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Elevated PSA test 6 years post op

Ajatater
Posts: 2
Joined: Feb 2017

It has been 6 years since my husband had prostate surgery.His PSA test have all been < 0.1 until 6 months ago when they were 0.1.does this mean his cancer has returned

hopeful and opt...
Posts: 2224
Joined: Apr 2009

Generrally 0.2 is a sign of recurrance. Some even consider 0.3 a sign.

VascodaGama's picture
VascodaGama
Posts: 3012
Joined: Nov 2010

Without the gland in place PSA shouldn't exist, but tiny portions (0.03 ng/ml) can be found as these are "manufactured" by benign cells in the urethra. In any case, laboratories specify PSA values depending on the assay used for the test. Some assays readings do not reach lower values lower than 0.1 (Lower Limit of Detection) and some others go further down corresponding to <0.1. In such cases one should think that the real value is in fact 0.1 or a lower value rounded up (ex; 0.01 to 0.09 equals <0.1). Here are details;
http://www.quansysbio.com/lld-lloq-uloq/ 

We make use of the PSA to identify cancer recurrence but this value is only significative after confirming several continuous increases. I recommend you to continue testing maybe at three months intervals, but using ultrasensitive assays that read two decimal places (0.XX ng/ml). This is proper for guys with no prostate gland in place (surgery) that would produce real tiny values.

Best,

VG

Old Salt
Posts: 720
Joined: Aug 2014

As stated earlier, the PSA=0.1 result does not prove that the cancer has returned. And, as stated by Vasco, more data are needed. The same test and the same lab should be used in order to draw meaningful conclusions.

To look at this issue in another way, with a result of <0.1, the actual PSA could have been 0.095. Most likely, this is not significantly different from 0.1. because of day-day variation in analytical testing.

Clevelandguy
Posts: 456
Joined: Jun 2015

Hi,

Old math rule, three points make a trend line.  Too early to tell unless the next few tests also show and increase with every test.

Dave 3+4

Ajatater
Posts: 2
Joined: Feb 2017

I posted a few days ago about my husbands PSA test.When he had surgery his doctors did say that they were pretty certain that they had gotten all of it and it seemed to be contained and not to have spread.6 weeks post op the pathology report show a more aggresive form than they first thought. What his numbers were before we dont know as they DO NOT show up when we look at past test results. I just remember looking once, 6 years ago, and seeing that over the past years how each year when tested they had increased.If memory serves me they were around 7.Since his surgery they have always been,0.1 until July when it was 0.1 and this past week it was 0.2..Monday his doctor wants to talk by telephone.Before surgery they gave him the option of surgery, waiting another year to see if his numbers went up or just don't worry about it. Even after he had a biopsy and 12 out of 16 cores came back with cancer cells they still didn't seem concerened...he doesn't worry but I do..

VascodaGama's picture
VascodaGama
Posts: 3012
Joined: Nov 2010

PSA= 0.2 ng/ml is indicative of biochemical failure. It could be recurrence. If such is verified then your husband will need further treatment using radiation. This is the job of a radiologist so that you may look for specialists you trust that can guide you on the matter, and that can provide you with a second opinion.

Typically doctors start salvage treatments when the PSA reaches 0.4 but one can start it earlier or after such marker. Some doctors recommend salvage treatment after confirmed three constant increases. The age of the patient, the expected location of the metastases (based on the pathologist's report and image studies) and the aggressivity of the cancer (Gleason rate) are elements required for a decision. Here is a link with details of a salvage treatment;

http://www.touchoncology.com/articles/salvage-therapy-prostate-cancer

Best wishes and luck in any additional therapy, if any.

VG

Guber4
Posts: 5
Joined: Feb 2017

What was his final pathology?  PSA  Gleason  Size etc. 

Nick51
Posts: 1
Joined: Mar 2017

I had prostate surgery and the prostate has been removed, however my PSA score is.02. What can I do to decrease this rise in the PSA score?

 

Steelchuggin26
Posts: 36
Joined: Mar 2013

0.02 is considered zero by most facilities. There will be some  psa still produced by the urethra that can be picked up with the ultra sensitive psa assay. This is clinically insignificant. No need to take action now. You would need subsequent rises on multiple tests, say 3 consecutive to be concerned.  And even then, it would probably have to reach the 0.2 mark before initistion of additional treatment would be recommended.

VascodaGama's picture
VascodaGama
Posts: 3012
Joined: Nov 2010

PSA=0.02 ng/ml is considered remission. Can you provide more details on your case and the PSA histology for us to understand the problem (if any)?

VG

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