Post PSA after surgery

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stepjnsj
stepjnsj Member Posts: 18
edited March 2014 in Prostate Cancer #1
Hello everyone I had prostate surgery Sept. 20th and my first six week check up PSA test was last Tuesday on Nov. 2nd it came out to be .29 he said my surgery went fine and my Pathology Report said that it was completely confined I had a gleason score of 3+4 =7 and he said that I would make a complete recovery.He scheduled another test in 30 days to find out if this is correct. Until I saw that test I am now concerned if this is good or bad a .29 does anyone have had a score like this after their first test.

Stephen

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  • BRONX52
    BRONX52 Member Posts: 156
    #2
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    My surgeon tested me at 6
    My surgeon tested me at 6 weeks post surgery and I had an undetectable reading. He did say that if I still had a psa reading it could still be ok as sometimes it takes a little longer for the blood to get rid of any remaining psa. However, if at the second reading the psa was still measurable then some additional treatments might be required. How long until your next blood test? I wouldn't want it to be too far out because any significant positive reading following surgery would concern me.
  • lewvino
    lewvino Member Posts: 1,010
    #3
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    Stephen...sorry to hear it
    Stephen...sorry to hear it wasn't 0. Follow up and retest as the doctor suggested in 30 days. Try not to worry (yes I know easier said then done).

    Let us know how it goes on the next test.

    Larry
  • stepjnsj
    stepjnsj Member Posts: 18
    #4
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    BRONX52 said:

    My surgeon tested me at 6
    My surgeon tested me at 6 weeks post surgery and I had an undetectable reading. He did say that if I still had a psa reading it could still be ok as sometimes it takes a little longer for the blood to get rid of any remaining psa. However, if at the second reading the psa was still measurable then some additional treatments might be required. How long until your next blood test? I wouldn't want it to be too far out because any significant positive reading following surgery would concern me.

    My Test
    Yes he has scheduled a retest in 30 days and I am hoping that there was some sort of error from their first test. However I am thinking about having another test from another doctor if the next comes back high too. But if it does comes back high what option do I have for treatment.
  • Kongo
    Kongo Member Posts: 1,166 Member
    #5
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    Post RP PSA
    I'm so sorry your PSA scores came back at the level they did six weeks after your surgery. Regardless of our treatment method, those of us with prostate cancer dread the possibility of a return of PSA readings that might indicate our cancer was not arrested by treatment and is continuing to grow. Men who chose radiation have to wait months for their PSA to decline to a nadir before they can have confidence their procedure worked. For those who choose surgery, the results are generally known much quicker but both groups face a lifetime of continued PSA readings to see if the cancer returns.

    While most men who choose surgery have an undetectable PSA reading six weeks after their operation (like Bronx) there is a large minority that do have a detectable reading but that doesn't always mean bad news.

    PSA has a half life of 2-3 days. While it’s possible that your readings are a result of residual PSA in your bloodstream that has not yet dissipated, the mathematics involved in tracking this reading strongly suggest otherwise. Keep in mind that when the prostate is removed it's not like they can unbolt it from the pelvis cavity and set it aside completely intact. Most often there is some prostate tissue remaining behind in what is commonly referred to as the prostate bed. The surgical process caused a great deal of trauma to any remaining prostate tissue and just like if you had a urinary infection or some other inflammation of the prostate, this damaged prostate tissue is going to throw off a higher amount of PSA (similar to what is seen after a biopsy) for several weeks. Hopefully, that is what you are experiencing.

    On the other hand, it is possible that even though your post surgery pathology indicated the cancer was contained and even though the surgeon said everything went well there could be some cancer in the prostate tissue left behind that is causing your PSA to increase. If this is the case, I am sure you would wish to get it treated.

    A remote possibility, in my opinion, given your overall diagnosis and pathology is that the cancer had spread to a nearby lymph node or into the tissue surrounding the prostate and that is what is causing the PSA.

    To me, the most likely scenario is that the remaining prostatic tissue is throwing off PSA following the trauma of surgery and if that is true, then your next PSA reading should be lower.

    Urologists now define biochemical failure following RP as a PSA score greater than 0.2 ng/ml and rising. With only one reading you obviously don’t know whether it is rising or not but the next test will tell the story.

    Long term prognosis in these cases is excellent. Possible treatments include follow-on radiation, hormone therapy, or a combination of both. I would take the time before your next PSA reading to read up on these options so that you can immediately discuss potential treatments with your doctors should your PSA reading on your next test be higher than it is now. You should also look at some of the nomograms available on the web for calculating PSA velocity following RP as that is an additional strong indicator of the potential severity of cancer left behind. (See the Sloan Kettering website for how to calculate these numbers)

    I hope your next reading shows a significant decrease in your PSA and that you have nothing to worry about.
  • YTW
    YTW Member Posts: 67
    #6
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    stepjnsj said:

    My Test
    Yes he has scheduled a retest in 30 days and I am hoping that there was some sort of error from their first test. However I am thinking about having another test from another doctor if the next comes back high too. But if it does comes back high what option do I have for treatment.

    Another PSA test
    Stepjnsj: Its my understanding that for an accurate determination of PSA findings, the tests should be done and interrupted at the same (lab) facility as there may be discrepancies between them. You may wish to check this out with your URO....Best of luck and keep us posted..............................Jimmy/Cleveland
  • jagostini
    jagostini Member Posts: 1
    #7
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    PSA after surgery
    I had my prostate removed in 2003, my PSA never dropped to zero. It varies between .1 and .2, these days I have my PSA checked every years, and I have not taken radiation nor any kind of medication. I would watch your health and eating habits, but do not go overboard. Good luck, and if you want to read some really good info, go to yananow.net. There are thousands of stories, youy can follow people for years, and you might find people that went thought the same exact thing and PSA reading as you. Good luck. By the way, my PSA was 4.5 and my gleason socre was 6 before the operation.

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