Psa 0.04 after 4 and a half y after RP

Please clarify. Is that two tenth of a percent, or two hundreds of a percent?

Hi Intern,

Work with your doctors and after they get a few more PSA readings on the graph they can determine a trend.  There are a lot of salvage radiation treaments + hormone reduction drugs if his cancer has returned.  You might want to get the pathology report they did after your Dad's surgery to see the extent of the cancer and it's location.  I would not worry too much at this point, but if the PSA does start to increase other courses of action as I stated above will need to be looked into.  Keep us posted on his progress, a lot of good people here with lot's of experience.

Dave 3+4

Intern,

PSA=0.04 ng/ml is still in remission levels. A portion of the urethra also produces PSA serum which could count for the extra 0.02. The assays LLD (low limit of detection) can easily provide a higher value (noise of the equipment) too. I think it better for your dad to continue the periodical test as he has been doing along the past 4 years.

By norm, recurrence is declared when the PSA follows a pattern of continuous increases reaching the level of 0.20 ng/ml. At a level of 0.40 doctors recommend a salvage therapy.

I wonder about you. How old are you? Sons and daughters with parents that have contracted prostate or breast cancer have higher risk for contracting the disease too. You should start checking your PSA (if male) at the age of 40. Does the 41 of the acronym mean your age?

Best wishes,

VG   

"A portion of the urethra also produces PSA serum which could count for the extra 0.02. The assays LLD (low limit of detection) can easily provide a higher value (noise of the equipment) too"

Did not know that about the urethra, though it makes sense. After all I've read deep into the archives of this forum, I did not know that.

Every time I think I needn't bother reading all the posts anymore, I learn something new.

When research was done back in the 70s, it was sitting in a stuffy library going through indexes for related subjects and plowing through pages and pages of journal entries.

What a phenomenal difference computers and the internet have made. If you think about it, the cumulative knowledge of VdG would have been impossible in the days of hard copy journalism, without devoting an entire lifetime to intense journal study. I think that is why I am stunned that he knows so much without being a professional with a PhD. And probably why this forum admin is a bit off guard. Who could have foreseen  a day when a layman with his computer and the internet would accumulate more knowledge on a particular subject than an academic who devoted his life to journal researching the same subject. I certainly didn't. To quote a 70s expression, it blows my mind, and takes some getting used to.

And In41... What VdG said goes for your family members too.

Intern,

You worry too much and the wordings you use to describe your feelings are exaggerated. I wonder your language and the country you are from. The translation of "dangerous", "fear", "horrible", etc, may have another meaning in your language but it is too drastic in English when judging the contents in the pathological report you share above.

Apically right margin positive means that they identified a possible route for extraprostatic extensions. It could be the reason for the classification as pT3a. Surely, doctors will consider such fact as a cause for any failed surgery and the area (apex) would make part of a salvage therapy if recurrence ever becomes apparent. In any case, for the moment the slight increase of the PSA is still very low to consider any thing.
The other data in the report is good. Can you tell us the type of the surgery, was it open or robot? Do you have any report on image exams?

You doing well in being vigilant but you need not to worry to the extremes. PCa takes many years to spread and is slower in development when comparing it with other cancers. We need to treat any advancement of the disease but should do it considering the quality of life. We survivors including your dad may die from other causes than prostate cancer.

Best wishes,

VG