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Low detectable PSA after prostatectomy – watch or treat?

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Posted 1/14/2015 5:46 PM (GMT 0)
Many men are anxious about low and perhaps increasing levels of PSA found on an ultrasensitive PSA test after surgery. Here's some evidence about the signs to watch for before treating.

Low detectable PSA after prostatectomy - watch or treat?

- Allen
Posted 1/14/2015 7:23 PM (GMT 0)
Allen, in your article you say "and it takes a median of 8 years for distant metastatic progression, and 13 years for mortality to occur, according to a Johns Hopkins study (by Pound et al.)."

When does the clock start ticking? That for me is the conundrum.

Cheers, Doug
Posted 1/14/2015 7:55 PM (GMT 0)
It says from the time of surgery. However, the men in that study were treated from 1982 to 1997 at Johns Hopkins, so most of those were treated in the pre-PSA screening era, and before most of the latest therapies were available. One would expect the median survival times to be quite a bit longer these days.

- Allen
Posted 1/14/2015 8:38 PM (GMT 0)
In retrospect I had confirmed mets at three months which would take a huge bite into that time frame. My Uro at the time hazard a guess that the tumour had been growing for more than five years, interesting.

Cheers, Doug
Posted 1/14/2015 9:36 PM (GMT 0)
I was undetectable (<.05) after surgery. Decided to do adj radiation because of pathology. 15 months later I had a low detectable psa (.09). I chose to treat early...ask questions later.

If I was a higher Gleason with a low detectable psa after surgery...I would treat immediately. It's an opportunity for a cure that should be done sooner rather than later. Just my 2¢.
Posted 1/14/2015 10:43 PM (GMT 0)
Shaba.Doug-
CHAARTED adds about an extra median 1.5 yrs too.
Posted 1/14/2015 11:33 PM (GMT 0)
Tall Allen,

I am one with low detectable PSA post RALP.
Thanks for posting the information!
Posted 1/15/2015 12:14 AM (GMT 0)
Lapilot, how soon after RALP was your PSA detectable. And how soon did you do SRT? Did that take care of it?
Posted 1/15/2015 12:59 AM (GMT 0)
I may be wrong here, but it is my sense from my readings, not research, that for that particular timeline, the patients had only primary treatment. I hope this is correct. Does any one know? In other words, the clock starts ticking after primary treatment and there is no additional treatment. At 8 years mets... wait 5 years, replicant termination date. That scenario works nicely for me, because at the met point, treatment is an option. An observation: What a rube goldberg machine we have in these studies, trials, lidat. Having said that, A rube goldberg machine will eventually plop the the slop into Einsteins, or was it Copernicus's bowl…. Hey, its who I am….
Posted 1/27/2015 11:52 PM (GMT 0)
Pratoman,

I haven't had SRT yet. My post PSA six week was undetectable, but the following 4 were at 0.1. So I am just waiting and see if and when it goes up to 0.2. Then I will make a decision on SRT.
Posted 1/28/2015 12:28 AM (GMT 0)
Got it lapilot , thanks. I misunderstood,must reread thru the entire thread including Allens article.
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