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PSA 0.08 after having surgery in 2004

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Posted 6/20/2009 3:03 AM (GMT 0)
Since having surgery in  2004, my PSA has risen from 0.04 to 0.08.  Should I have additional treatment? Is this rise cancer?

Not sure what to do

Posted 6/20/2009 3:42 AM (GMT 0)
Burgh, Here is how I see it (I am sure many here on this forum will provide their opinion). First, you need to determine if this is a recurrence. Yours is still a very low ("undetectable") reading. Some other parts of your body make very small amounts of PSA (uretra does). The healthy prostate tissue left behind after prostatectomy grows and produces PSA, so you really need to see the dynamic of the PSA growth and act only if it reaches a "detectable" level of 0.1. I think you need to look at few more variables. PSA doubling time from the last two or three tests, your age, Gleason score and pathology. And, of course, talk to your docs. (BTW, if you go to control panel and update your stats, it'll make it easier - no need to repeat your stats to everyone). Then, if it is a recurrance, you need to figure out the way to deal with it. With low Gleason and high PSA doubling times, doing nothing (watchful waiting) is an option. Radiatin is an option too. Depending on your age, hormonal therapy is an option. There probably are some more. But first things first - you need to know this is a recurrence. As you see from my signature, my case is a little different. It is undoubtfully a recurrence, but the question is whether it is local or systemic. I am betting on local and going for radiation treatment.
Posted 6/20/2009 5:30 AM (GMT 0)
Yes, please provide your stats following surgery. There are various nomograms online where you can plug in your numbers and get the probability of a recurrence x number of years after treatment. That being said, I doubt many would recommend taking action immediately unless your pathology was poor. Even if your PSA continues to rise to 0.1 and beyond, it will probably not do so very fast based on your history, giving you time to work on a salvage therapy. If your pathology was good, you may find that your likelihood for a recurrence could be very low.

I have been interested (obsessed?) with the ultrasensitive PSA test since my surgery. Some men are lucky and have a very low number that never fluctuates. Others have to deal with anxiety that goes along with fluctions that may only be noise. Due to my excellent pathology, I have decided to switch urologists and go forward with the "standard" PSA test with a minimum sensitivity of 0.1. This is also the general recommendation from Johns Hopkins. I have had a very small increase from <0.008 to 0.02 over about 18 months, which is probably insignificant, but I still find myself thinking about it. I know some will say that I will lose information about PSA velocity, but I cannot see how this would change my course of action in the event of an eventual recurrence.

Please provide your pathology statistics.

CaPCa

Posted 6/20/2009 9:12 PM (GMT 0)
Greetings, Burgh.  Maybe I'm naive and too trusting, but my doc only uses a scale in tenths and my PSA report alwasy comes back less than .1 which he calls zero.  There are several reasons why your PSA can vary just slightly between tests.  As long as it is less than .1 I would monitor but not be too concerned.  David

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