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What Do The Following PSA Readings Suggest?
Question: Dear Dr XXXXXXX
Thanks for your expert advice re. my previous thread
http://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=198524
We have just seen our oncologist and suggested monitoring PSA for the time being, though they prefer RT or continuous ADT. My father’s latest PSA in early July has risen from 0.03 to 0.05, the first time to rise after his discontinuation of ADT in mid March. His PSA history are -
12 July 2014 (20.9),
16 Oct 2014 (16.7),
26 Nov 2014 (18),
2 March 2015 (0.06, after 1st ADT shot on 18 December 2014),
20 April 2015 (0.03),
30 May 2015 (0.03)
6 July 2015 (0.05)
For this rise from 0.03 to 0.05 after about one month, is it a fast rate ? I understand that PSA doubling time is an indicator of disease progression, apart from PSA reading. Rise to which PSA level should we be alert?
Doctor said to monitor the PSA every 4- 6 months, is this sufficient?
His Hgb has gradually improved after stop of ADT and once XXXXXXX to 12.1 but the latest reading again dropped to 11.1. Platelets remains around 90k. Do you think these indicates a bone marrow problem, His platelet started to drop in Sep 2013 drastically from 200k to 120k after an infection. Then his platelet gradually declines to this current level, but doctor has not alerted us of this. His Hgb was unaffected until after first ADT shot. In your opinion, do you suggest my father doing a bone marrow biopsy?Why or why not?
Best Regards,
Thanks for your expert advice re. my previous thread
http://www.healthcaremagic.com/AskDoctorInboxServlet?page=viewQuery&queryId=198524
We have just seen our oncologist and suggested monitoring PSA for the time being, though they prefer RT or continuous ADT. My father’s latest PSA in early July has risen from 0.03 to 0.05, the first time to rise after his discontinuation of ADT in mid March. His PSA history are -
12 July 2014 (20.9),
16 Oct 2014 (16.7),
26 Nov 2014 (18),
2 March 2015 (0.06, after 1st ADT shot on 18 December 2014),
20 April 2015 (0.03),
30 May 2015 (0.03)
6 July 2015 (0.05)
For this rise from 0.03 to 0.05 after about one month, is it a fast rate ? I understand that PSA doubling time is an indicator of disease progression, apart from PSA reading. Rise to which PSA level should we be alert?
Doctor said to monitor the PSA every 4- 6 months, is this sufficient?
His Hgb has gradually improved after stop of ADT and once XXXXXXX to 12.1 but the latest reading again dropped to 11.1. Platelets remains around 90k. Do you think these indicates a bone marrow problem, His platelet started to drop in Sep 2013 drastically from 200k to 120k after an infection. Then his platelet gradually declines to this current level, but doctor has not alerted us of this. His Hgb was unaffected until after first ADT shot. In your opinion, do you suggest my father doing a bone marrow biopsy?Why or why not?
Best Regards,
Brief Answer:
no this is not counted as rise
Detailed Answer:
Hi
thanks for following up.
A PSA rise from 0.03 to 0.05 is not really considered a 'rise'. If there is sustained rise over 2-3 readings and at least to 0.5 then I would consider a rise. Not necessarily we should restart ADT at that time as we can wait till 5 ng/ml at least.
I would get 3 monthly PSA in him. That should be enough.
Regarding the hemoglobin and platelets, I would wait till Hb drops below 10 or platelets below 75000 before considering bone marrow aspiration. There may be some underlying marrow dysfunction but not of major concern at this point.
Hope this helps.
regards
no this is not counted as rise
Detailed Answer:
Hi
thanks for following up.
A PSA rise from 0.03 to 0.05 is not really considered a 'rise'. If there is sustained rise over 2-3 readings and at least to 0.5 then I would consider a rise. Not necessarily we should restart ADT at that time as we can wait till 5 ng/ml at least.
I would get 3 monthly PSA in him. That should be enough.
Regarding the hemoglobin and platelets, I would wait till Hb drops below 10 or platelets below 75000 before considering bone marrow aspiration. There may be some underlying marrow dysfunction but not of major concern at this point.
Hope this helps.
regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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