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PSA of .4 Just one year after Prostate Surgery

Ric G
Posts: 2
Joined: Mar 2013

Surgery to remove prostate due to cancer occurred March 2012, two PSA test later revealed a score of .001 which was excellent.  Just had a PSA test and it is now .4.  Doctor tells me I probably have a recurrence of prostate cancer.  Somehow some cells most of stayed behind.

My Gleason score at time of prostate removal was a 7, margins were clear and I was given probability of cure of 97%.

Obviously now very concerned, just went and had a PET Scan done though early I know just to see if the Doctors can spot any metastes in the bone.  Maybe to early, Doctor did rectal check and found only scare tissue no tumers.  Tells me we should do another blood test in 3 months and see what is going on then.  He tells me possibly targeted chemo but we most first find what to target if not possible hormone therapy.

Comments, thoughts what next?

VascodaGama's picture
VascodaGama
Posts: 1588
Joined: Nov 2010

Ric

If the doctor is diagnosing you already with recurrence, you will need a salvage treatment, which, after RP is usually radiation; however, this is recommended when positive margins or extra capsular extensions have been found by the pathologist who analyzed the prostate specimen (after surgery).

In your case, you got a comment of negative margins and post op PSA levels of 0.001 which makes it hard to believe in the last result of 0.4.

I would recommend you to get another PSA test the soonest (do not wait for the three months time suggested by your doctor), probably in another reliable laboratory to certify that in fact you are in recurrence.

Just curious; why have you gotten a ultra sensitive PSA test on the three decimal places (0.XXX ng/ml) initially and the last one is just a common test with one decimal place (0.X ng/ml) ?  

I wonder why the doctor found scar tissue at your rectum. Have you undergone any radiotherapy?

The PET scan may have been negative because of the low levels of PSA. In any case, I cannot understand the reason for a salvage with chemo instead of hormonal treatment.

I would recommend you of getting second opinions from some medical oncologist specialists in prostate cancer.

 

Best wishes.

VGama

Ric G
Posts: 2
Joined: Mar 2013

No radiotherapy, and I will do what you suggest of getting another PSA test ASAP and look for a medical oncologist.  Don't understand the difference in the test scores, remember that on the Doctors order it had total PSA.  Thanks for your reply.

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