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Is this a rising psa?

Posts: 24
Joined: Feb 2004

I had an rp on 7/25/03. 54 years old and psa 4.7. After rp gleason score of 7+ and cancer found on margins. Three months after rp - psa was 0.14 (they said they were getting the psa two ways - the old way of 0.14 and the new sensitive way which equated to 0.04). Psa went (new way) from 0.04 to 0.03 to 0.02 to 0.01 and then went up to 0.04 (old way 0.14). My uro said he was concerned that if it stayed that way we would have to do more test but it went to 0.03. Why does it not stay at 0.01 or lower? I have never had a bone scan or any other test. Do you think this is needed or not necessary because the psa is too low? Any help you can give me is really appreciated.

2ndBase's picture
Posts: 220
Joined: Mar 2004

Generally a psa that low does not warrant a bone scan and the change from .01 to .04 is not satistically signifigant. psa readings vary. I had two done within a week and got .66 and 1.2 when run at two different labs. I had a psa of 24.5 and it went to .14 and is now .66 and my urologist is not concerned unless it gets over 1.0 which is likely to happen within a year but you really should not be very concerned about a .04 reading.

Posts: 57
Joined: Jul 2005

Hi Mike

I had a very similar pathology to you...Gleason7s,8s in 10 cores, psa 6.0 and extension on left side. Had bone scan which was negative. I had an RP in 4/8/04 psa was 0.3 after operation which was considered significant and I had salvage RT. The reason that my urol and onc thought it was significant was that my psa had been low for the pathology of the tumour.

The bottom line of this is that you seem to have a low psa for the pathology of your tumour and that the psa therefore has little relationship to the fact that you might still have cells floating around. I don't want to seem negative but my psa went down to 0.22 and stayed there but I still managed to get mets in my lymph system found by regular mri scans. Bone still negative. You perhaps should ignore your psa and request regular mri scans at least annually if not every 6 months.

If you need to talk some more I am happy to have a private exchange of emails.

Kind regards
David aka photon

Posts: 117
Joined: May 2003

Could you be a little more descriptive with regard to the "old way" & "new way" (more sensitive?? Could it be the difference between total PSA and "Free PSA"? Two totally different methods of measurements. Other than that I agree with the other respondents. Even with an "old" value of 0.14 I suspect a bone scan would be worthless (data that is!, obviously not the cost!)
Cheers & good luck, Ben

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