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14 PSA after removal of benign enlarged prostate 18 months ago

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Posted 6/9/2021 9:54 AM (GMT 0)
Father in law had his entire prostate removed in January 2020, his biopsy came back clear.

Since then his PSA has been close to 0, but on last test it came back at 14. He is 75yo.

What can cause this if he didn't have cancer detected and he has no prostate left?
Posted 6/9/2021 10:52 AM (GMT 0)
Welcome Sandie,

Well such an increase is not welcome, nor common in such a short period of time after surgery. Please confirm the actual result and the position of the decimal point. Make sure it wasn’t .014, or .14. An increase after surgery most always signals active cancer. about 35% of surgery men still have cancer that the surgeon was unable to remove. Often it is years before this can be determined, primarily from increasing PSA. How was he and you informed of the recent PSA results. Has the doctor quickly scheduled an appointment to consider the next treatment? If not, it makes me question that the PSA is really 14.00. Please double check the result view the actual result document.
Posted 6/9/2021 10:58 AM (GMT 0)
So two months ago PSA was 4, and now it is 14. He had no cancer detected after surgery. The urologist said it might be an infection and he gave him a long course of antibiotics referral for an ultrasound...
Posted 6/9/2021 11:09 AM (GMT 0)
Sandie,

If his prostate was removed (why?) and was cancer free, then we have a really weird situation, and one that needs a serious look at by the real experts. With no prostate, and especially being cancer free, his PSA should be non-detectable.

Where is he located? Where is he getting treated?
Posted 6/9/2021 11:14 AM (GMT 0)
He is in Romania, not in the US. He had a very enlarged prostate which was removed during open surgery and sent fpr a biopsy. It came back as BPH. I am thinking doctors could still leave some tissue there?
Posted 6/9/2021 1:55 PM (GMT 0)
Sandie, yes. The only way to have measurable PSA is if there is prostate tissue present. As far as I know, there is no other organ that expresses PSA. Very, very strange.
Posted 6/9/2021 2:13 PM (GMT 0)
Any unexpected jump in PSA should be confirmed with a retest. This can usually wait until the next test interval, but for this large a jump, I would retest now. There could be an error.

Even a PSA of 4 soon after RP is very large and needs to be investigated. If his PSA is confirmed as rising, the next step may be a scan to check for metastases.

Can you post his complete post-op pathology report?

Thanks,

Djin
Posted 6/9/2021 3:46 PM (GMT 0)
Yes; retest!
Posted 6/13/2021 10:52 PM (GMT 0)
He may have had a simple prostatectomy, not a radical prostatectomy. The first is a BPH procedure for very large prostates.

In such case, he still has a prostate, which, although partial, can still produce PSA.

If this is the case, he could have a benign issue or infection or inflammation.
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