After Radical Prostatectomy PSA is at 29.5 3 Months Later

Hi all,

Just met with the urologist yesterday. He told me my PSA was at 29.5 three months after the radical prostatectomy (DaVinci) that included seminal vesicle removal performed in July - not good at all with the PSA exactly the same as presurgery value. My Gleason score was 9 and I was diagnosed with Stage 3 prostate cancer. Redoing bone and CT scans early November and will meet with urologist and radiation oncologist the following two days.

Anyone else have/had a similar situation? Any suggestions or advice?

Thank you,

Mike Nyte

Not what you wanted to hear. Very improbable that it would be the same reading and not a little bit different. Of course it should be considerably different. I would first find out whether they sent the pre-surgery reading by mistake. Then, I would re-test.

We have had other men that had three month post-surgery PSA similar to pre-surgery, but as I recollect the PSA was much lower, like 7 or 8. Recently we had a man with a post-surgery PSA higher than his pre-surgery PSA and they found an error upon retesting and he in fact had a drop consistent with expectations.

My advice is don't freak out......check the reporting, and, potentially retest.

Big thanks for the advice!

I had another PSA done yesterday after meeting with the doc; waiting for the results. I am not on HT yet or radiation therapy because the doc said he wanted me to heal for three months, so that's why things are just starting to fall into place now. The long wait has been frustrating. I just asked the PCP if I should see an oncologist for chemo.

BTW - still leaking but much improved since surgery. Doing 100 Kegels 3X/day.

ED a problem; I feel bad for my wife. Pills don't work. Tried Caverject at doc's office with nurse. Pinch was bearable, but much pain with the erection. Pain did not subside until erection went away. I think he used 20 as the dose. He wants me to try the injection again, but I'm hesitant. Anyone have luck with vacuum pump?
______________________________________________________________________________________

Age 55 now and at DX.
History:
PSA 29.5 - 4/2015.
Biopsy - 4/2015. Result = Gleason 9.
RP and seminal vesicle removal- 7/13/2015 (Lucky 13!). Result = Stage 3 PC verified.
PSA 29.5 - 10/22/2015.

Hi Mike,

Sorry you have to be dealing with this. After hubbies surgery in 2011the PSA was over 6 three months post op. Really hoping its a mistake.

You're a young guy and you may wish to pursue some GOOD imaging to find out where any residual cancer may be hiding. Then radiation can be targeted. We got on the imaging train a bit late. Don't make the mistake we did and get on hormone therapy before the SCANS though. Did you have any Ct or bone scans before your surgery?

My hubbie had several sensitive scans in the past year-- a feromoxytl scan at NIH and the DCFBC scan; both clinical trials at the National Institutes of Health in Bethesda. both showed a single pelvic lymph node that was cancerous. Those were both at no cost but couldn't be used as a diagnosis because of the trial.

He is currently recuperating from extended lymph surgery at Mayo Clinic. Dr. Kwon (w/surgeon Dr. Tollafsen) diagnosed with C11 choline scan this same positive lymph node. Pathlology showed only that one node out of over 20 removed to be positive for cancer. Time will tell if the surgery helped.

http://www.mayoclinic.org/medical-professionals/clinical-updates/general-medical/novel-treatments-for-recurrent-prostate-cancer[url]

Let us know how it goes. This forum has been a godsend on our journey, helping to support and educate us. our email is active if you have questions.

Take care
Marie and Jim

Mike

I am sorry to hear about this. My questions for you are 1) did you have lymph nodes removed when you had the RP? 2) If so, what was the pathology report on these?

If I were you, I would immediately make an appointment with Dr. Kwon at Mayo (referenced above by Warmpuscats). Dr. Kwon and his C11 Pet Scan are the best in the country at finding hidden PC. Chances are that your bone scan and new CT or MRI will not show anything yet.

Mike, if. Am understanding correctly, your PSA at diagnosis in April was 29.5, you had RP surgery 3 months ago, which would be July, just 3 months after the 29.5 reading. And the 3 month reading post surgery remained at 29.5.

If I am correct, and I'm not missing anything, then this makes no sense whatsoever. Was this your first Post surgery test, or was there one before this and if so, what was it.

Just to fill you in, if you didn't see the threads referred to above, I had surgery in January, and after 3 post surgery PSA tests coming back I ndetectable , my most recent one two weeks ago, came back at 3.88. My Dr felt there was a high likelihood this was a lab error, and retested, the results of the retest showed it in fact was a lab error.
Subsequently the original lab retested the original blood sample and in their words "could not duplicate the original result of 3.88", and in fact the retest confirmed 0.00 obtained by my doc.

So I will bet money, even with a G9, that there is a really big mistake here. Can you share with me, what lab you used? I used Quest. If it is Quest, and it in fact is a lab error, this would be, coupled with my experience, egregious and indicative of a pattern.

I have been in touch with the Director, Test Design, Senior Scientific Director/oncology , at Quest, who oversaw the investigation and retest of my blood, I am sure, if this does turn out to be an error, that he would be very interested learning f your situation. I'd be happy to transmit your issue and information to him to look at, if in fact the lab happens to be Quest. Feel free to email me if you prefer.

I am very interested in learning how this turns out, please follow up and let us know.

Post Edited (Pratoman) : 10/22/2015 7:05:55 PM (GMT-6)

Hi Mike,
Welcome to the site, There are a lot of smart guys on this site who do tons of research. Me, I am a fellow G9r.

I must say, having a post op PSA that is identical to your pre-op PSA is curious at best. Good to hear that you are getting retested. If your post op PSA is indeed the same as your pre-op then you may want to start discussing some sort of salvage radiation therapy in the hopes that the Pca is still confined to the prostate bed. My uro recommended salvage radiation which was declined by Kaiser and now I am faced with growing lymph nodes in my pelvic region. It is unlikely that I will ever be cured but had I had salvage radiation I may have stood a better chance of surviving this beast long term.

So if your scans come back clean I would strongly consider that. Best to you.