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or "watch the bouncing ball"  Show this Post

 
the one constant following a diagnosis of prostate cancer – regardless of treatment – or no treatment at all… is the mandatory PSA tests on a regular basis – usually every 3 months.  this becomes a watch and wait scenario or "watchful waiting" as they like to refer to it… or the now more politically correct "active surveillance" or the over-the-top "expectant management", because they sound more like you're actually doing something – instead of sitting on your hands and simply keeping track of the quarterly PSA numbers.
 
usually, there's a target (could be an absolute number or a doubling rate) – that either your medical team has chosen or that you and your oncologist may have settled on together, and when your PSA hits or surpasses that target is when the next treatment regime is implemented – whether that be surgery (in the case of having done nothing previously), or radiation or something else.
 
in my situation, the first target following surgery was not something I was consulted on – but from correspondence from that period it appears to have been related to a doubling time.  All I know, is that it wasn't very high at all (in relative terms), but when you've had a radical prostatectomy that ideally was supposed to eradicate the disease – any reappearance of the prostate-specific antigen in your system – means they didn't get it all.
 
over the two years following my surgery, my quarterly PSA levels fluctuated between minimal levels of 0.07 and undetectable (which is what they call anything that's < 0.02).  It's a bit odd to see "something" and then 3 months later have it disappear again – but this happened a couple of times in that period.
 
however, in September 2004, just over 2 years since my surgery, I had a PSA result of 0.15 which (as infinitesimal as it is) was almost double my previous result of 0.08 – and my urologist had me have it retested – and when it came back the same, I was immediately scheduled for a consult with a radiation oncologist at the Toronto Bayview Regional Cancer Centre (yes, if you read the first couple of posts – this is what I will always call it).   
 
and so – the next phase of my "living with prostate cancer" began…