Post-Op PSA has risen.... is this a problem?

Well, it's been a long time since I last posted.... This site was instrumental in helping me make my decisions relatively easy.... for that I am most grateful. I have been monitoring my health closely, especially paying close attention to my blood workups and making sure to get my PSA levels checked ever 6 months or so.

I was diagnosed with PC in 10/18/06, gleason score 3+4.... had the surgery done via DaVinci on 12/18/06. Post-op reports gave a positive prognosis. Every PSA since has been 0.10. Being someone with Type II diabetes I watch what I eat and pay attention to details of my diet. The first thing I look at on my blood workups is my PSA. Sure enough the last PSA done 9/18/10 shows a jump to 0.20.

While I'm not overly concerned, one has to ask ones self.... if I have no prostate how does one produce more PSA? Sometimes I don't want to think about the answer.

One more thing. As I read the posts on this board I continually see post-op people referring to their PSA as 0.01; when they jump they state the readings as 0.02 or higher. My post-op PSA readings has never shown itself as anything other than <0.1. What gives with that?

I have an appointment scheduled for 11/24 with my urologist, the one who did the original prostatectomy.... should I push up the date? Should I worry???

Interested in reading the responses to this post........... thanks in advance for your input.

Later,

Jay

Hey Jay,

Well...the definition of biochemical recurrence (BCR) is a read of equal or greater than 0.2 with one subsequent rise at least 3 months later. So is this something to worry about...not just yet. Get another reading in 3 months and go from there. Of course you Uro may follow a different protocol and want another test in 30 days.

You are on the standard assay PSA tests which only show in the tenths i.e. 0.X Many doctors that are tracking psa for those at risk will go down to the hundredths 0.XX using the ultra sensitive tests to follow psa levels more closely and detect recurrence often times as much as a year in advance. Only problem with the ultra-sensitive tests is it raises a lot of anxiety in men with fluctions below the 0.1 mark.

I don't see a need to push your appointment up from what is already scheduled.

Although you might want to make sure the same lab is performing your tests and using the same equipment. Different labs use different equipment and that will change the results.

Best of luck

i would meet with your uro, and setup an appt with a good radiation or medical oncologist, salvage radiation might be in your future. if that .2 reading is accurate, its already on its way up to that decision point. hope there's a better answer. good luck.

david in sc

Jay:
Have you the pathology report from the operation? Yes? Good! If there is any mention of positive margin(s), extra capsular penetration (ECE) Extra prostatic extension (EPE), Seminal Vesicle invasion (SVI), bladder neck infiltration, or other mention of potential leak of cells outside the organ proper then you have a good chance of dealing with this with radiation. If the report was clean and clear in all aspects then the chance of radiation success is more questionable, though still possible. In any case you have other tools at your disposal such as Dutasteride, finasteride, vitamin D, diet, bio-curcumin, resveratrol and other mild supplements with some potential for succes in the near term. Get thee to an oncologist and a radiation oncologist. Once you do that then all we offer is for naught.

I too have only ever had tests to the nearest 0.X and not 0.XX. (But my situation has been so obvious that this has not been a problem.)
I jumped so much in jumping from 01. to 0.4 that there was no great problem in my case in working out that something was wrong and that I needed to do something about it

One small rise is not the same. The key thing is to wait till the next test before too many conclusions can be drawn. (But another test in 3 and not 6 months is clearly advisable - perhaps even in 2 months)

PSA anxiety ain't easy. With this rounding up of decimal places the problem is that a 0.1 can of course be anything between a 0.06 and a 0.14 and a 0.2 can be anything between a 0.16 and a 0.24. There are thus two extremes: If you've moved from a 0.14 to a 0.16 it's a very small change. If you've moved from a 0.6 to a 0.24 it's a bit more worrying. Thus there are situations where a more sensitive test can have its advantages.

Alf