Specialising in the human experience of Living with prostate cancer – warts and all

My Fight: The significance of PSA readings

with 4 comments

PSA or Prostate Specific Antigen is a protein which is secreted into ejaculate fluid by the healthy prostate. One of its functions is to aid sperm movement. Normally, only very low levels of the enzyme are able to enter the blood stream. However, because in cancer the normal structure of the tissue is disrupted, considerably more PSA is able to leak into the blood stream, and for this reason, a raised level of PSA in blood (or serum) can indicate the presence of prostate cancer.

The PSA level in a healthy man should register between 0 and 4 as determined by a blood test.  One test does not make a diagnosis and the validity of the test itself is currently being questioned by the medical profession.  A reading above the normal range is cause for investigation of potential prostate cancer.

I was diagnosed (April 2008) with an aggressive (Gleason score 9), stage 4 (terminal) tumour which had escaped the prostate and had developed tumours in the skeleton (metastases) with the only treatment available being palliative.  At this stage, my PSA measured around 1,000.

Over the next nine months, androgen deprivation treatment (Zolodex + Androcur) brought me to remission with a reading of 0.6.  The objective of this hormone therapy is to reduce the production of testosterone which is billed as the food supply of the tumour.  First time around, it worked as anticipated although I reacted badly to the treatment destroying my quality of life.  One often hears that the treatment for cancer can be worse than the disease itself.  After that treatment, I agree with that belief.

In July 2009, my pain receptors were reset with ketamine (a detox program) and the remission lasted til the new year (2010) when the PSA readings began their inevitable rise again.  The androgen deprivation was started again but this time it could not prevent the PSA progressing from 3 in Feb 2010, to 15, to 40, to 53, to 75, to 115, to 214, peaking at 957 at the end of July 2011.

So, how high can the PSA reading go and what are the consequences?  Extensive inquiry indicates that the ever increasing level indicates the relative activity of the tumor which continually grows inside the body until all the available space is taken up.  At that point, the tumor will likely attack the vital organs (liver, lungs, etc) but more importantly will consume all the nutrients that are taken in effectively starving the rest of the body which will wither and die.  In my case, the bone cancer (metastases) has degraded my bones which appear to be ‘moth eaten‘  as shown on CT scans with the left hip bone socket fractured without any event having taken place.  With the potential for fracture being like that, one has to remember not to move suddenly in case another bone gives out.

Obviously, this restricts my movements and threatens to cripple me if my bones can break that easily.  The accepted treatment for this condition is the regular infusion of  ZOMETA which can strengthen the integrity of the bones.  One of the side effects can cause lockjaw if ones teeth are not healthy.  Consequently, I have been to the dentist to have this checked out.  To my pleasant surprise, I qualified for the federal Government dental program for chronically ill patients and have been able to undergo over $3,000 worth of dental procedures giving me access to the Zometa procedure should it become necessary.

Common side effects for patients with multiple myeloma and bone metastases due to solid tumors include bone pain, nausea, fatigue, anemia, fever, vomiting, constipation, shortness of breath, diarrhea, weakness, muscle pain, anorexia, cough, joint pain, lower-limb swelling, worsening of your cancer, headache, dizziness (excluding vertigo), insomnia, decreased weight, back pain, numbness/tingling, and abdominal pain. These side effects are listed regardless of any potential association with the medications used in registration studies of ZOMETA in bone metastases patients.  So once again, one has to ask, is the treatment worse than the condition?  How do make such critical decisions?

The most recent blood test (Oct 2011) returned a PSA reading of 440 which is a reduction of more than half that of that three months earlier.  What caused the drop?  The doctors are not prepared to speculate because I have not been on any treatment program designed to reduce the level of testosterone – they have nothing to hang their hats on.  From where I stand, I suggest it could be related to the radiation I had in early June successfully destroying some of the tumour or the progesterone cream might have contributed to the decline.  It doesn’t really matter … what is important is the reduction itself.  If the continuing rise in PSA is a bad sign, this reduction has to be a positive.

The Peter McCallum Cancer Institute operates to the “World’s Best Practice” and every patient  is offered the gold standard treatment for the category of the disease being treated.  But then, some of us stretch the limits until the successes we may have achieved are then incorporated into the gold standard.

As part of that world’s best practice, the oncologist at Peter McCallum wanted me to return to the androgen deprivation program in an effort to slow down the spread of the cancer.  He suggested that I might get an extra month or even two added to my longevity.  So I asked the question, “Would that be an extra couple of months of breathing … or playing football?”   Unfortunately, the answer was breathing.  I cannot justify compromising the quality of life that I had to fight so hard for (when I was on the hormone therapy before)  for the possibility of ‘breathing’ for an extra couple of months.  At this time, I have refused this offer of treatment.

Having explained the loss of quality of life I had undergone on the androgen deprivation program, the oncologist volunteered the comment that palliative chemotherapy rarely benefits the patient as the side effects are so severe  – and the hormone therapy is a chemical (chemo) process.


Written by Greg Naylor

13 October 2011 at 8:20 pm

4 Responses

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  1. Thanks for the update, Greg. Obviously your brain is still working and you’re as coherent and concise (and chillingly honest) as ever. I can’t begin to comprehend what you’re going through but, and I say this sincerely, you are a true source of inspiration to all of us. I think it might be your strength of mind that has possibly got you this far. That and your iron will. Sorry about the GF & C’wood’s loss to the big headed Cats but you got one in anyway … last year against us. Cheers mate.

    Ray Dixon

    14 October 2011 at 11:12 pm

  2. I can’t believe how much I am still learning as the disease takes it’s toll. From the outset, I have said that I was not qualified to die and have had to make a career of the process – or go nuts. I am genuinely trying to document what I have learned so that others who eventually share the same fate can better understand what is happening within their bodies. It seems that those of us who challenge the conventional wisdom and stretch the envelope with treatment options sometimes bring about major changes that actually raise the standard of care in spite of the impossible odds.

    For example, the success I have achieved with natural progesterone cream has raised the awareness of this option amongst both GPs and Specialists associated with my case. Amongst these people, it is now considered that tumours that are hormone based will respond positively to the hormone progesterone. Maybe, my cancer has made a difference that others can benefit from.

    Greg Naylor

    16 October 2011 at 9:07 pm

  3. “My Fight: The significance of PSA readings GREG’S LEGACY” ended up being a great article and also I really was pretty satisfied to read the article. Thanks a lot,Edith

    15 February 2013 at 7:39 am

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