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Post surgery PSA level detected

justmry53's picture
Posts: 2
Joined: Jul 2015

My husband has prostate cancer, he's only 53 (I'm older). He had symtoms that our old doc blew off, new doc INSISTED on a physical exam and could feel a nodule. Ultrasound and biopsies showed cancer in four spots, it was stage 7 on the Gleason Scale (specifc scale they use for prostate) his PSA levels were actually ok, on the high side but normal range for his age. Doc said since there was a nodule PSA levels get tossed out.  Post-op they found cancer on the outside of his prostate but not in the surroundimg tissue or lymph nodes. Now it's a stage 9. Got the results of his first blood work and it came back with a small trace of PSA, there shouldn't be any now that the prostate is gone. Now instead of every three months getting tested, he will go every month. If the levels stay as low as they are (0.01) they will not do anything. If that level starts to rise.....then there's more cancer. This is a second marriage for both of us, it took me most of my life to find him, we've been married for seven years. Don't want to lose him. My nerves are shot, but I push on, I have too. At least he's back to work so that helps keep him busy, I still work full time as well but if this develps into more, I will be retiring a couple of years sooner than I had planned. Has anyone else had PSA levels detected so soon after surgery (six weeks)? Did it get worse, stay the same? I lost my mom from lung cancer April 21 2013 and a brother to pancreatic cancer less than a month late on May 18 2013. Dealing with cancer for the third time in two years is just numbing. I'm shell shocked. Husbad is handling it very well but I know him well enough to see behind the facade he puts up. He's a very nice, kind, hard working man. Can't imagine my life without him.

VascodaGama's picture
Posts: 3332
Joined: Nov 2010

Your post is wonderful. I do not think you are going to “lose” him for the prostate cancer.

The PSA is not totally produced by the prostate gland (tiny portions are produced at the urethra) therefore there will be always a value registered. After op the serum should be lower than 0.06 ng/ml. This is what doctors call “remission” and your man is experiencing such with his PSA=0.01.

You have not shared details of the pathologist report but from your narration in regards to the risky Gleason score 9 and the positive extra capsular extensions, I think that he could be involved in a salvage treatment (radiation therapy) now or wait until recurrence becomes apparent. Typically, this is declared when the PSA rises to a value of 0.2 ng/ml. In any case, many in similar circumstances lived many years without the worries of a cancer return, or the endurance of added side effects from salvage therapies. Young patients in particular are at risk of losing things taken as natural for their age. Sex becomes a hardship affair and the possibility for fathering a child has been lost.
Your man’s façade may be related to his quality as manhood. He needs your understanding, more than ever.

I would recommend him to get second opinions from a medical oncologist once he gets his next PSA results.

Best wishes and luck in the times ahead.


Posts: 1013
Joined: Mar 2010

Glad to hear that your husband's surgery was apparently successful but am a little confused when you say that they found some cancer outside the prostate but not in the surrounding tissue or lymph nodes.  If it's outside the prostate, it's outside somewhere, even if they cut out what they found. 

While there is always concern about the recurrence of PCa after surgery, which would be indicated by a rise in PSA, you also need to be concerned where the cancer cells that got out of the prostate will eventually land.  So, some sort of additional cancer screening also needs to be done for early prevention/detection.  Typically, if cancer escapes from the prostate, bladder and bone cancer would be the areas of greatest additional concern.  So, you may want to ask for additional screening in these areas, even if your husband's PSA does not rise significantly.

Good luck!


Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3627
Joined: May 2012


Like Swing, some of what you write is unclear to me. Perhaps if you review his surgical record it would be clearer just how they feel the cancer had escaped from the gland, but any cancer outside the gland is problematic.  Also, his Gleason numbers are indicative of aggressive disease.  As Vasco stated, PSA of less than .01 IS clinically "undetectable; it does not represent (at that level) the presence of prostate cancer while that low.  Nonetheless, I would consult with a medical oncologist and discuss the possible need for salvage therapy.  I am surprised the surgeon did not discuss this with you already.

But be aware that even metastatic prostate cancer usually moves slowly, and is usually controllable for many years, if not decades.  I would do some consultations with both medical and radiation oncologists if it were me or a loved one, but wothout panic.  His current PSA is where it should be.  But a man as young as he is, and with a Gleason that was that high, needs to be thinking very long-term.



Posts: 4
Joined: May 2015

So glad for you and him.  The good sign is that the prostate is gone and the MRI/Bone scan showed no cancer in the limp nodes or bones.  My gleason scores were mostly 9s with an aggressive cancer in the prostate and in the neck of the bladder-nothing in the bones or limp nodes. I am 66 and my PSA was only 4.8.  I am on hormone therapy and will start radiation mid Sept.  MRI's cannot detect minimal cancer cells in the bones and limp nodes and therefore, my doctor will radiate the limp nodes also.  I remain hopeful, have changed my diet completely and with God's help, will be fine.  I would HIGHLY recommend reading a book titled "ANTI CANCER A New Way of Life" by David Servan-Schreiber, MD, PHD.  I wish I would have read this book years ago!  My thoughts and prayers will be with you both.

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