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Cancer: Prostate Message Board
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Old 06-14-2008, 04:37 AM   #1
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alex1945 HB User
Smile Post-op PSA

Hello all
I am a new poster here and I have a PSA situation which is making me nervous. I had radical prostate removal on Oct 15, 2007 via DaVinci robotic.
My pre-op PSA was up to 8.4 and my biopsy showed gleason 3+4 & Parlin
T2A. The post-op showed no marginal tissue or lymph node cancer. However,
my first PSA reading at 6 wks <0.05, at 3 mos 0.05, at 6 mos 0.07, at 7 mos 0.08, and this week at 0.07. The tests were done with conventional equipment with low cut off supposed to be at 0.05.
My surgeon claims that there should be no cause for alarm at this point since your body seeks a PSA level after surgery and my PSA is not at the point where the readings are most accurate
(0.1), and not at the "recurrence" point (0.2).
He claims that your body produces trace amounts of PSA even with no prostate, and your body seeks a "normal" post-op level over time.
Has anyone experienced this type of increase, and should I be concerned with these reading increases in this short period after surgery? Any comments will be appreciated.
Thank you.

Last edited by alex1945; 07-04-2008 at 03:52 AM.

 
Old 06-26-2008, 05:59 PM   #2
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Re: Post-op PSA

Hi Alex,

I noticed no one has responded yet so I want to pass on some information. I'll insert it in green. Jim


Quote:
Originally Posted by alex1945 View Post
Hello all
I am a new poster here and I have a PSA situation which is making me nervous. I had radical prostate removal on Oct 15, 2007 via DaVinci robotic.
My pre-op PSA was up to 8.4 and my biopsy showed gleason 3+4 & Parlin
T2A. The post-op showed no marginal tissue or lymph node cancer. However,
my first PSA reading at 6 wks <0.05, at 3 mos 0.05, at 6 mos 0.07, at 7 mos 0.08, and this week at 0.07. The tests were done with conventional equipment with low cut off supposed to be at 0.05.

Conventional equipment may have been used, but such results are considered ultrasensitive. My doctor has nearby equipment with a lower limit of <.04, but because of the nature of my case, sometimes we want a test that will go to <0.01, and we have to ship that out.

My surgeon claims that there should be no cause for alarm at this point since your body seeks a PSA level after surgery and my PSA is not at the point where the readings are most accurate (0.01), and not at the worry point (0.02).

I'm thinking you meant to write .1 instead of .01 and .2 instead of .02. Of course I don't know what equipment/test kit the doctor is using, but there are PSA tests that are reliable and accurate down to <0.01 in a normal clinical setting, not just a specially prepared research setting.

He claims that your body produces trace amounts of PSA even with no prostate, and your body seeks a "normal" post-op level over time.

That "trace amount" statement is true, I think, but the amount is extremely small. Research in one study showed that patients with a post-op PSA of <0.01 had the best odds of cure, with patients with results of 0.01, 0.02 and 0.03 having very good odds but with increasing risk of recurrence. Patients at 0.04 had a fairly substantial risk of recurrence, and patients at 0.05 and higher had a strong chance of reaching a PSA of .2 at some later date. A PSA of .2 is generally accepted as the definition of a significant recurrence.

Has anyone experienced this type of increase, and should I be concerned with these reading increases in this short period after surgery?

Based on what I've read and heard, I think you are right to be concerned, but there is an encouraging possibility. It is possible that a small amount of healthy tissue was left and that that is accounting for the PSA reading. If so, it should stabilize, and the last three readings hint that that may be happening. Maybe your doctor uses a technique that often leaves a small amount of healthy tissue (around nerves that are spared, for example), and that could explain why he is not concerned at this point. The thing to look for is an increasing trend.

Please keep in mind that I'm a fellow layman survivor with no enrolled medical education, so take what I've posted as leads but not authoritative.


Any comments will be appreciated.
Thank you.
Take care,

Jim

 
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Old 07-04-2008, 04:00 AM   #3
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alex1945 HB User
Re: Post-op PSA

Quote:
Originally Posted by IADT3since2000 View Post
Hi Alex,

I noticed no one has responded yet so I want to pass on some information. I'll insert it in green. Jim




Take care,

Jim
Hello Jim
Thank you for the information. I am hopeful that your comment about the healthy tissue being left behind accounts for my .07 level - time will tell.
Thanks again and have a great day.

 
Old 07-04-2008, 06:30 AM   #4
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Join Date: Jul 2007
Location: Plano, TX
Posts: 33
mauryfromplano HB User
Re: Post-op PSA

Hi Alex,

Am in the same boat as you.

First three PSA's after surgery last July were <=.05 This facility considers this undetectable

This last one last week was at .06.

The Doctor wants to wait a month a retest to see if maybe it was a false reading.
Not sure what will happen after that second test.

Regards,

Mark

Last edited by mauryfromplano; 07-04-2008 at 06:31 AM.

 
Old 11-29-2008, 07:55 PM   #5
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alex1945 HB User
Re: Post-op PSA

Hello Jim
I want to thank you for the information you provided to me. I have read your comments several times the past few months and I have to tell you that you have provided the most logical and definitive information that I have been able to find.
I am hoping that your comment regarding the surgeon leaving healthy prostate tissue behind is the answer, as I have had several PSA readings at the 0.07 level over the past 8 months.
Thank you again for taking the time to respond to my question. I hope that all is well with you.

 
Old 11-30-2008, 04:36 AM   #6
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Re: Post-op PSA

Hello Alex,

You're welcome. We are all here for each other, and I'm glad I was able to help.

Good luck,

Jim

 
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