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psa 7 6 weeks after robotic prostatectomy

rmaj
Posts: 1
Joined: May 2018

Just wondering if anyone has had similar results and what your opinion is.

age 50

11/17 routine PSA 21.3

12/17 biopsy 15 of 19 core positive and gleason 3+4

3/21/18 robotic prostatectomy

pathology report: Adenocarcinoma, Grade gourp 5, Gleason 4+5 involving both lobes and associated with extraprostatic seminal vesicle invasion, surgical margin positive at left proximal urethral and right posterior margine, stage pT3bN0. perineural and bladder neck positive, 2 lymph nodes removed negative

6 week post op PSA 5/3/18 7.0

have not talke to radiation oncology yet

Old Salt
Posts: 720
Joined: Aug 2014

Labs occasionally mess things up. Let's hope for that. 

If not, you will need to engage a medical oncologist with experiece in prostate cancer to map out a treatment plan. And yes, you should also ask a radiation oncologist for advice

VascodaGama's picture
VascodaGama
Posts: 2968
Joined: Nov 2010

The pathologist report and the PSA confirm surgery failure. Spread is highly probable and you may be in risk for existing far metastases. I wonder about the results of a past image exam, but I would recommend you to get a PSMA-PET before advancing with any. In your shoes I would start thinking in a salvage treatment to include radiotherapy (after complete RP recovery) if far metastases are ruled out.

I am sorry for the findings.

Best wishes and luck in your continuing journey.

VGama

Will Doran
Posts: 207
Joined: Sep 2015

rmaj

I am also sorry to hear of your PSA results. 

I started with a PSA of 69 when diagnosed.  I was a stage pT3bN1.  One lymph node involved, a spot so small it didn't show up in my MRI's.  After surgery, two years of Lupron and 8 weeks of radiation as follow up, my PSA held at <0.010.  As of this August it will be 5 years since Diagnosis. Had Robotic Surgery in Dec. 2013. As of this week,  my PSA still remains below 1.00.  It is up to 0.747 at this time. This is a much slower rise than my doctors were expecting.   When it hits 2.00, I may have to go back on some sort Hormone therapy.  My wife and I are very thankful, as are my doctors.  They are all very surprised as well.  They keep it real, that the cancer will always be with me, but we will do our best to control it.  

Did you have or will you have radiation and Hormone therapy?  That is usually the follow up after RP.  If you do have radiation and hormone treatments.  The hormone treatments started before the Radiation to weaken any remaining cancer cells, so the radiation could work better.  That should bring the PSA down a good bit.  At least that was my experience.  My PSA came down rather fast post surgery.  I'm thinking I was below 1.00  a couple weeks after the surgery, before the hormone and radiation treatments started.  

Stay with this and don't back away.   Seek other advice from other doctors if you aren't confident in the results.  I have My Urologist/Surgeon, My Radiation Oncologist, and My Chemo Oncologist working on this with me.  They are all on the same "Channel" as far as their treatment options, and their thoughts as to my recovery.  At first, the Chemo Oncologist I was with was in constant disagreement with the other doctors.  She left the practice, and I got a new Chemo Oncologist.  The guy I have now talks to the other doctors and they are working together.  That wasn't the case before, becasue the first Oncologost we too busy with her private life, so it seemed.  Just make sure all your doctors are working together.  

Love, Peace and God Bless

Will

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