RP in April, '05, PSA 16, bone scan clear. Post op numbers - Gleason 7 (3+4), Stage T3a, positive margin, lymph nodes clear, PSA .06 in July '05, .09 in Oct.'05, and consistent increases to .23 as of Feb 13 '07. Doctor says not to worry until PSA reaches .40 twice in a row. Needess to say, I'm concerned...anyone else been in the same boat? Thanks in advance.

Constable, age 68.

Your doctor is probably considering your PSA doubling time which is an important indication.

A doubling time of less than 10 months is often discussed as being more serious, with more chance of metastases, compared to PSA doubling over a longer time frame.

Dr Scardino's book covers PSA after surgery and associated treatment subjects in some detail, and is worth reading.

Another post here on pomegranate juice touches on doubling time.

John

Constable:
probably is a good time to consult with a prostate cancer oncologist to see if it is appropriate to begin some sort of hormone therapy. If you had a positive margin in path report it might be wise to "head this off at the pass". Is your doctor (you didn't mention what kind of doctor he is) an oncologist who has a specialty in prostate cancer?

Ken in CA

Thanks everyone for your input.
My urologist/surgeon hasn't discussed the steady rise in PSA until I brought it up 2 weeks ago. In prior visits he would just mention that things appear ok so far or something to that effect. AFter doing some research via the internet, I started to become very nervous. My doctor is content to wait for any further intervention until I reach 0.40 twice. I've just made an apointment for a 2nd opinion in Duluth, Minnesota. The nurse I spoke with expressed concern over my situation, and scheduled me for next Tuesday even though there weren't any openings. I would think that the PSA level rising shortly after surgery plus the positive margin issue with Gleason at 7 would raise the 'red flag'. I have also read some studies out there that rely heavily on the marker of 0.40. Like so many others, I'm trying to look at this as a longer term issue; you hope and pray that the decisions made now will not place a heavy burden on family and caregivers 5-10-15 years from now.
Thanks again.

New to the forum, but your post rang a bell....

I'm 46, diagnosed 5/06, Geason 7, PSA 39. RP 6/06. Pathology was T3a, positive margin. Post Surg. PSA waivered between .04 and .09, then went up to .24 in November.

I did a lot of talking and reading and came up with .2 as the line in the sand I wanted to draw to seek out treatment. I saw different numbers all over the place, but .2 and .4 were the most common. I saw a radiation oncologist who recommended 6 months hormone therapy and 36 radiation treatments, which I finished up a month ago (in month 4 of hormone therapy).

My radiation oncologist was not as concerned about the .24 spike as he was about my age, pre-surg PSA, and positive margin. You definitely want to start treatment BEFORE it hits 1, and before it hits .5 if you can help it.

A positive margin makes it MORE LIKELY (although not certain) that the PSA recurrence is due to residual disease at the surgical site. NOTHING suggests it hasn't already set up shop elsewhere in the body.

This all drove me nuts for a while, but my urologist encouraged me to talk to a radiation oncologist to get THEIR number for salvage treatment. I was comfrotable with that --- and would highly recommned you do a similar consultation just to get a different practicioner's take on things...Hope this helps--- good luck!