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Upward trend in PSA post surgery

Posts: 2
Joined: Aug 2014

I am 58 years old. I had my prostate removed (Da Vinci) on 4//14/14 with a 3/4 Gleason. One of the ten lymph nodes removed was positive. In late June, my PSA was 0.06. In late July, it was 0.07. And, today, 8/28, it was 0.08.

Should I be concerned about the upward trend?


Posts: 3
Joined: Aug 2014

I was 51 on 12/24/13 when I had an open RP for a 4/3 Gleason and PSA 3.2. Post op I had 1 of 4 lymph nodes positive, positive surgical margins, seminal vesicle invasion, and cancer had escaped the capsule. My PSA was 0.03 after surgery, which I thought was low, but my urologist said it was a detectable level. He felt this adverse pathology left me at high risk for recurrence and strongly advised adjuvant radiation and hormone therapy. I completed 33 radiation treatments on 6/24/14 and I just had my 3rd Trelstar injection.

I was advised not to wait for the PSA to climb. I hope I made the right choice and didn't just pile on the side effects. My PSA was undetectable last week. 

VascodaGama's picture
Posts: 3355
Joined: Nov 2010


Welcome to the board.

The PSA is going up but your concern should be directed to the positive lymph node. This surely means that you will need salvage treatment and so you should try getting a second pathologist's opinion on the specimen dissected at surgery. Typically these cases are sent to a protocol of IMRT.

The level of the PSA is still very low. Usually recurrence is declared when it reaches 0.2 ng/ml but with a pathological stage of ECE extra capsular extensions (lymph node invasion) one may not wait for that threshold PSA to trigger a salvage. After confirming the pathologist's finding you should consult a PCa radiologist for a second opinion.

Best wishes.


Posts: 2
Joined: Aug 2014

Thank you.

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