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Three month post davinci PSA

Will_10_2010
Posts: 43
Joined: Nov 2010

I had davinci procedure on Dec. 15. Post operation pathology report confirmed "extra prostratic extention". Six week follow-up PSA was .030. Three month follow-up PSA is .050. I am scheduled to see my urologist mid April. My feeling is not to be concerned, just keep checking PSA to see if there is any pattern &/or increase. Any thoughts or advice???

VascodaGama's picture
VascodaGama
Posts: 1517
Joined: Nov 2010

Will

The variation in PSA represents approximately a PSADT=3 months. If we rule out any effect on the increase due to other causes other than cancer, this increase is significant because of the extra prostatic extension. The values however are very small and I wouldn't rush to a negative conclusion.
It has been reported before that PSA tests done in different assays/laboratories can produce different results, and the same applies to the date when we draw blood.
Nevertheless, your extra prostatic extension may signal a future recurrence, which would be declared on the third consecutive PSA rise or at a level of 0.2ng/ml. Those tests should be done at least over 6 weeks to 3 months. The Gleason score (?) can give you a better idea of the prognosis.
Your next appointment with the doctor will give you peace of mind.

I wish you a continuous recovery from treatment.
VGama

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

Hi Will,

The extra prostatic extension is an indication that your PCa had spread beyond the confines of the prostate gland to the surrounding tissue prior to your surgery. Without treatment these escaped cells will probably eventually manifest themselves in increasing PSA readings that are indicative of prostate cancer continuing to grow. You may already know that prostate cancer tends to grow faster outside the prostate than while it is contained within the gland.

Having said that, there are plenty of men with EPE who never see their cancers grow to a threatening level so I wouldn't be hitting the panic button just yet.

Given the relatively small difference between the two PSA readings I believe your numbers are probably within the standard deviation of the testing procedure at this point in time. I think these two readings alone are not enough information to draw a conclusion regarding PSA doubling times although others may disagree. I would go with your doctor's advice on this which will most likely be to wait and see what the next reading reveals. Should your six month PSA reading show another rise I suspect he will want to start discussing potential follow on treatment. In the meantime, if I were you I would start educating myself on what post RP treatment options are available so that if the time comes when your medical team starts recommending action you will be well educated in the various methods and drawbacks of potential treatments.

You might also consider some dietary changes at this point if you haven't already. One book I've read recently that has profoundly affected my outlook on diet and cancer prevention (even after diagnosis) is "The China Study" by Dr. Colin Campbell and published in 2005. I heartily commend it to anyone who has had a cancer diagnosis.

Best of luck to you.

K

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