PSA after Prostatecomy

It means...congrats! That value is exactly what it says - it's lower than the detectable level where that test was performed. Here's hoping it always stays "less than" for you.

Thank you so much for the warm words and thank you halbert for asking about my
Husband post surgery.
The continent is good, no erection wait.
Do you think radiation and hormonal therapy
is usually recommend with Gleason 7+3, 5% tertiary
5, and seminal Vesicle involved (Biopsy
Post surgery)?

Post Edited (Smara) : 1/28/2018 5:45:57 AM (GMT-7)

Others here are more expert or know better by their own experience, but I think the recommendation from NCCN is to have adjuvant radiation in cases with an intermediate or high grade gleason together with high risk surgery findings. Seminal extension is T3b stage and it is supossed to be a very high risk feature independently of grade. ADT is reserved for lymph extension. However, the recommendations are variable and sometimes ambiguous depending on who wrote them. Just ask his doctor, it is possible that he knows better than us. But his first PSA is hopeful in any case.

Congratulations to your husband and to you Smara, for your hard work and caring. Hoping he keeps that < for a long, long time

smara,

I think you may have mis-typed the result of his post-op pathology. Did you mean "Gleason 7 4+3, 5% tertiary 5?" If so then that, combined with the seminal vesicle involvement, puts him in a somewhat higher risk category for recurrence. The tertiary 5 is worrisome. It's good that his first PSA after surgery was undetectable, and it's likely that his doctor will just want to monitor his PSA closely, but it wouldn't be a big surprise if his doctor thinks about radiation and maybe hormones.

Smara,

If he trusts his doctor then he should trust his doctor. It is sensible to watch and wait at this point. The doctor will probably want to check his PSA every three months. The only way his slightly higher risk category will make a difference is in how fast things need to happen if his PSA starts to go back up.

That's great news!
Take care, all the best.

Smara,

He is 6 weeks out from RALP. Even if he needed radiation, it can't start for a while, until his surgical healing is complete. For now, celebrate the cancer free status, and try not to second guess. I'm not sure about this, but relatively few doctors will move into immediate salvage treatment until they are certain it's needed. And the evidence for the need is more involved than the pathology.

That's a great post-surgery result Smara! Congratulations to you and your husband. It's a very stressful time, but you are both doing really well. I hope this is the beginning of a great year for you both.
All the very best, Jaybee&GG

Smara said...
Yes, his post surgery diagnosed is 4+3 (7), 5% tertiary 5 combine with Seninal vesicle, clear margin.
His Doctor (seurgon) does not recommend any other treatment now but watch and wait.
From posts here I understand that maybe because of his high risk diagnose (by biopsy) of recurrence
We should consider to maximize the treatment with radiation/ hormone therapy.

jmadrid said...
... I think the recommendation from NCCN is to have adjuvant radiation in cases with () high risk surgery findings. Seminal extension is T3b stage and it is supossed to be a very high risk feature independently of grade.

I agree with jmadrid that your husband will probably receive radiation within the next 6-12 months, possibly combined with hormone therapy, because of the seminal vesicle invasion. The reason for this is that the cancer has already spread outside the prostate and invaded the tissues in his pelvis, and it is best to radiate the area before the cancer can spread any further.

I was in the same high risk situation. My surgeon told me immediately after surgery that I would need radiation even though he said my PSA was undetectable at the time. My PSA was then tested every month until radiation was scheduled. The result is that my PSA is now zero.

Even though your husband is high risk it can still be treated and most likely cured. But for now he must wait and heal from the surgery before further treatment can begin.

Ding, ding, ding. We have another winner.

Hello everyone,
My husband last PSA test 2 months a go was still
<0.05.
Just for reminder:
Age 64,
Gleason 4+3, 5% tertiary
5, and seminal Vesicle involved (Biopsy
Post surgery). Stage T3b.
His Doctor/seurgon did not recommend
any treatment beside follow up with PSA
Test very 3 months.
The fact that my husband
don’t get any treatment after surgery can put him
In big risk recurrence of the disease?
Why he didn’t reccomend radiation treatment to try to prevent it?
Does the Doctor decision makes
any since at all?

Post Edited (Smara) : 6/28/2018 6:57:40 AM (GMT-6)