pca Metastasis

I had RRP on 4th may 2011.PT3b

First 2 post RRP PSA (3 &6 mos.)<0.03

Then it rose to  0.13 ( today). All what i read mention local or systematic(metastasis) recurrence.

What I really don't understand is  WHY SYSTEMATIC? .I guess these  systematic  Pca cells were roving

somewhere in my body even before my surgery. then, logically their PSA should ...be detectable from the very first instant as there is no prostate organ to produce PSA. MY PSA was undetactable after surgery and now Iam suddenly talking about systematic disease. Layman's dillema! isn't it?

Thanks all.

Hi Nenea,
Stage T3b disease is used to describe prostate cancer which has extended into one or both of the seminal vesicles. Stage T3b is also used to define disease which combines extracapsular extension with either unilateral or bilateral seminal vesicle involvement.

This means you had localized invasion in the prostate fosa(where the gland used to be) or systemic disease. After RP the major tumor volume is removed(debulked), but you might have residual tumor cells in the local area(you could also have residual benign tissue). Depending on the number of benign or tumor cells left behind and their propensity to leak PSA protein, your blood PSA might be initially undetectable and later be recognized by the PSA assay used. You might consider checking if the same PSA assay has been used for all these tests. There are significant variations between PSA assays.

Rather than accepting this PSA result as recurrence, be sure to have another PSA test to verify the result. Never act on the result of a single PSA test. Wish you the very best.

RalphV

Nenea, I had an increasing PSA at 9 months as well. Mine went from undetectible to .07. I retested right away to make sure the test was accurate and then tested again in 3 months to make sure it was continuing to rise. The waiting was agonizing, but you have to make sure that you actually have a recurrence. I used the time to research next steps, treatments, docs to see and treatment facilities. Hopefully you won't need any. I also read that a quick recurrence is a indication of systematic desease, but by far not a certainty. Walsh gets into it in his book. Best of luck. I sincerely hope this is just a bump in the road for you. BB

I can understand your worry and concern, and it certainly warrants keeping a close eye, but I don't think you can even be declared as "recurrance" at this point from window. You may be or may not be. My doctors want to see 3 consecutive rises above .10 before declaring that.

Salvage Radiation obviously is most effective if the remaing cancer is still located in the prostate bed. I personally don't buy into the thinking that quick recurrance can be a good thing. Perhaps for some, not for all. My surgery failed within 9 months, then I was giving only about a 20% chance of the salvage radiation working. It failed, with extreme complications in less than 9 months.

This cancer just runs so different from person to person.

If I were you, I would wait for two more readings, before declaring any surgical failure. In the meantime, good time to start reviewing your secondary treatment options, if recurrance ends up being in your cards.

Good luck to you, hoping recurrance isn't in your future.

david in sc