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First PSA post surgery

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Posted 5/23/2015 11:34 AM (GMT 0)
My first PSA post surgery is .3 (5 weeks after). This is very disappointing because everything I have read tells me it should be undetectable or at least less than .2 . I will see my surgeon next week and am wondering what his plan of action will be. I have also heard that a second reading is usually what the doctor relies on. Maybe someone out there can enlighten me or at least ease my anxiety a bit. (Self diagnosing and second guessing internet articles
is making me crazy.) smhair
Posted 5/23/2015 11:40 AM (GMT 0)
Five weeks seems early to me. This is exactly why my doctor waits 3 months to test. Wait for that second test before you panic too much, but I know that is easier said than done. Good luck!

Tom
Posted 5/23/2015 12:11 PM (GMT 0)
Seems a little early to me too. Doctors usually wait at least three months after surgery to test PSA.
Posted 5/23/2015 12:41 PM (GMT 0)
Some docs do test early, not sure why. Mine does, but at 6 weeks and I was good. But 5 weeks does seem early.
Might be wrong, but I think we have a good example that will help you, in our member Halbert, who I'm sure will chime in. I think up he had a 4 week test that showed detectable PSA, and he just had his 3 month test which came back undetectable.

Try to stay positive with your pathology and presurgical PSA, you should be fine.

Have you gotten your surgical pathology back yet? That might be helpful
Posted 5/23/2015 3:26 PM (GMT 0)
Too early for this data point. Check again in 7 weeks.

You'll be happier.
Posted 5/23/2015 4:13 PM (GMT 0)
baltimore1,

Ever since randomized clinical trials showed a benefit to adjuvant radiation over waiting, surgeons have tried to detect PSA earlier. You can read about the prognostic accuracy of earlier testing in the following article (toward the bottom):

When should the patient and doctor consider salvage radiation therapy?

The half life of PSA in the serum is about 2-3 days, so your PSA should have declined below .3 inside of two weeks. Certainly get another uPSA in 3 weeks. Ask for an ultrasensitive PSA (uPSA) next time. They wouldn't begin adjuvant radiation quite this soon anyway - they have to wait for the tissues to mend first. You didn't say whether there were signs of adverse pathology on your pathology report - positive margins? stage? pathology Gleason score? How is your recovery coming along - any signs of returning continence?

You may also want to read the following article:

What should one do if one’s PSA remains detectable after radical prostatectomy?

- Allen
Posted 5/23/2015 4:18 PM (GMT 0)
Can you share any more details of the pathology report?

If total PSA half-life is 2 or 3 days, then another test is a couple of weeks would tell you more - if that would be better for you than the anxious uncertainty you cite.

And maybe talk to your medical team - if further treatment is indicated they might advise first allowing time for surgical healing anyway.

Best to you - this forum is your friend, and replete with good advice.
Posted 5/24/2015 10:52 AM (GMT 0)
Thanks to all of you guys who responded to my post. This forum is truly amazing and you members seem almost like family. I'm thinking that you all are right. My surgeon will most likely order another PSA before he jumps the gun. In any case, I don't feel that I have truly healed enough yet for any procedure. I am resigned to accept whatever comes next. This disease has made me look at this world in a whole new way. Ever since I was diagnosed, I have spent hours reading the threads in this forum and also the member blogs. Many of you are my heroes.
David
Posted 5/24/2015 11:33 AM (GMT 0)
David, right on schedule, here I am ;)

My 6 week psa was detectable, and my 3 month was non-detect. From what I understand, this is not uncommon. The trend however, is exactly what you want to see.

Hang in there....
Posted 5/25/2015 3:12 AM (GMT 0)
Hi David,
I also think that a 3mos PSA result is more representable for the surgery.
Mine was done 4 weeks cause the Uro wanna to plan my next treatment...due to G9er.
Anyway all the best the coming 3 mos PSA test.
Posted 5/25/2015 6:49 PM (GMT 0)
Thanks for chiming in halbert and yk. Much appreciate your input.
Posted 5/27/2015 1:33 AM (GMT 0)
Three years ago had radical DeVinci removal,1st psa 1 year was .02, second year was .04 3rd year was .17, last one two weeks ago was 1.17, very concerned about this jump in one year, any comments.........
Posted 5/27/2015 1:50 AM (GMT 0)
Sorry to hear you are dealing with this.

There is obviously something going on, and some sort of action needs to be taken with your PSA over 1, after RALP.
What does your Dr. suggest? Have you talked it through with him?

It would be helpful to everyone, especially the really knowledgeable members like Tall Allen, if you could post your stats, what was your final pathology after surgery - gleason score, margins, ECE, etc. If you go into My Profile, above, on the right side, you can create a signature with these stats that will appear when you post.
Posted 5/27/2015 3:15 AM (GMT 0)
woodyvt,

If, owing to age and co-morbidities your life expectancy is less than ten to fifteen years, you don't have to do anything. Otherwise, please move on this quickly. My concern is that you've already let this go way too long. Please make an appointment with a radiation oncologist immediately. Get a NaF18 PET scan, if you can. If you can't get that, at least get a bone scan.

- Allen
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