PSA after RP

Connector,
Glad you are here.
You did pay to have ALL of your prostate removed didn't you? LOL
What were you pre-surgery statistics? PSA- prostate size
some of the real smart guys on here can use PSA half life and determine how fast it should be going down
It has been five years since my surgery but I think I remember that my Dr. was comfortable with a reading at six weeks
some would say three months
you are sure that you are reading 2.36 not .236

Well, I have to disagree. After a radical prostatectomy, I would think it's very unusual to have a PSA of 2.36 six weeks after the surgery.. I would think that would be a clear indicator that your surgery has "failed," and that you're going to need salvage radiation treatments.

Still, it would be very helpful to know the results of your pathology, both at biopsy and following the surgery.

A PSA of 2.36 would be different if you had just finished radiation treatments. In that case, it might be useful to talk about "half life. " But 6 weeks after surgery, I'd be looking for numbers less than .1, and hopefully even lower than that.

Others may have a different thought on this. What did your doctor say about this?

I agree with Clocknut- 2.36 really does seem high
Let us know what your doctor says

Hello Connector,
I may not have posted here a lot, but i have done a lot of research for my father he was dx in 2004 wirh PSA of 36 and had RP classical surgery his PSA reading 2 months after surgery was 0.80, and pathology pT3a G2 M0 N0 and GS 4+3. to cut the story short the doctor always said that he would like to have the PSA 0 after RP, so he had radiation .... HT ... but PSA never 0 near but never 0.
Since we are not from US it is a bit harder for us to get to some new treatment protocols so i had to do my research to try and help my father. Than last year I got nervous since his PSA was rising again after chemo and had to seek options for him, I got a second opinion from a US doctor and was also lucky to get in contact with Dr. Strum trough P2P where he put all the things in perspective for me to understand. He has now started Abiraterone and we hope to see positive effects from it.
I am hoping that this will not be the case for you and I hope that you see a decrease in your PSA and all works out fine for you but I had to share what I learned.
Although harsh in his words Dr. Strum is probably or evidently true that all the things done to my father although right for the treatment for this illness by the book are not always best form of treatment for every patient. So I suggest that you see all the possibility and seek special advice if you conceder radiation because radiation should be done properly.
I could send the details from my communication with dr. Strum it is a good read for anyone it may help you understand how important it is to tailor make a treatment for each patient.

Best wishes
Bianca

Hi Connector

Sorry to hear about your situation but I can relate. I'm from Illinois but went to Henry Ford in Detroit for RP.  Before surgery my psa was 6.7 and Eight weeks after it was 6.9. My surgeon said that some guys just have more trouble getting it out of their system. My Urologist here at home had nothing to say that was informative (that's another story) Both though only suggested Hormone T. and only Lupron, nothing else. My psa has gone down to .9 after two months. a four month shot. Regardless, we are heading soon to Chicago to Uni. of Chicago Medical Center to get hopefully good advice and care. (Dr. Walter Stadler.)

Dime- Would love to have your communication from Dr. Strum.

Take care all!

Jim in Illinois

surgery

Hello Jim i will send you an e-mail. Take care Bianca

tarhoosier, clocknut, Jim, Tony, Bianca, Octorobo:

Thanks for all of your comments.  It is very helpful to hear what you all have gone thru.  Here is some additional information regarding my situation:

Path Report:  G7 (4+3); tertiary G5; weight 71 g.; 17% involved (mostly right side); posterior margin involved; right seminal vesicle invasion (T3B); perineural invasion; no invasion of right pelvic and left pelvic lymph nodes; no other metastasis noted.

After seeing my 6-week PSA of 2.36, my doctor recommended radiation, but is undecided about HT during radiation, at this point.  I have heard that the combination can be beneficial. Does anyone have experience with that?  If so, when did HT start, and end, and what type (Lupron?).  He believes the radiation will knock the PSA down to where it should be (near zero).

Also, would appreciate any comments on the various radiation types (IMRT, IGRT, Rapid Arc, TomoTherapy, Proton Therapy) that anyone can offer in regards to which is best for minimizing the effect on adjacent healthy tissue/organs.  Or, are they all about the same?  It is hard to know which is best with the marketing blitz out there to promote their own program. 

Hi Connector, your postop PSA does seem high, maybe down the track it will settle down hopefully, mine was also strange. After RP it came back at 0.5, and even after SRT it only went down to 0.4, the back up to 0.6 where it stayed for 4 years! Only recently last year in July it jumped to 1.31, then over the next 3 months went down to 1.0.

I hope you and your medical team work out the best future plan for you.

Regards Mal.