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Low, slowly rising PSA post RALP

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Posted 5/24/2018 11:46 PM (GMT 0)
Greetings all. After my RP in May 2016, I had six months of undetectable PSA, then followed by detectable, very low, but slowly increasing PSA. I realise that these numbers and the trend are nothing compared to what some of the people on the forum deal with, but I nevertheless wonder what is going on, and whether anyone has some thoughts about this.

Thank you.

Ps. I also measure CEA (had colon cancer / surgery / chemo in 2015). Was <1 for a long time. Last reading was 1.1, but simultaneous CT scan appears clear. Again, a very low ('normal range') CEA, but it was <1 for many readings, and now slightly rose. Maybe nothing, maybe totally unrelated, but I added it for completeness in case it is relevant.
Posted 5/25/2018 12:09 AM (GMT 0)
it's not much PSA. Until it gets closer to .1 (or .05) I wouldn't worry about it too much.

Could be some prostate tissue the surgeon didn't get.

Likely all you need to do is keep monitoring.
Posted 5/25/2018 1:07 AM (GMT 0)
Your pathology did have a +margin, but it is only g-6. Those are awful low numbers. My lowest # was .05. When I was getting <.1, my uro said I didn't need an ultra sensitive pSA test. Don't need to do anything till .2psa. I would relax till at least .1
Posted 5/25/2018 1:32 AM (GMT 0)
Hi, Delta2,

Results <.03 are not reliable predictors of biochemical recurrence. The 2015 UCLA study indicated better long-term outcomes if salvage radiation therapy is started when the PSA reaches .03 instead of waiting till it hits .1 or .2 (the classic thresholds that urologists typically cite). See When should pt & md consider SRT?.

You're well below even the .03 mark. The minor variation in 3-month results is getting you little other than useless anxiety. You're still looking good.
Posted 5/25/2018 10:58 AM (GMT 0)
InTheShop,

Question for you...I thought that leftover prostate tissue could not generate PSA because it no longer has its blood supply so it dies off, but cancer cells have their own blood supply therefore are able to continue to spill out PSA.

Is that true or can left over prostate tissue still make PSA?
Posted 5/25/2018 12:54 PM (GMT 0)
You have had a rough road with two cancer surgeries. Ouch! But I think you should regard your PSA numbers as pretty good news. Your pathology was good and indicative of a successful surgery. In my case, I had a much worse pathology after the surgery, and while my PSA was undetectable at first, it rose to .05 after ten months, at which point I had RT. I was persuaded by the research showing that a PSA of .03 was predictive of an eventual full-blown recurrence. Based on that, you've got a long way to go. So, be happy!
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