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PSA increase @ +7 & +12 after surgery

Posts: 1
Joined: Jan 2012

(12) weeks ago (10/17/11), I had my prostate removed after 6+ years of PSA increases and numerous biopsy. The last PSA was 13 with the bio results in 3+4 =T1. I chose robotic surgery.
1st post surgery PSA @ +7weeks = 0.38
2nd post surgery PSA @ +12 weeks = 0.43
Based upon PSA increases, and pre surgery CT, MRI & bone scans, all Negative, and my understanding that PSA scores based upon prostate cells in blood stream, where do I go from here? Radiation to the pelvic area seams ill-advised based upon my previous observation. DRs. continue to consult and investigate with colleagues.

Kongo's picture
Posts: 1166
Joined: Mar 2010

Hi, Bruce. Welcome to the forum and I'm sorry that your prostate cancer does not appear to have been curbed by your recent surgery. You didn't mention the result of your post-surgical pathology...did you have positive margins? Was the Gleason score upgraded? Any other useful information about possible spread to lymph nodes or seminal vesicules?

With your prostate removed, the only thing left to make PSA is a small abount of prostate gland and prostate cancer cells. I doubt very much that the PSA increases yhou are seeing now are the result of left behind benign protate tissue.

I'm not sure why you believe radiation is ill-advised at this point. Most of the literature I've read stongly suggests that the sooner radiation treatment begins after PSA rises following surgery the better the long term outcomes. This salvage radiation is frequently conducted in conjunction with hormone therapy. The only good reason I could see for delaying this treatment is if you have not yet regained continence after your RP, in which case the radiation treatment may cause a longer healing process on the road to full continence.

It might be worthwhile for you at this point to seek second opinions regarding potential next steps.

Good luck to you.


gkoper's picture
Posts: 174
Joined: Apr 2009

I decided on Davinci after a rapid rise in PSA. 4 of 12 samples affected, 3+4 grade. clear margins.
1st post surgery: .3. Each month it rose...when it hit .7 I opted for IMRT. My 37 sessions were finished 2 years ago. Have been PSA ZERO since. Of course, be sure your margins are clear before you decide on radiation.
All the best,

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