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Low PSA before surgery (below 2), 0.2 still as met threshold?

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Posted 6/13/2021 5:04 PM (GMT 0)
An old question: I have a very low PSA (never above 2ng/ml), but high gleason score, before the surgery. It sounds the tumor did not produce many PSA. So the standard PSA .02 after surgery should still be regarded as met threshold? The treatment should be different?
Posted 6/13/2021 5:16 PM (GMT 0)
Wait a few months then recheck PSA. Without a prostate it should be zero!
Posted 6/13/2021 5:38 PM (GMT 0)
Some PCa can express little or no PSA. A former member was a G9 and over the period of several years he had numerous treatments for Mets, but his highest PSA was 1.9 before surgery.

In your case I remember you had an average size prostate and an expected PSA based on the size. However, I can’t find you surgical pathology information. Please update us and then put it in a signature so we know what your situation is.

As Howard mentions you wait at least 90 days to see what the post surgery PSA is. If it is not undetectable then your docs need to determine the next step based on your original dx and surgical pathology and developing trend. The 0.2 is a guideline that is used to confirm a recurrence. In actuality it would be much less for anyone that actually teaches that point. Some docs will consider SRT at a much lower level.
Posted 6/13/2021 5:50 PM (GMT 0)
There are separate thresholds for two different issues: (1) persistent PSA soon after RP (0.1 or higher) and (2) BCR, a return of a PSA (after being undetectable post-op) to 0.2 and rising.

Please create a signature with all your salient data (PSA history, date of RP, all post-RP path findings including path staging in the report), post-op PSA's and their interval after RP.

Persistent PSA usually means your primary treatment of surgery needs to be completed with RT.

Regarding BCR, whether salvage RT should be started before PSA reaches 0.2 depends on many factors.

Be careful typing PSA values: I think you meant 0.2 and not 0.02. When writing number less than 1, It's best to use a leading zero before the decimal point to avoid confusion: without the zero, it's impossible to know if .02 means the decimal point was misplaced or the decimal point is correct but the leading zero is missing. I'm not trying to be Chief of Decimal Police -- folks are free to type what they like -- I'm only saying that the reader may be confused.

Thanks,

Djin
Posted 6/13/2021 6:09 PM (GMT 0)
Thanks. How to create signature?
Posted 6/13/2021 6:18 PM (GMT 0)

116grove said...
Thanks. How to create signature?

click on my profile above and then edit profile. don't be alarmed if your signature doesn't show right away. it should eventually
Posted 6/21/2021 12:18 AM (GMT 0)
My husband had a very unusual case... high volume Gleason 6 with a low psa, pathology confirmed by Epstein. His pre-surgery psa fluctuating 2.4- 1.9
We consulted with numerous specialists ... most of them say pay close attention to the ultra sensitive psa numbers... a trigger for SRT would probably be .03 -.05 ... he is 28 months post surgery and has been <.01
Posted 6/21/2021 12:28 AM (GMT 0)
Thanks a lot, Leah. It is a valuable info for me. I must pay a very close attention to ultra sensitive PSA.
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