PSA positive after Radical protatectomy


I had radical prostatcetomy on may14 and my PSA level was 0.3 and rose to 0.6 where it has stayed for 2 months. The pathology postoperative showed the the cancer had been encapsulated in the prostate and 21 lymph nodes showed no signs of anything.  Am being sent to an oncologist but am concerned about radiation and also am still not dry form incontinence 3 months later even though am doing physical therapy and  kegel exercises .

Any one got idea for questions I should be asking the oncologist



  • VascodaGama
    VascodaGama Member Posts: 3,692 Member
    Can you trust your team of physicians and Laboratory?


    Welcome to the board.

    The info you share may not be enough to get opinions and help. Can you tell about your previous status before surgery, your age, the PSA and clinical stage, etc?

    In fact, the PSA after surgery should be zero. A typical remission is provides a PSA of less than 0.06 ng/ml, which is obtained two weeks post operation. This level would indicate success of surgery.

    Your first result at 0.2 was high and the increase to 0.6 is indicative of biochemical failure and probable recurrence. I wonder if the measuring units are nanograms per millilitre. Have you reapeted the test at a different laboratory?

    The info you share about the pathologist's report leads to think that you are experiencing recurrence due to a miss of the pathologist in finding positive margins.  You could also have a piece of prostate left behind by the surgeon, that is producing PSA but this should be for a small value. Recurrence cases are usually declared when the PSA increases and reaches the mark of 0.2 ng/ml.

    Your case with clean margins, high PSA and no prostate gland in place are not common but they exist. I would try to get a re-anylising (or second pathological opinion) on the slides of the prostate and lymph nodes. You could inquire with the oncologist on the possibility of having an erraneous pathological report. In any case, you should also inquire about a salvage treatment.

    Best wishes and luck in your journey.