rising psa after radical prostatectomy

24

Comments

  • The Nev
    The Nev Member Posts: 50
    griff 1 said:

    paul
    what side effects did you have after the radation treatments. thanks griff

    Dont mean to Hijack
    I don't mean to hijack this thread but just took a gut punch myself this morning.I'm 55 yrs I had robotic surgery last Sept lymph nodes clear negative margins Gleason 7 3+4. All PSA since 0 then this morning PSA .75 so I guess its radiation now. I had my surgery at MD Anderson Houston Tx and have a call into them for the next step; any idea's on what tests they may run and what I can expect from here?
  • ezra99
    ezra99 Member Posts: 18
    The Nev said:

    Dont mean to Hijack
    I don't mean to hijack this thread but just took a gut punch myself this morning.I'm 55 yrs I had robotic surgery last Sept lymph nodes clear negative margins Gleason 7 3+4. All PSA since 0 then this morning PSA .75 so I guess its radiation now. I had my surgery at MD Anderson Houston Tx and have a call into them for the next step; any idea's on what tests they may run and what I can expect from here?

    my experience
    Sorry to hear of rising PSA. I never got the chance to have a time of undetectable PSA so not sure how I'd feel if I was in your shoes. I too had negative margins although I was a T3B with seminal vesicle involvement. I'll let you know what I did. I met with a radiation oncologist and a medical oncologist and would encourage getting appointments with both. I talked extensively about the appropriateness of radiation with negative margins. I wanted some "magic test" to tell me that cancer cells would be in my prostate bed which is what is going to be radiated. Prostascint was discussed but I chose not to do that and it wasn't encouraged by either MD as they felt it would not give me useful information with a PSA of only .37. The biggest discussion was whether to do ADT concurrently with IMRT. Some indication that doing ADT for 2 months before, 2 months during and 2 months after radiation increases chances of staying undetectable for 5 years after. I really struggled with the decision but chose to do IMRT only. IMRT alone option for me was 35% chance of 5 year undetectable and 53% chance of 5 year undetectable with ADT andd IMRT concurrently. Two biggest reasons I choose IMRT only was I'm concerned about weight gain and impact on my diet & exercise controlled diabetes. Hate of survive prostate cancer and die from complications of diabetes. Also I was worried that I would not know if a post radiation undetectable PSA was due to radiation or ADT and that thought bothered me. I figured I can handle it if my PSA is still detectable after IMRT but not sure my "head" can handle not knowing if it is due to success of radiation or temporary undetectable due to ADT. I may have made a stupid decision not to do both ADT and IMRT but I'm okay with it and really feel like it time for me to get a decent break so I'm betting IMRT will work. Whatever the outcome is I will be okay with it because I made the informed decision. No one told me what I had to do. I haven't started IMRT yet so can't tell you if it was a good decision based on my outcome. I start within a week.

    Prep for radiation is another one of those "experiences". Not that bad but I really get tired of "exposing myself" to so many different people. Keep thinking it would get better but ever time they tell me to remove "all your clothes and put on a gown" I cringe. Anyway, only uncomfortable part was they put contrast liquid into the ureathra and placed a plastic clamp on the penis to do a scan. Rest of prep was fine.

    Good luck to you.
  • The Nev
    The Nev Member Posts: 50
    ezra99 said:

    my experience
    Sorry to hear of rising PSA. I never got the chance to have a time of undetectable PSA so not sure how I'd feel if I was in your shoes. I too had negative margins although I was a T3B with seminal vesicle involvement. I'll let you know what I did. I met with a radiation oncologist and a medical oncologist and would encourage getting appointments with both. I talked extensively about the appropriateness of radiation with negative margins. I wanted some "magic test" to tell me that cancer cells would be in my prostate bed which is what is going to be radiated. Prostascint was discussed but I chose not to do that and it wasn't encouraged by either MD as they felt it would not give me useful information with a PSA of only .37. The biggest discussion was whether to do ADT concurrently with IMRT. Some indication that doing ADT for 2 months before, 2 months during and 2 months after radiation increases chances of staying undetectable for 5 years after. I really struggled with the decision but chose to do IMRT only. IMRT alone option for me was 35% chance of 5 year undetectable and 53% chance of 5 year undetectable with ADT andd IMRT concurrently. Two biggest reasons I choose IMRT only was I'm concerned about weight gain and impact on my diet & exercise controlled diabetes. Hate of survive prostate cancer and die from complications of diabetes. Also I was worried that I would not know if a post radiation undetectable PSA was due to radiation or ADT and that thought bothered me. I figured I can handle it if my PSA is still detectable after IMRT but not sure my "head" can handle not knowing if it is due to success of radiation or temporary undetectable due to ADT. I may have made a stupid decision not to do both ADT and IMRT but I'm okay with it and really feel like it time for me to get a decent break so I'm betting IMRT will work. Whatever the outcome is I will be okay with it because I made the informed decision. No one told me what I had to do. I haven't started IMRT yet so can't tell you if it was a good decision based on my outcome. I start within a week.

    Prep for radiation is another one of those "experiences". Not that bad but I really get tired of "exposing myself" to so many different people. Keep thinking it would get better but ever time they tell me to remove "all your clothes and put on a gown" I cringe. Anyway, only uncomfortable part was they put contrast liquid into the ureathra and placed a plastic clamp on the penis to do a scan. Rest of prep was fine.

    Good luck to you.

    thanks
    Thanks for the reply Ezra, hope your IMRT comes out ok. Its a strange thing for me looking like my future was long and now looking to making it another 5 years. But one day at a time I still have to get my appt and talk to the Dr and make a decision hope I'm as content after as you are.
  • ezra99
    ezra99 Member Posts: 18
    The Nev said:

    thanks
    Thanks for the reply Ezra, hope your IMRT comes out ok. Its a strange thing for me looking like my future was long and now looking to making it another 5 years. But one day at a time I still have to get my appt and talk to the Dr and make a decision hope I'm as content after as you are.

    5 year
    Don't get concerned about the 5 year thing. I'm a couple years older then you. All my MD's kept throwing that 5 year failure rate term around. I finally stopped the medical oncologist and ask what he was saying "in plainer English". He said that he wasn't saying that I was looking at advancing metastatic disease in 5 years....just that I would had a 30-35% chance of non-detectable PSA in 5 years -so a 65-70% of detectable PSA. He said it's entirely possible that I would have a PSA low enough that I wouldn't need to start ADT for several years. He said that if my PSA approached 10 they would recommend ADT. He briefly talked to me about intermittent ADT and said he has had similar patients like me that have lived 20 or more years with out advancement. He said it's still highly likely that I would die WITH prostate cancer but not FROM prostate cancer. I am trying to do some things like avoid meat and dairy, exercise and living health lifestyle.
  • The Nev
    The Nev Member Posts: 50
    ezra99 said:

    5 year
    Don't get concerned about the 5 year thing. I'm a couple years older then you. All my MD's kept throwing that 5 year failure rate term around. I finally stopped the medical oncologist and ask what he was saying "in plainer English". He said that he wasn't saying that I was looking at advancing metastatic disease in 5 years....just that I would had a 30-35% chance of non-detectable PSA in 5 years -so a 65-70% of detectable PSA. He said it's entirely possible that I would have a PSA low enough that I wouldn't need to start ADT for several years. He said that if my PSA approached 10 they would recommend ADT. He briefly talked to me about intermittent ADT and said he has had similar patients like me that have lived 20 or more years with out advancement. He said it's still highly likely that I would die WITH prostate cancer but not FROM prostate cancer. I am trying to do some things like avoid meat and dairy, exercise and living health lifestyle.

    The % don't really mean much to me
    When I had my biopsy they told me there was about a 75% chance it was not cancer, and of course it was. Then after surgery they said I had better then an 80% chance of no return in the next 5 years and one year later its back. So I know they really don't know, as I said one day at a time I'll deal with it as it comes thanks.
  • dalindg
    dalindg Member Posts: 11
    5 years post op, double lab PSA tests, one rising
    My DH had a radical prostestomy March, 2005 at age 38, PSA 7.2, Gleason 3+3=6, Stage T2, prostate was 2cm X 1.2cm, clear margins, not spread to lymph nodes. Mayo Clinic, Minnesota.
    We have had PSA tests every 6 months. The Spring tests are mailed to the lab at mayo, and results have all been <.1 "undetectible", The Fall tests are the more sensitive tests from our local Nebraska lab.
    August 2006 - .00?
    August 2007 - .00?
    August 2008 - .012
    August 2009 - .021
    August 2010 - .052
    Local Doctor is freaking out. Calling for Nuclear Bone Scan, CAT Scan, and repeat test in 3 months. Call to mayo in 2009 told me not to worry until .1 is breached.
    I personally want to go back to Mayo and schedule the diagnostics there.
    Liver enzymes also were high, so now my husband is worried that the cancer is in his liver. I think it is a side affect to the zoloft antidepressants he is on.
    Any advice?
  • Kongo
    Kongo Member Posts: 1,166 Member
    dalindg said:

    5 years post op, double lab PSA tests, one rising
    My DH had a radical prostestomy March, 2005 at age 38, PSA 7.2, Gleason 3+3=6, Stage T2, prostate was 2cm X 1.2cm, clear margins, not spread to lymph nodes. Mayo Clinic, Minnesota.
    We have had PSA tests every 6 months. The Spring tests are mailed to the lab at mayo, and results have all been <.1 "undetectible", The Fall tests are the more sensitive tests from our local Nebraska lab.
    August 2006 - .00?
    August 2007 - .00?
    August 2008 - .012
    August 2009 - .021
    August 2010 - .052
    Local Doctor is freaking out. Calling for Nuclear Bone Scan, CAT Scan, and repeat test in 3 months. Call to mayo in 2009 told me not to worry until .1 is breached.
    I personally want to go back to Mayo and schedule the diagnostics there.
    Liver enzymes also were high, so now my husband is worried that the cancer is in his liver. I think it is a side affect to the zoloft antidepressants he is on.
    Any advice?</p>

    Welcome dalindg
    Sorry that these test scores are causing you anxiety. More than a specific PSA reading, I believe the trend is what is most important. In your case, the PSA rise since August of 2008 has been pretty consistent and you may want to start considering options but I think the Mayo Clinic is giving you good advice about not worrying (easy to say, I know) about it till PSA goes above 0.1 ng/ml. Most definitions of recurrence are associated with a rising PSA that goes above 0.2 ng/ml.

    One thing to keep in mind is that the standard deviation for the ultra-sensitive tests are often well within the the difference between your reading...in other words, it may just be a function of the lab procedure or equipment calibration.

    Since you had a favorable biopsy at RP you have every reason to be optimistic and even if they should determine that there is a recurrence, the advances in just the past few years in salvage radiation therapy are very, very promising.

    Please keep us up-to-date on your decison process.

    Best
  • dalindg
    dalindg Member Posts: 11
    Kongo said:

    Welcome dalindg
    Sorry that these test scores are causing you anxiety. More than a specific PSA reading, I believe the trend is what is most important. In your case, the PSA rise since August of 2008 has been pretty consistent and you may want to start considering options but I think the Mayo Clinic is giving you good advice about not worrying (easy to say, I know) about it till PSA goes above 0.1 ng/ml. Most definitions of recurrence are associated with a rising PSA that goes above 0.2 ng/ml.

    One thing to keep in mind is that the standard deviation for the ultra-sensitive tests are often well within the the difference between your reading...in other words, it may just be a function of the lab procedure or equipment calibration.

    Since you had a favorable biopsy at RP you have every reason to be optimistic and even if they should determine that there is a recurrence, the advances in just the past few years in salvage radiation therapy are very, very promising.

    Please keep us up-to-date on your decison process.

    Best

    Getting follow up tests locally
    Thank you Kongo for your reply. I hope the test variances are because of calibration, but wish one of results had gone down, instead of up.

    I just got off the phone with the Mayo clinic urology department. They would like us to get the tests as suggested by our local doctor. The tests can be performed here in Nebraska, and they will accept those results. Our RP doctor (Robert Myers) is no longer at mayo, so I havn't made an appointment with them yet. Surprisingly, they could get us in tomorrow, two weeks, and three weeks from now with another urologist.

    Just trying to stop crying at work right now. At least we had 5 years with no worries.
  • Kongo
    Kongo Member Posts: 1,166 Member
    dalindg said:

    Getting follow up tests locally
    Thank you Kongo for your reply. I hope the test variances are because of calibration, but wish one of results had gone down, instead of up.

    I just got off the phone with the Mayo clinic urology department. They would like us to get the tests as suggested by our local doctor. The tests can be performed here in Nebraska, and they will accept those results. Our RP doctor (Robert Myers) is no longer at mayo, so I havn't made an appointment with them yet. Surprisingly, they could get us in tomorrow, two weeks, and three weeks from now with another urologist.

    Just trying to stop crying at work right now. At least we had 5 years with no worries.

    Upsetting
    I know how upsetting this is but if you research the background on recurrence you will see that about a third of the men who have RP experience a rising PSA within 10 years. Many times, if the PSA rise is very slow, no treatment at all is required. If the PSA doubling time is less than 2 years (which your numbers suggest)it may be an indication that the cancer is starting to grow along the margins which is very easily treated. There are several treatment options that provide excellent long term results. Typically treatment includes some form of hormone therapy or radiation treatment or a combination of both.

    There could also have been a small amount of prostate material left behind at the time of surgery that could be causing the rise in PSA.

    While the tests your local doctor is suggesting are prudent, given the readings you have described I would be astonished if they showed anything but I think what they want to do is rule something out. If the cancer had moved someplace else where it could be detected by those tests, I believe your husband's PSA score would be much, much higher.

    As you did before when your husband was first diagnosed, you have to take this one step at a time and make sure you are getting second opinions and doing your homework.

    This forum is an excellent place to get good information and many men who post here have dealt with similar circumstances and you will receive a lot of strong support.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    dalindg said:

    5 years post op, double lab PSA tests, one rising
    My DH had a radical prostestomy March, 2005 at age 38, PSA 7.2, Gleason 3+3=6, Stage T2, prostate was 2cm X 1.2cm, clear margins, not spread to lymph nodes. Mayo Clinic, Minnesota.
    We have had PSA tests every 6 months. The Spring tests are mailed to the lab at mayo, and results have all been <.1 "undetectible", The Fall tests are the more sensitive tests from our local Nebraska lab.
    August 2006 - .00?
    August 2007 - .00?
    August 2008 - .012
    August 2009 - .021
    August 2010 - .052
    Local Doctor is freaking out. Calling for Nuclear Bone Scan, CAT Scan, and repeat test in 3 months. Call to mayo in 2009 told me not to worry until .1 is breached.
    I personally want to go back to Mayo and schedule the diagnostics there.
    Liver enzymes also were high, so now my husband is worried that the cancer is in his liver. I think it is a side affect to the zoloft antidepressants he is on.
    Any advice?</p>

    Liver enzymes...
    suggest that you contact your pharmacist and doctor, and google on the internet for possible side effects of zoloft antidepressants, and any other meds, both prescribed and over the counter...
  • dalindg
    dalindg Member Posts: 11
    Kongo said:

    Upsetting
    I know how upsetting this is but if you research the background on recurrence you will see that about a third of the men who have RP experience a rising PSA within 10 years. Many times, if the PSA rise is very slow, no treatment at all is required. If the PSA doubling time is less than 2 years (which your numbers suggest)it may be an indication that the cancer is starting to grow along the margins which is very easily treated. There are several treatment options that provide excellent long term results. Typically treatment includes some form of hormone therapy or radiation treatment or a combination of both.

    There could also have been a small amount of prostate material left behind at the time of surgery that could be causing the rise in PSA.

    While the tests your local doctor is suggesting are prudent, given the readings you have described I would be astonished if they showed anything but I think what they want to do is rule something out. If the cancer had moved someplace else where it could be detected by those tests, I believe your husband's PSA score would be much, much higher.

    As you did before when your husband was first diagnosed, you have to take this one step at a time and make sure you are getting second opinions and doing your homework.

    This forum is an excellent place to get good information and many men who post here have dealt with similar circumstances and you will receive a lot of strong support.

    Be with husband during tests?
    Our local hospital will be doing the CT scan 9am Monday, and the Bone Scan at 1pm. My DH says I don't need to be there since I can't go in the testing room with him. I've been with him (well... in the closest waiting room) through all the tests and procedures with the RP 5 years ago, and want to be there for him now.

    For you who have been on his end, should the wife push to try to be close, or is it really something you want to deal with alone? I remember him being very tired after first set of tests, but then that was with the fresh "C" diagnosis and facing unknowns at being diagnosed at age 38. We both are dealing with this episode much calmer.

    We both work full time, and can take time away from work (sick days are available, so no pay loss)...
  • dalindg
    dalindg Member Posts: 11

    Liver enzymes...
    suggest that you contact your pharmacist and doctor, and google on the internet for possible side effects of zoloft antidepressants, and any other meds, both prescribed and over the counter...

    Thanks hopeful
    I love your name! I checked webmd, and "abnormal liver function tests" is a side effect of zoloft. I will have to point that out to our doctor when we go in to have the other test results.
  • hopeful and optimistic
    hopeful and optimistic Member Posts: 2,339 Member
    dalindg said:

    Thanks hopeful
    I love your name! I checked webmd, and "abnormal liver function tests" is a side effect of zoloft. I will have to point that out to our doctor when we go in to have the other test results.

    I think that it's a good idea
    to deal with the Mayo Clinic, a center of excellence..find the best doc there...i'm not knowledgeable enough to know what specialty, maybe a medical oncologist who specializes in prostate cancer...........your local doc, my opinion...a doc should know the side effects of what is prescribed.



    About going with your husband to get the tests, I think that it would be positive..but you need to respect his wishes...but I would definately go for the results with him.

    It's going to work out
  • Wanttoknow
    Wanttoknow Member Posts: 7
    Billybumps:
    Same story with

    Billybumps:

    Same story with me. I was seen every three months post surgery and when my PSA comtinued to rise from .14 , my oncologist recommended radiation therapy which I did undergo. Since then it continues to rise (now at 1.67)and the recommendation is Hormone Therapy. Still haven't decided to go this route because of the side effects. I am on a homeopathic diet right now. Every case is different. Trust your doctor but also research all you can. A PSA at this level is still just a number and we are treating just a number at this stage. My bone scan and MRI recently were both negative.

    J
  • worriedwife
    worriedwife Member Posts: 15
    The Nev said:

    Dont mean to Hijack
    I don't mean to hijack this thread but just took a gut punch myself this morning.I'm 55 yrs I had robotic surgery last Sept lymph nodes clear negative margins Gleason 7 3+4. All PSA since 0 then this morning PSA .75 so I guess its radiation now. I had my surgery at MD Anderson Houston Tx and have a call into them for the next step; any idea's on what tests they may run and what I can expect from here?

    Dont mean to hijack
    My husband has been cancer free for 10 years after RP. April was .02. This month his PSA is 3.7

    I am confused. His urologist, not the original, said he would re-do PSA in 3 months to make sure it isn't something from another gland that just pushed his PSA up.

    All of you keep saying that when your PSA is above .30 you are having radiation already. My husband is off the charts compared to you and his doctor wants to wait 3 months.

    did you wait 3 months and it show up again on the PSA test before they decided on radiation?

    I am scared but my husband is comfortable waiting as he believes it to be a false positive.....

    Thanks for any suggestions.
  • worriedwife
    worriedwife Member Posts: 15
    Aricka said:

    Rising PSA after radical prostatectomy
    Here's my story for what it's worth. I had RP in December of 2000. It was caught very early and completely encapsulated. No Chemo or radiation recommended. 7 years later PSA still undetectable. In 2007 PSA 0.2. Early 2008 PSA 0.3. April 2009 PSA 0.3. Now Doctors recommend Radiation therapy. I guess I was naive about this thing and had begun to believed the waiting for the other shoe to drop was over. I'm sorry but I'm so angry. I see the look in my wife's eyes and can't stand to know I'm having to put her through this again. Especially knowing her father died of prostate cancer a year after we were married. I didn't mean to bring this thing to her. I'm so very sorry. I don't how to begin to make this up to her. Hell we're only 60 and recently retired. I just don't know what to do.

    Aricka
    Are you still online? I have some questions?
  • buzzz
    buzzz Member Posts: 26

    Billybumps:
    Same story with

    Billybumps:

    Same story with me. I was seen every three months post surgery and when my PSA comtinued to rise from .14 , my oncologist recommended radiation therapy which I did undergo. Since then it continues to rise (now at 1.67)and the recommendation is Hormone Therapy. Still haven't decided to go this route because of the side effects. I am on a homeopathic diet right now. Every case is different. Trust your doctor but also research all you can. A PSA at this level is still just a number and we are treating just a number at this stage. My bone scan and MRI recently were both negative.

    J

    biopsy?
    This is horrible to read, all these recurrances after surgery, I though with surgery they took the gland so the threat was very low, and that they wouldn't do surgery if cancer was outside the gland. Now I read this thread, does anyone think that maybe it's because of the biopsy, that it spread one tiny speck of cancer? What else could cause so many relapses?
  • lewvino
    lewvino Member Posts: 1,010
    buzzz said:

    biopsy?
    This is horrible to read, all these recurrances after surgery, I though with surgery they took the gland so the threat was very low, and that they wouldn't do surgery if cancer was outside the gland. Now I read this thread, does anyone think that maybe it's because of the biopsy, that it spread one tiny speck of cancer? What else could cause so many relapses?

    I don't think that the
    I don't think that the biopsy causes the relapse. For many it comes down to two factors:

    The Gleason score post surgery when they examine the complete speciman and if you have what is referred to as a positive margin post surgery.

    The higher Gleasons 7, 8, 9 and 10 have more risk then a Gleason 6.

    When the surgeon removes the prostate there is a very fine line between 'how much to cut'.
    If you cut to little you may leave cancer behind and if you cut two much then you get into other problems. Or on examining the surgical speciman cancer is found at the very edge or 'positive margin'.

    I'm Gleason 7 and a positive margin. Tomorrow morning I get my 14.5 month PSA result. I'm being monitored about every 4 months on blood work and will post in the morning.

    Larry
  • bdhilton
    bdhilton Member Posts: 846 Member
    lewvino said:

    I don't think that the
    I don't think that the biopsy causes the relapse. For many it comes down to two factors:

    The Gleason score post surgery when they examine the complete speciman and if you have what is referred to as a positive margin post surgery.

    The higher Gleasons 7, 8, 9 and 10 have more risk then a Gleason 6.

    When the surgeon removes the prostate there is a very fine line between 'how much to cut'.
    If you cut to little you may leave cancer behind and if you cut two much then you get into other problems. Or on examining the surgical speciman cancer is found at the very edge or 'positive margin'.

    I'm Gleason 7 and a positive margin. Tomorrow morning I get my 14.5 month PSA result. I'm being monitored about every 4 months on blood work and will post in the morning.

    Larry

    Larry...wishing you the best
    Larry...wishing you the best and I hate this waiting game as much as but I am sure it will ease as more time passes on...God bless-B
  • worriedwife
    worriedwife Member Posts: 15
    Kongo said:

    Upsetting
    I know how upsetting this is but if you research the background on recurrence you will see that about a third of the men who have RP experience a rising PSA within 10 years. Many times, if the PSA rise is very slow, no treatment at all is required. If the PSA doubling time is less than 2 years (which your numbers suggest)it may be an indication that the cancer is starting to grow along the margins which is very easily treated. There are several treatment options that provide excellent long term results. Typically treatment includes some form of hormone therapy or radiation treatment or a combination of both.

    There could also have been a small amount of prostate material left behind at the time of surgery that could be causing the rise in PSA.

    While the tests your local doctor is suggesting are prudent, given the readings you have described I would be astonished if they showed anything but I think what they want to do is rule something out. If the cancer had moved someplace else where it could be detected by those tests, I believe your husband's PSA score would be much, much higher.

    As you did before when your husband was first diagnosed, you have to take this one step at a time and make sure you are getting second opinions and doing your homework.

    This forum is an excellent place to get good information and many men who post here have dealt with similar circumstances and you will receive a lot of strong support.

    Upsetting
    My husband had the RP in 2000. Over 10 years now. His PSA was always around 0.02
    His last test in April was still at 0.2.

    He just had his PSA done this month and it was 3.7!!!! I am really worried.
    I met with his doctor who is not the original doctor. We moved in 2004.
    He said not to be worried yet. He will retest his PSA in 3 months. Then he
    will make a decision to do further testing if it does not go down.

    When my husband had the cancer last time his PSA was 1.4, no outward signs,
    and found by accident during a TURP procedure. I explained all this to the
    doctor.

    My husband is comfortable with the test being redone in January. He doesn't
    really want to talk about it anymore. He was even hesitant when I wanted to
    talk to the doctor myself. The doctor did say that, if I could not wait the
    3 months, he could do a CT scan or MRI. I wish we still lived up north. His
    original doctor was so much more concerned about these things.

    Since it was at 0 in April, could this be just a bad PSA test. He has been cancer
    free for 10 years, now this????????
    My husband is only 64. He was 54 when he had the RP.