Rising PSA after 12 years post surgery

rgroden

Had robotic surgery at Cleveland Clinic in 2010. Gleason 3+3. Nerve sparing surgery and results indicated cancer was contained. PSA undetectable for 12 years. 2023 measured .04. 2024 measures .08. MD says to watch and wait.

Don't understand why after 12 years suddenly rising.

rgroden

By the way I am 69 years old.

Oldernow

I found this information rgroden -

A small, one-time rise in PSA levels after a prostatectomy might not indicate that cancer has returned, as PSA levels can fluctuate. However, a PSA that rises on consecutive tests after treatment could indicate that cancer is still present. The most widely accepted definition of a recurrence is a PSA level of 0.2 ng/mL or higher. Some medical groups suggest that if the PSA rises more than 2 ng/mL above its lowest level, further treatment should be considered.

Clevelandguy

Hi,

Had my Prostate removed @UH Siedman cancer center in 2014. I have done the ultra sensitive test just in the last couple of years and I am stable at .05(undetectable is <.1). Other parts of your body like your Cowpers gland produce small amounts of PSA. The main thing is that your PSA remains stable. If it was me I would not get too excited unless it climbs up above .1. Points like .04 and .08 could be variables in test samples, look for ever increasing trends over several readings.

Dave 3+4

Old Salt

More PSA measurements are needed to see if there's a trend; I suggest every 3 months from now on.

On_A_Journey

Yes, 12 years' worth of minimal readings followed by consecutive jumps does seem unusual, but I totally agree with Old Salt. Insist on quarterly PSA tests and follow-ups from now on and see if there is a trend emerging.

Did you know that the chance of biochemical recurrence happening at any stage after prostatectomy is as great as one in three?

Marlon

https://csn.cancer.org/discussion/comment/1716432#Comment_1716432

On A Journey - more info please. Not heard of this.

Clevelandguy

https://csn.cancer.org/discussion/comment/1716432#Comment_1716432

The reoccurrence rate for radiation treatments is about 20-30% also.

Dave 3+4

On_A_Journey

https://csn.cancer.org/discussion/comment/1716433#Comment_1716433

@Marlon, there is good info out there. I just found this article and it seems to summarize things nicely:

https://www.health.harvard.edu/blog/how-to-handle-a-relapse-after-treatment-for-prostate-cancer-2009031122

I'm not suggesting that @rgroden is actually going to end up with recurrence, but it is something that he should probably be aware of, if he isn't already. Even if he ends up there, it doesn't necessarily mean anything fatal.

I'm a bit time poor at the moment but I'd be happy to write in more detail about my own experiences with biochemical recurrence later.

On_A_Journey

@Marlon,

@Oldernow is correct. A PSA reading of 0.2 or higher is the technical definition of biochemical recurrence after RP. If RT was the primary treatment, it is 2.0 above the low point, or nadir.

My biochemical recurrence story…diagnosed February 2015, Gleason 3+3, PSA 7.0, stage T1. Decided to wait a while. June 2015, PSA 10.6, went ahead with surgery. Surgical report said Gleason 3+4, stage T3a, negative resection margin. First PSA test after surgery in August 2015 was 0.53 and the next one was 0.75 in November 2015. Salvage radiation (33 doses) was then undertaken without hormone therapy and it wasn't until May 2018 that I reached my nadir of 0.04. May 2019, PSA was 0.06. May 2020, PSA was 0.11. November 2020, PSA was 0.16. I then went to 3-monthly checks, but it wasn't until February 2022 that I actually had a PSA reading above 0.20. It is currently 0.54 (I get blood drawn for my next follow-up next week) and the PSMA PET scans I have had in the intervening period have not detected anything.

I am not worried. Once I became aware that such a high percentage of men do experience a recurrence at some stage, I never felt like I was an outlier; a rare, unlucky victim. For my grading and staging after surgery, the chance of recurrence is actually 50/50.

Even though my surgery was initially unsuccessful, it still took almost seven years for me to be considered as suffering from a recurrence and almost four years from my PSA nadir. I don't consider that to be unacceptable.

hunter49

You had nerve sparing so there may be a slight amount of prostatic tissue there starting to grow. Did you get any covid vaccines. I had an RP in November 2011 was undetectable and in October 2021 started to rise 6 months after RNA vaccine. I have a friend who attended 2 seminars this year indicating similar cases possibly from the vaccine

rgroden

https://csn.cancer.org/discussion/comment/1716476#Comment_1716476

No vaccines.