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8 years post Radical Surgery and 39 radition treatments

Coco_Scout
Posts: 1
Joined: Feb 2011

I am 8 years out from surgery and raditiion. After radition my psa undetectable >.001. Thne in Jan 2011 my annual check up my PSA was .02 and I just had another PSA last week which was .02! Now what do I do wait for the 6 month check up or get a PSA at 3 months.
Thanks
Jim

Kongo's picture
Kongo
Posts: 1167
Joined: Mar 2010

Scout,

Welcome to the forum. I think the easy answer to your question is to follow your doctor's orders but it depends on your doctor. If it's your GP who is now supervising your follow-up, I would put in a call to your urologist's office and pose the question there. If it was your urologist who is doing the testing, I would be curious as to what he told you to do with respect to PSA follow-up testing.

I sense that the underlying, unasked question from your post is with these new PSA readings, do I have anything to worry about (as in am I looking at a recurrence of my cancer)? Given the differences between the decimal points in the readings you evidently had before your recent annual physical and the scores you received in 2011, it may be that you're looking at results from two different lab procedures or perhaps the laboratory that your doctor's office is using changed their PSA procedure or your doctor changed labs and didn't mention it. There are several different methods various laboratories use to measure PSA and the number differences may be nothing more than a procedural change. My guess, based on the information you shared, is that there is something going on with the laboratories your doctor is using.

You are a long way out from surgery and radiation with historically very low to undectable PSA readings. I wouldn't be losing too much sleep over this unless you see a trend that is definitely moving upward. A single point is not a trend and the two readings you have had in 2011 are both at 0.02.

Frankly, it doesn't make any difference whether you have 3-month or 6-month PSA tests. Except for the issue of cost, you could do a PSA test every day although I think the anxiety created by the potential of reading too much into slight variations would outweigh any real benefit such a course might have. If it makes your mind more at ease, do a couple of 3-month tests and see what is happening. If it's stable then maybe you can go back to 6-month or even annual testing -- based of course on the advice of your doctor.

Best of luck to you and congratulations for being a long term PCa survivor.

K

sbj
Posts: 24
Joined: Jan 2011

I've been having 6-monthly PSA checks, then 3-monthly when the rise set in. Monthly tests might produce tiny scary changes that are not so much due to malignancy reoccurrence as lab errors. I'm at the stage you were evidently at 8 years ago. Just into my second week of prostate bed TomoThrerapy radiation, having decided to have the just the bed treated - not lymph nodes. This made me wonder what you selected and how you came about to make your decision. If you would like more info on my pathology, so as to compare with yours, then see my posts under Prostate Cancer.

Meanwhile I hope your tests remain flat around zero.

sbj

BRONX52
Posts: 156
Joined: Apr 2010

A urologist/surgeon once told me that undetectable psa doesn't mean 0.000. He advised mean that there is a concensus among most of the medical community that a reading of 0.05 and below are considered undetectable. When I asked how can "undetectable" contain a number, he said it has to do with the instrumentation used and its capabilities. Go figure!! I wouldn't worry too much based on your current numbers but do speak with your urologist who should be able to answer your concerns. If he can't answer your questions, then I guess it's time for a new urologist,,,,,,good luck !!!!

VascodaGama's picture
VascodaGama
Posts: 1648
Joined: Nov 2010

Hi Coco

Welcome to the forum. You can take my experience as one example to help you in your decisions.
However, you should wait for readings of PSA in a constant rising pattern.
I had surgery (in 2000), followed by radiation and now I am on hormonal therapy. In my case the PSA reached its nadir (the lowest level) at 0.05 (may be the lowest measurement of the assay), and from nadir the PSA raised constantly during 29 month indicating biochemical recurrence. My doctor put me on hormonal therapy when the PSA reached 1.0 level, four years after RT.

This is his own threshold for my case but studies confirm better results on HT if it is started in PSA <2.0 for SRT patients.

Wishing you the best.
VGama

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