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psa after prostatectomy surgery

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Posted 4/9/2019 8:01 PM (GMT 0)
In 2015 I had robotic surgery to remove my prostate. prior to surgery the biopsy results showed cancer in all quadrants and I was told it is aggressive. After surgery I was informed that they had found cancer outside of the prostate I believe in the nerve bundles but they had removed the cancerous tissue and thought they had got it all. My psa up until now was Zero. In March 2019 my doctor sent me back to the urologist after my psa rose to 0.09 ng/mL. before this time regular testing showed no variations in psa. My question is how often at this point should I have my psa tested? I understand that ~0.2ng/ml is the magic number but testing every 6 months seems like it should be more often than that seeing how I was told it is aggressive?
Posted 4/9/2019 8:45 PM (GMT 0)
Welcome to HW.

Do you recall your gleason score or PSA pretreatment? That would help us give a better answer.

You need to confirm that reading (lab errors are possible). At that level, I'd think once every 3-4 months. If you get a couple of more PSA rises from here, you'd need to be talking to an RO about SRT.

First though, I'd wait a couple of weeks and retest to confirm the last number.

If this number is true, you might want to start the conversation with and RO now about your options.

Andrew
Posted 4/9/2019 9:42 PM (GMT 0)
The PSA doubling time (PSADT) is the most important indicator for recurrent PC after RP--more important than pathology Gleason score, or anything else--and your several years of undetectable results post RP bodes well for you. After those years of undetectable, a new reading of 0.09 ng/mL (you have obviously gotten an ultrasensitive PSA test, if that was your result) is an unexpected result. Rule of thumb: never make any decision on just one unexpected PSA result. PSA test results are notoriously "flakey." If you get an unexpected PSA result, the first thing one should do is have a repeat test, using the same lab. No need to rush out for it, but I also wouldn't wait 6-months either. My suggestion is to have a re-test to validate or invalidate the recent unexpected result in the next month or two.

Post Edited (Blackjack) : 4/9/2019 3:46:22 PM (GMT-6)

Posted 4/9/2019 11:12 PM (GMT 0)
There is no magic number for when you should initiate salvage treatment. The idea that you should start radiation when PSA hits .2 is somewhat outdated now and there is a lot of evidence that results are better when radiation is started sooner. I agree with the idea of checking your PSA again, but I think you might also want to consult with a radiation oncologist. Check out this discussion on this site:
https://www.healingwell.com/community/default.aspx?f=35&m=3495340
Posted 4/10/2019 12:06 AM (GMT 0)
My doctors were involved in the early research to help establish that .03 seems to be a good place to start SRT. They let me go to .06 before I started treatment. I have been <.,006 every time for 47 months. Very thankful to God and their abilities to get me “done”.
Hope all goes well for you along this journey.
Posted 4/10/2019 4:32 AM (GMT 0)
It's wonderful that you've been undetectable for 47 months after your SRT treatment, Octorobo. Congrats!

However, had I taken your doctors advice and had SRT treatment @ .03 it would've been at a great expense to have my body radiated for nothing, since my PSA subsequently fell to .01.

Patience has never been one of my strongest virtues. But if there's one thing this dreaded disease has taught be it's patience.
Posted 4/10/2019 10:44 AM (GMT 0)
Hello TJ: From your signature, it looks like your PSA went up to .03 on one reading and then fell again. What a relief that must have been! I think you are absolutely right about the virtue of patience and avoiding panic when when one PSA reading comes back looking bad. It's always the trend that matters, and that requires waiting.
Posted 4/10/2019 1:17 PM (GMT 0)
thank you all for your reply's. My age at diagnosis was 58 I am 62 now. I do not remember the Gleason score
and could not find my old records. I have heard debate surrounding the "magic Number" as I put it. I will schedule another test asap and once results are known go from there. I hope the lab results are better this time. Again thank you all for your advice.
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