Ultra-sensitive PSA - tendency to bounce up after surgery even with no eventual recurrence?

I have noticed, after following a number of signatures from other members, that the lowest ultra-sensitive level is achieved on the first test after surgery. This assumes that sufficient time has elapsed to to allow for the prostate-generated PSA to decay away. Some men eventually experience a biochemical recurrence, reaching 0.2ng/ml. However, this seems to be true for many men who probably will never have a recurrence. Levels seem to go up a bit from the post-surgery test, plateau, or move back down. Some men are lucky and see a steady sequence of levels over time. However, I don't think I have EVER seen a decay down from the first test, e.g. 0.04, 0.02. 0.01, etc.

This is by no means a scientific observation. I was wondering if anyone else has noticed this and whether there is a medical explanation. I know of the "bounce" from radiation treatment, but I have not heard of a "bounce" described for surgery. I thought I had read a one time that the prostate not only produces PSA but absorbs some of it as well. This might explain explain why the loss of a prostate lets other minute sources of PSA (Cowper's gland, etc.) become more apparent over time. Thoughts?

CaPCa

CaPCa,
Good question. I was wondering the same. As you can see from my signature my psa is rising ever so slowly but rising. What would cause the psa to start going down?

It seems to me if you are lucky enough to achieve <.01 at six weeks after surgery then you are in very good shape and will stay that way.  Anything above that seems to be a crap shoot which leads me to the theory that in alot of these cases there was prostate tissue left behind, not necessarily cancerous.  I believe the big downside to robotic or other nerve sparing surgeries is the tendancy to leave tissue behind in order to spare the nerves which is great for your sex life but problematic for future psa testing.

My father's first post op PSA was .07 and his second one a few weeks later went down to .05. However, they were done at two different labs, so it is possible the differences in labs resulted in the difference in PSA . Of course, I am hoping it was because his PSA went down because he was not even 12 weeks post op. He started radiation and HT shortly after, so we don't know what the third would have shown. Interesting topic. I am also interested in the timing of the first post op PSA's and whether the 6 week vs. 12 week post op PSA's really make a difference.

CapCa:

Wondering how your psa is today?  I am very worried about my dad. My dad's post surgical psa reading have been similar to yours.  His post surgery psa was <.01 until 18 months after surgery.  At that point it was .01.  Stayed there for 6 months until 5/10 at which point it was .02.  He is being re-tested in the next couple of weeks, but my anxiety is high.  The oncologist thinks it may be a recurrence - his surgeon disagrees.  I am praying that your psa has remained  stable. 

Laughing Again.