uPSA 0.05 - 10 months after RP

Wilderness said...
Good morning Zzarth.

Over 32 months I've had uPSA numbers up to .06 from one lab with a few ups and downs. A second lab reports undetectable.....

I suggest another test soon (a month?). This one could be an error. But if PSA is rising quickly, it might be better to know sooner than later.

You also might learn what assay is used by your lab, report that here -

If it fits your style have you considered optimizing lifestyle (diet/exercise) to slow progression?

Here's hoping this turns out to be nothing - you return to undetectable.

Wilderness

Harvard Prostate Kowledge Article said...

Scenario 1. Sometimes the PSA level never becomes undetectable after a prostatectomy. This situation, which is fortunately rare but among the most challenging to treat, means either that some cancer cells remained in the prostatic fossa (tissue left behind during surgery in the area once occupied by the prostate gland), or — more likely — that micrometastases had already spread beyond the prostate. A man in this situation may need additional therapy right away. The options offered may be radiation or hormone therapy, or both, or an investigational therapy.

Scenario 2. Sometimes the PSA falls to undetectable levels for several months following radical prostatectomy, and then begins to creep up. Typically, a man in this situation learns during one of his follow-up tests that he has experienced a biochemical recurrence. If the PSA level rises within the first year after surgery, it usually indicates metastatic disease. The treatment option most often offered is hormone therapy (either intermittent or continuous).

Scenario 3. The PSA does not begin to rise until a year or more after surgery. This is more likely to indicate localized disease, although it is possible that the disease has spread. Your treatment options depend on the PSA doubling time — how quickly PSA is increasing. If your PSA doubles in less than six months, and certainly less than three months, your doctor may recommend treating the area again, but this time with radiation or hormone therapy, in order to eradicate the disease.

Scenario 4. The PSA rises a year or more after surgery, but the doubling time is slow (a year or longer). This is probably the best scenario of all, as it indicates that the cancer may be localized and not aggressive. In this situation, you may opt for active surveillance — monitoring PSA and periodically having other tests, but not necessarily choosing an active intervention right away.

My Primary Care Doctor said...

The repeat ultra-sensitive PSA is elevated above that which would be expected in the post prostatectomy state. I suggest we confer with your urologist.


If you have any questions or concerns, please don't hesitate to call.

Sincerely,
Dr. [snip]

My response said...

Dr XXX
Thank you for sending out the email to me on Friday about my PSA test going up.

I will immediately go talk to a Radiologist Oncologist, with a seconday priority to see my urologist (as you recommended).
Keep in mind that urologists don't treat salvage RT patients.

With a rising u-PSA, eventhough it's under 0.2 ... it's probably best if we move quickly.. remember my PSA was over 15 when it was first tested ... Also, my urologist didn't treat me... also, I'm still a little bitter .. I should have had my PSA tested years ago when I reported urination problems.. My urologist prescribed me FloMax without even a hint to doing a precautionary PSA ... I would have paid out of pocket.
See you soon

Wilderness said...

My psa not undetectable until 19 months after surgery, then again 32 months after.