Mets day 99 - PSA issues

Yesterday Charlotte from Fox Chase called me to say that my PSA test score was slightly over the acceptable threshold for the clinical trial.  Dendreon's guidelines say that a PSA score should be no greater than 1.1; my score was 1.11.  Really?  That one tenth of one percent matters that much?

I was surprised I had any PSA score, since I don't have a prostate.  When my prostate was removed on May 2, I was found to have prostate cancer, but my Gleason scores were pretty low, and there was no pathalogical evidence that it has spread outside of the prostate.  By the way, a new JAMA study (abstract here; NY Times article here) concludes that early surgical intervention for low-grade prostate cancer has no beneficial effect over watchful waiting.  Given that such surgery usually creates long-term issues with incontinence and impotence, my advise to men with low-grade prostate cancer is DON'T HAVE THE SURGERY.  Just watch and wait.  Most men have prostate cancer when they die, but low grade prostate cancer is rarely fatal.  The side effects of the surgery are not worth it, and it won't prolong your life.  This is unless you like wearing a diaper each night, not getting a good night's sleep, and being impotent. If that's your thing, then go ahead, have the surgery.

I didn't have much of a choice, since my bladder cancer was highly aggressive, I had failed chemotherapy, and the CT scan showed that it had metastasized into my lymph nodes.  I had to have the surgery.  But if I had just the low-level of prostate cancer that I did, and not bladder cancer, I would not have had the surgery.  It saddens me that as many as 90% of men with prostate cancer have lower level prostate cancer, and don't need the surgery, because it won't prolong their life according to the JAMA study, and the side effects suck. 

Anyway, all patients being accepted into the Dendreon trial have has their prostate removed along with their bladder, so I have a hard time understanding why they care about the PSA level.  Maybe they don't want patients with any residual prostate cancer floating around.  But a 1.11 instead of a 1.1 seems to be a maddeningly minor distinction.

The Fox Chase solution was to have me re-tested for my PSA level.  So I went into a Labcorp facility to have another blood draw.  Charlotte called this morning to ensure I had it taken care of, and will call Labcorp to get the results.  Apparently they really want me to participate.  Earlie this week, Charlotte emailed me to say that Dendreon had agreed to cover all of my travel expenses associated with the trial.  Maybe I'll start staying at the Four Seasons or Ritz and ordering room service . . . .

Update:  Charlotte just emailed to say that the second PSA test was fine, and now the ball is in Dendreon's court to tell me into which arm I'll be randomized.  I should know sometime next week.