Brian.PSA postRP .65,T=37 said...
I understand the PSMA scan is the most advanced test out there but according to my RO it only picks up only macro particles which is basically cancer cells larger than 3mm (1/8”) diameter. With a PSA of .65 two months after my radical prostatectomy, I’m a little disillusioned with the PSMA scan. My RO told me after getting the results from the latest scan that is great news “,that no macro cells have been found in my bones, soft tissue, or the prostate bed. So he started me on Lupron for six months and radiation starting the middle of August for 5 1/2 weeks with PSA tests every two months. Hopefully, six months from now my PSA will be .00. Any comments? Thanks
Hi Brian and Welcome to the Forum! Perhaps you could add a signature file with your salient data. It will automatically append to your posts and will help focus answers based on your post-op status. Add your history: PSAs, biopsy results, and post-op path-report findings.
Ideally, one wants to have a post-op PSA of less than 0.1 (<0.1). A PSA of 0.65 at two months means that something was left behind, in the prostate bed, adjacent anatomical structures, local or distant lymph nodes, or other mets. Your PSMA results were
good in that if all the cancer is local, radiation may knock it out and your PSA would then drop
in time: the remaining cancer cells are not removed as happens with surgery, but rather slowly die off from the radiation.
No PSA test, however sensitive, reports only zeros. The lowest a test can go is a "<" sign before its lower limit of detection. So a test that can detect 0.1 reports <0.1 because it has determined only that your PSA could be anything below that. Quest's ultrasensitive test can detect down to 0.02, so the lowest it can report is <0.02 and not zero. And so on according to the specific test used. (Also, some non-prostatic, healthy tissue, like the urethra, can produce very small amounts of PSA, which is another reason not to think your PSA would ever be zero).
What was your post-op staging, and were there any positive margins noted in your path report? Tiny amounts of cancer can be left behind if it grew through the prostate capsule before your RP (did your report note, e.g., positive surgical margins, extraprostatic extension, bladder-neck invasion, etc?).
Please keep us posted, and best of luck with your treatment!
Djin