Panic mode

sfigato,
You said your Gleason was mostly 6. Was your post op pathology find only G6 or was any of it upgraded to G7? This is very important! If it was confirmed as a G6 you are in good shape as G6 does not metastasize. If you were upgraded, then the rise in psa is significant and needs to be confirmed and further treatment is probable.
Please clarify your post op pathology.

Was this a different lab?

Well, It's always good to be concerned. However, I wouldn't go into "panic mode" at this point.

Your result of 0.03 is still around what your previous results showed. They showed <0.10, which 0.03 is still less than 0.10. The lab probably just reported the actual number vs the standard <0.10 number you got earlier.

Was there some other reason for the doc to refer you back to the urologist?

This stuff always messes with your mind, so beware of that and look for a reference.

There are lots of good folks here with more experience than I have on this, so I bet they will chime in here shortly.

Breath deep, it's a bumpy road.

Ok, given what your "doc" said about "partial prostate removal", I've never heard of that. Which leads me to question the advice.

So, even more reason to back out of panic mode.

Yes - the < 0.1 from the Uro seems to cover the 0.03
But I guess the real issue is 2 systems and methodologies
And my internist talking about "most people show zero after..."

Next test is this Friday - I'm pretty sure though that I read concern in my internist's response and that freaked me out

sfigato said...
I haven't been around for a while

I had a prostatectomy in 2010 at age 49
For the first 4 years my PSA was zero/undetectable as per my urologist/surgeon

I skipped last year and then this week did a test at my regular physician
The result came back as 0.03 and the doctor told me I should see my urologist

So here I am extremely upset and angry, I thought that at least after having surgery at 49 and then having zero test results for a few years would be some consolation for a completely devastated sex life and completely messed up head

So now I will go and do a retest ( my uro is in a different system)
And to top that I waited 20 minutes on hold to get an appointment and was cut off while talking to the scheduler

So question is
How ****ed am I? My Gleason at surgery was mostly 6 IIRC

You are not screwed at all, and I can not believe your doctor who told you you need to go see your uro did not pick up on and explain this. Please notice something from all of your other so called undetectable PSAs, copied here from your signature:
"Feb 14, 2011 PSA < 0.10 (effectively zero), Jun 13,2011 < 0.10, Nov 4, 2011 < 0.10, May 2, 2012 PSA undetectable"

Consider that <0.1 can equal .09, or .06, or .03(your current reading) or .003 or .001. All of those readings are <.1. All <.1 means is that the tests have been run on a machine which can not measure lower than 0.1, which was pretty much the norm in most places until just recently. Now they have switched you from the standard test to an ultra-sensitive test, with newer machines which can measure much lower.

Therefore, as far as you know, you are just as undetectable as you ever were. By the standards of the older machines that you had been tested on from Feb 11 through at least May 12, your current PSA will have to TRIPLE to become detectable on the older machines.

Now .03 is still an exceedingly low level, though there are a couple of studies that indicate if you do finally reach that level, you will sooner or later go over that .1 or .2 mark. Which they call biochemical recurrence, or BCR. But even BCR is a long ways from clinical symptoms of PC, metastasis or death, especially with a moderately low risk case like yours. Still, probably most folks with BCR choose to have some radiation added, which almost always(again in your risk group) puts you back in the "undetectable" group.

So relax for now, keep a close eye on it to make sure it does not keep going up from here. But if all of your previous readings were "undetectable" at < .1, as far as you know with this .03 reading you have not gone up one iota. (unless it was not in your signature that you have previously < .03, but even if that is so, .03 does not call for any feeling of being screwed, not yet)

EDIT:

sfigato said...
Yes - the < 0.1 from the Uro seems to cover the 0.03
But I guess the real issue is 2 systems and methodologies
And my internist talking about "most people show zero after..."

Next test is this Friday - I'm pretty sure though that I read concern in my internist's response and that freaked me out

I'm going to call BS on the internist's concern. No one should be concerned with a .03 when as far as you know all of your previous readings have actually been .03(or even .04 or .05, you don't know! ). Tell him/her to relax, and cancel all panic mode for now at least. You can always panic later if it keeps on going up.