PSA after RP

RLR64

My husband went in at 6 weeks for his first PSA after da vinci RP and the Urologist used an ultrasensative test. The reading came back at 0.02 and he says it should be 0.00. He repeated the test and we should know results of that on Wed. I am wondering if anyone could share their experiences with initial PSA results after surgery. The Urologist wants to do 5 weeks of radiation if the PSA comes back elevated again since my husband's cancer was agressive and he did have a "focally positive surgical margin for tumor". What confused me is that in many places people are rejoicing at 0.02 and calling that undetectable..and my husband's brother (also had RP) has remained .02 for 10 years. Please share any experiences or thoughts..

Photon

Hi

My psa after the RP was 0.3 and the urologist held out for 5 months before he gave me conformal RT and it made next to no difference to my psa. My psa stayed around the 0.25 - 0.31 level (high sensitive tests)for a year until the urologists just by chance decided to give me an mri scan where they found metastatic disease in the lymph system and put me on 150mg casodex when the psa then dropped to 0.005.

Medical opinion is that enlightened urologists give RT after the operation to kill any cells that might have escaped regardless of low psa....this is something that their radiology colleagues have been pressing them to do. I found conformal RT a breeze there were minimal side effects.. I already had non nerve sparing surgery so impotence was already present but it is a consideration if the nerves were spared. However if my psa had been 0.02 I would have fought tooth and nail not to have RT because I had this view, erroneously, that it would cause too many side effects.

By the way I also had positive margins on my tumour and Gleason's 8s & 9s in 10 cores of my prostate and a psa of 6.0, before surgery so my surgeon was worried that he hadn't caught all the cells and because my psa was low initially for the grade of tumour 0.3 did not reflect the true picture. You have to look at the bigger picture psa versus tumour grade and therefore your husband 's brother's psa of 0.02 might not be the same as your husbands' if he initially had a low psa with a high Gleason score and a tumour with a positive margin like mine.

Apologies for the length of this but I hope it helps. All the best

rogermoore

RLR,

I am a 5 yr survivor of a RP and did not have any treatment following surgery. My surgeon indidcated that the reading from tests may be impacted by the lab and type of testing instruments used. I.E. some devices may have a low reading of 0.10 and others 0.01. My PSA has been hovering around 0.06 - 0.08 for several years. I consider that to be totally acceptable as do my Dr.s. I would be hesitant to undergo additional treatment with a reading of 0.02!!

Roger

MSvicki

rogermoore said:

RLR,

I am a 5 yr survivor of a RP and did not have any treatment following surgery. My surgeon indidcated that the reading from tests may be impacted by the lab and type of testing instruments used. I.E. some devices may have a low reading of 0.10 and others 0.01. My PSA has been hovering around 0.06 - 0.08 for several years. I consider that to be totally acceptable as do my Dr.s. I would be hesitant to undergo additional treatment with a reading of 0.02!!

Roger

My husband had RP the end of Feb 2006. His PSA was 0 until two weeks ago. It rose to 1.0. The path report said it was no where near outside the margins and the cancer was only in 1% of the prostate.
We are so dissappointed in this. They have sent us to a Radiologist, but right now we don't know what to believe. He went from being able to wait 3 years for the RP to them wanting to do RT immediately.

rogermoore

MSvicki said:

My husband had RP the end of Feb 2006. His PSA was 0 until two weeks ago. It rose to 1.0. The path report said it was no where near outside the margins and the cancer was only in 1% of the prostate.
We are so dissappointed in this. They have sent us to a Radiologist, but right now we don't know what to believe. He went from being able to wait 3 years for the RP to them wanting to do RT immediately.

Morning msvicki

Before I underwent any type of additional therapy, I would have another PSA run at a different office.

Roger

Willx

Eight years ago TODAY (hooray!!!) I had surgery to remove the prostate gland because of cancer. Since then, my PSA result has ranged from <0.1 to 0.16 and I have had no radiation. I did take 50mg Casodex for a year and a half (stopped last October) and my PSA result last month was <0.1. Maybe I've got it beat, but who knows? There will still be quite a few weapons in the armamentarium should we need to battle it again.

shipjim

Mine was .01. Per my doc. labs don't usually report 0.0 but use less than .01 as a measure. It doesn't seem .02 is much but then I didn't think I had cancer either. Keep the post current as many of us would like to know the answer. jj

Liam

Do what your doc says. Mine is 0.04. My doc said my wife would have the same reading

MSvicki

rogermoore said:

Morning msvicki

Before I underwent any type of additional therapy, I would have another PSA run at a different office.

Roger

Update, we had another PSA, bone scan, and MRI of the prostate bed. MRI and bone scan were good. The unexpected news was the PSA that dropped from 1.0 to 0.6. All the tests were done at the same lab. The Radiation Oncologist recommended another test in 6 weeks. All of us were thrilled.

rico6

Even if the PSA rises after surgery, other treatments can lower it again. I'd be thrilled with 0.02 post RP. Mine was 2.43+/- but went to <0.1 (Kaiser, doesn't regularly get too precise) with hormone ablation. It's been there for over 5 years now.