CSN Login
Members Online: 4

You are here

Accepted psa level 40 days post surgery - removal of posterate

JKTABLAJE
Posts: 1
Joined: Sep 2018

I am 58 yr old and was diagnosed with posterate cancer in september 2018. Gleason score was 7B and was told it was organ contained. PSA at surgery was 11.4.  Surgry performed on 23rd November with Robot. I had my 40 day post surgery PSA test and result is 0.1. Had a discusion with surgeon assistant and was told

 

- 14 lymph nodes taken but only 1 showed 1mm cancer cells on it. when I asked if cancer had spread, I was told it has not spread to other areas.

- They will do nothing if the PSA remains 0.1 but will follow up with radiation if it rises.

I will be going for my 3 month post surgery PSA test on 28th February but I am concern of the PSA value of this first test. Should I be be concerned on this PSA level and what can I suggest to the dr. if it continues to be 0.1 even after the 3 month PSA test?

VascodaGama's picture
VascodaGama
Posts: 2938
Joined: Nov 2010

JKT

The decrease in the PSA (11.4 to 0.1 ng/ml) is at first impression a success. The positive lymph node is the baddy of the story. It certainly signifies spread which places you with a pathological stage of pT3N1. I wonder if they found positive margins, positive seminal vesicles, any PIN and the type of cancer.

This is too early to draw conclusions. The results are ambiguous as one doesn't know if the surgeon managed to get rid of whole infested tissues (gland, surroundings and lymph nodes). The PSA is at the moment the only marker to judge the outcome. In such regard I would suggest you to do the next (and following) PSA tests with assays of two decimal digfits (0.XX ng/ml). These ultra sensitive assays are proper for guys without the gland (your case). Remission is usually considered when the PSA is lower than 0.05 ng/ml, higher values are called biochemical failure. Surgery failure is considered at PSA levels above 0.20 ng/ml.

Let's hope that the next PSA comes in remission levels.

Best wishes for full recuperation.

VG 

 

Max Former Hodgkins Stage 3's picture
Max Former Hodg...
Posts: 3116
Joined: May 2012

 

JKT,

As always, Vasco is correct in all he wrote (I've never noted an exception to this fact).  I would add that regardless of whether you receive ultra-sensitive testing or more conventional, your results will ALWAYS show some digits to the right of the decimal point. This is true even if you are wholly cured, and no residual PCa remains in your body.

Labs vary a little in what they regard as "Undetectable PSA."  My first two years post-op my PSA tests always showed some digits to the right, as I noted, but the doctor, who has a huge amount of PCa Cancer treatment experience, says it is Undetectable and irrelevant.  Later, the lab printout results were changed, and now it only syas "Undetectable," without digits of any kind.  This is undoubtedly a more soothing presentation for most men. Just remember that, by themselves, non-zero numbers on your results are not automatically a bad thing. It depends on what the numers are.

You are still only about six weeks post-op.  It is conceivable that your number has not yet drifted down as far as it is going to; possible, but just a guess.

If you do reach .20 or above (the definition of post R.P. relapse), the Best Practices response is to begin IMRT/IGRT radiation, the sooner the better.  This is very often completely curative, and potentially kills whatever PCa cells were missed.  Radiation begun after PSA has reached .5 is statistically less successful than radiation begun sooner.

Also, get a paper copy of your complete surgery Pathology Report and the Surgeon's Report, for future reference. And also a copy of your initial biopsy.

max

greenteaguy
Posts: 2
Joined: Jan 2019

Best wishes for a full recovery.

Subscribe to Comments for "Accepted psa level 40 days post surgery - removal of posterate"