Dad's PSA results 1 month post surgery

Hello all,
I haven't posted in quite a while but am always reading and learning from all of you. Just wanted to give an update on my dad. He had his prostate removed back at the beginning of November. Gleason upgraded from 7 to 4 + 4 and Stage 3C. Today he got the results from his first PSA since the surgery. His level was less than .01! Does that mean that he is cancer free? You may remember that the urologist did not do a biopsy of the lymph nodes during surgery nor did he do any scans prior to surgery. My dad is scheduled for a bone scan next week. If it had spread to the bones, would his PSA be higher? That is my biggest concern right now. The dr. had previously said that he would need radiation after surgery. Is that normally the case when the PSA is this low or is that standard protocol with stage 3? Sorry for all the questions, but still trying to be as informed as possible.

p.s.: Dad has been having night sweats like crazy. What's the deal with that? He is also waking 3 to 4 times to go pee. Still dealing with incontinence but I believe that is normal, right?

Thank you!

Sandi

Sandi,
That sounds like an excellent outcome over all.
Yes Gleason 8 is worse than you/he thought, but an actual PSA of less than 0.01 at four weeks is as good as anyone would hope for. Your dad is in the zero club.
I disagree with Ed, and don't think it's time for adjuvant treat,ent, but I'm not medically qualified to say that. However it looks to me like there has been no spread given such a low PSA and I would think that the docs may reappraise his situation on the basis of this and that he won't need any more treatment just yet. (my first post surgery PSA was 0.1 and they didn't do anything at that stage even though my cancer had spread to the seminal vesicles; they waitied till there was a rise above 0.2.)

Four weeks is early days in the continence battle, especially as I'm guessing it's only three weeks since the cath came out.
Getting up at night can be helped by not drinking too much if at all after about 8pm. And remember that too many kegels can have an adverse effect as they make the muscle tired. I find that my night situation gets worse if I lie in bed awake and worrying about it, so I usually try some simple thngs to relax me at bedtime.

Not sure about night sweats, has the doc suggested any help. Could just be his body's reacton to all the meds he's had (both for surgery and for pain elief after.)

And I know that this is the difficult area for daughters to deal with, but I hope he's not suffering in silence about ED etc and knows what to do to help achieve optimum recovery over time.

Congratulations on the great report. Sounds like your dad is doing get. You can't hope for a better PSA than that.

If the PC had spread to the bones the PSA would be a lot higher so you do need to question whether adjuvant treatments are needed. You could wait a few months to see if the PSA rises any. Really depends on whether or not the surgery got all the cancer cells or not. Very hard to say for sure.

The other symptoms are likely to improve with time but call the doctor if you're concerned. I get very bad night sweats after surgery due to the pain meds but it goes away when I am able to stop taking them. Is you dad still taking any of those? But you still might want to ask the doc about that.

All the best,
Andrew

momx4,

In another thread I posted a link to a study that suggests that neo-adjuvant hormone therapy improves cancer control for high-risk men who have had their prostates removed. Here's the thread:

www.healingwell.com/community/default.aspx?f=35&m=2577217

and the link to the study:

Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy: SWOG S9921 study


Since your dad's Gleason score was bumped up slightly in the post-op pathology it's something you might want to think about.