
Another good video. Had TURP surgery July 2023, yet my PSA remains elevated (most recent reading of 27) and has not decreased which is the normal scenario post-surgery. Categorized as Gleason 3 +3. PSMA Pet scan revealed nothing of note outside the prostate. My urologist is concerned about this and has suggested treatment but I am holding off until my next PSA test and subsequent biopsy. Has something possibly been missed here?
I have had an indwelling catheter for a year, had Triple Therapy, ADT, injections and pills, radiation over the last year. PSA went down from 200 to 7. How much will the Catheter affect the PSA.? Prostate was never removed.
I have a question: Can a PSMA PetScan differentiate between actual prostate cancer and residual prostate tissue left behind after a nerve-sparing radical prostatectomy done over 20 years ago?
I had a prostatectomy in 2015.Everything was well with 0 PSA and everything normal with gradual rises through the years.The last year or so it has risen from 0.270 to 0.520.Doc had me do a PSMA Pet scan which showed no cancer,but although unseen my Doc still thinks its cancer in the Prostate Bed.He sends me to radiologist for counsil and says he will zap the prostate bed though cancer is unseen.Are my Docs right about this or is the Pet Scan.Does the cancer have to show it's ugly self first before it gets serious?Appreciate any output for this 74 year old confused man.
I have been down the same road as you my psa also went back up to 0.52 had a pet scan which showed nothing in the end i had rad to the prostate bed and the pelvic area . just over a year later psa is going back up i would wait and have a pet scan again in 6months and wait till it finds the cancer .At 74 you will have along life and all will be ok i will be 58 at xmas and plan to get to 74 .
That's why there are further checks when the PSA is rising. Frequently it is an indicator of cancer unless your activities involve something that could raise your PSA
My elevated PSA led to cancer diagnose 2 years ago.Doctors were reluctant to order a biopsy.I was decided to have it done anyway.Best to weigh on the side of caution when it comes to your health.
I agree with you about the last part of the post. My mental state is SO fragile when it comes to my PSA. Because when my numbers started rising in March of 2021, my pcp AND urologist were very nonchalant about the PSA and its importance to my health. “ come back in 3 months “ they said… well… when I was greated with a PSA of 38, and it jumped to 68 2 weeks later… So, yeah, the PSA discussion is definitely a trigger… but I am very grateful for the support you give us.
Timestamps for this video:
0:40 What does a sudden spike in PSA usually signify?
2:58 How are lab errors usually detected?
5:08 Which physical activities can affect PSA levels?
6:25 Is it advisable to get a PSA recheck before opting for a PSMA scan?
7:40 What degree of PSA spike usually indicates a lab error?
8:14 How long should a patient wait in between PSA readings?
8:48 How long should a patient wait after a high PSA reading before getting a PSMA scan?
9:41 Is there a kind of PSA test that is the most accurate or advisable?
10:42 Are ultra-sensitive tests the standard in modern PSA testing?
11:17 How can you tell the difference in PSA test readings?
11:39 Are other assays more useful than the PSA test for post-treatment monitoring?
12:42 Alex's conclusions
Could a video be done please at some point on how early can a prostate cancer spread once it goes to a 3+4 or 4+3 or a 4+4
Stage four castrate resistant metastatic prostate cancer. Been through all the hormonal treatments and they held my psa around 10 for ten months. The meds failed and my psa jumped to 98 then 300. Started pluvicto 16 weeks ago after first treatment psa was 390 after second treatment went to 598. I’m currently in the hospital because of leg weakness and pain and psa has spiked to 1622. I have third pluvicto next week but may not be able to get it because my blood counts and platelets have dropped considerably. Hope this helps people who are struggling with this issue praying for all of us ❤
Praying for you brother ❤
Praying and hope the drugs kick in and work god bless.
Praying for you my brother...
🙏
🙏🏾
The last point made in this video is spot on! I'm well beyond three years of prostate removal and still doing excellent. I'm anxious just thinking about the "what ifs"
Alex, you are a great interviewer, I love your precision and clarity!
I agree with you about the last part of the post. My mental state is SO fragile when it comes to my PSA. Because when my numbers started rising in March of 2021, my pcp AND urologist were very nonchalant about the PSA and its importance to my health. “ come back in 3 months “ they said… well… when I was greated with a PSA of 38, and it jumped to 68 2 weeks later…
So, yeah, the PSA discussion is definitely a trigger… but I am very grateful for the support you give us.
Another fantastic video. Thank you!❤
Very useful video -- thanks, PCRI! Don't know what we would do without you ❤
As always speaking truth! Thank you for all that you all do.
After 10 years my PSA had been slowly creeping up. March 2020 0.52, Feb 2022 0.76, Feb 2023 1.38, March 2024 3.29. Then they decided to give me a scan. It had spread up my lymph nodes around my aorta nearly to my oesophagus and to one of my ribs as well. I can't help feeling that they should have started looking sooner then maybe more could have been done to zap it in it's infancy. Now it's advanced and I know it is not going to be a good ending. So it's hormone injections and Enzalutamide for the time being until that doesn't work.
Most helpful video, the balance your video’s provide is most reassuring.
Thank you for the time you all commit to making these presentations.
Best regards
The grey area is when PSA is rising but still below the level where pet psma detects where it now is. So do you let cancer grow larger in order to find out where it is (although it may also be elsewhere, but smaller, or during that waiting it may establish elsewhere as well) or do you do abandon pet psma and do whole pelvic radiation, plus ADT and hope the diffuse treatment is effective. Or do you start adt for a while, up-regulate psma expression, then do a pet psma scan. Is there a standard of care for this scenario.
You are so great very helpful thank you so very much for doing this for us.
Excellent coverage of all the details, Alex.
Spot on when it comes to pretreatment bumps or rises in PSA caused by exercise. If you engage in a sport where the legs move in a way that puts pressure on the prostate (kicking in swimming, kicking in Karate, etc.) you can get a substantial spike in your pretreatment PSA.
@@gary4451 this vid is about post treatment.
This is SO currently relevant about PSA interpretation of PSA lab data. This is a OVERLOOKED consideration of the confusing PSA fluctuation data that happens. Prostate Cancer is a devious form of Cancer... That even the Expert Doctors do not understand.
I started with Labcorp for first few tests and then when I went to Emory University Hospital to see a new urologist they have their own lab. I got a number waaay lower than anything previous. I think samples got switched or something. Went back to Labcorp now 3.5 years. Love Emory, l have had many procedures there, just recently Inspire implant for moderate obstructive sleep apnea. Everything went perfectly now still getting used to the tongue stimulation. Right now l have low blood platelets 110 versus lowest normal being 150 and pretty much no other blood issues or symptoms of low blood platelets. 3 tests over last 5 months all low, never before that. B12 is fine. Abdominal CT scan with contrast was unremarkable with no suggested follow up. Now bone marrow biopsy in 2 days. I read radiation can cause this, that was 2 years ago to the day practically. 35 grey in 5 sessions mri- linac. I have a great doctor, one of the best hematologists in Atlanta.
Contact our prostate cancer helpline for support: pcri.org/helpline
We have many support groups! Find one that feels right for you:
pcri.org/supportgroups
ancan.org/prostate-cancer/
zerocancer.org/help-and-support
malecare.org/support-groups/
Another good video. Had TURP surgery July 2023, yet my PSA remains elevated (most recent reading of 27) and has not decreased which is the normal scenario post-surgery. Categorized as Gleason 3 +3. PSMA Pet scan revealed nothing of note outside the prostate. My urologist is concerned about this and has suggested treatment but I am holding off until my next PSA test and subsequent biopsy. Has something possibly been missed here?
Not related, but I saw Mayo Clinic has a 7 Tesla. Mayo seemed to indicated it is for brain scans. Is this something coming into the pc space??? 🙏
I have had an indwelling catheter for a year, had Triple Therapy, ADT, injections and pills, radiation over the last year. PSA went down from 200 to 7. How much will the Catheter affect the PSA.? Prostate was never removed.
I have a question:
Can a PSMA PetScan differentiate between actual prostate cancer and residual prostate tissue left behind after a nerve-sparing radical prostatectomy done over 20 years ago?
My Dad's PSA is within normal range at 0.025 but testerone has risen from 2.4 to 4 Is this alarming?
What PSA value for a person after FOCAL treatment would be cause for further investigation?
I’ve had two recurrent, been on Lupron for 4 years, now my psa is rising was .006 three months it’s .15
I'm no doctor but PAS .15 the way I understand it is not an issue
How long can I be on ADT and Apultamide? Three years now after PSA rose to 0.2 three years after surgery. Ever since it’s 0.01 last three years.
Where did the cancer show up
I had a prostatectomy in 2015.Everything was well with 0 PSA and everything normal with gradual rises through the years.The last year or so it has risen from 0.270 to 0.520.Doc had me do a PSMA Pet scan which showed no cancer,but although unseen my Doc still thinks its cancer in the Prostate Bed.He sends me to radiologist for counsil and says he will zap the prostate bed though cancer is unseen.Are my Docs right about this or is the Pet Scan.Does the cancer have to show it's ugly self first before it gets serious?Appreciate any output for this 74 year old confused man.
.2 to .5 is nothing, you should not even be worried about it
I have been down the same road as you my psa also went back up to 0.52 had a pet scan which showed nothing in the end i had rad to the prostate bed and the pelvic area . just over a year later psa is going back up i would wait and have a pet scan again in 6months and wait till it finds the cancer .At 74 you will have along life and all will be ok i will be 58 at xmas and plan to get to 74 .
@@poppiefruciano Thank You.
@@andrewgynn4502 Thank you and good luck.
Is Dr. Schulz your father?😊
father in law
But PSA isn't an indication of cancer.
It is if you've had your prostate gland removed.
@schmingusss true mine is removed. I had a slight rise, and found out your body can still produce a psa with other factors..siliva being one of them.
@@RH-xd3nx Interesting. Well, I pray that you will be healthy and cancer free for years to come.
That's why there are further checks when the PSA is rising. Frequently it is an indicator of cancer unless your activities involve something that could raise your PSA
My elevated PSA led to cancer diagnose 2 years ago.Doctors were reluctant to order a biopsy.I was decided to have it done anyway.Best to weigh on the side of caution when it comes to your health.
I agree with you about the last part of the post. My mental state is SO fragile when it comes to my PSA. Because when my numbers started rising in March of 2021, my pcp AND urologist were very nonchalant about the PSA and its importance to my health. “ come back in 3 months “ they said… well… when I was greated with a PSA of 38, and it jumped to 68 2 weeks later…
So, yeah, the PSA discussion is definitely a trigger… but I am very grateful for the support you give us.