Since April 2013 ( surgery in August 2012) my PSA has risen from 0.028 to 0.047 using the ultrasensitive PSA test (same lab) given every 2-3 months. There have been fluctuations at times — an example of that is the last three test results, which were 0.044, 0.042 and the latest 0.047. I am 2 years post-surgery.
I know that using the standard PSA test (< 0.1) would have me still in the undetectable range but what could possibly be going on with my PSA at such a low level? Should I be overly concerned? I went over my post-RP pathology report and the only two “negatives” found were my final Gleason total was 7 (3 + 4) and a small positive margin at the apex with a Gleason grade of 3 at that margin. Could this be the guilty culprit causing the minor fluctuations in my PSA level? If so, would it be wise to start salvage radiation right away or will waiting until recurrence (0.2 ng/ml) is evident be sufficient? I ask this because I’ve heard that not all positive margins will cause recurrence. Also some men have reached 0.1 ng/ml and never progress any further!