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PSA after surgery interesting

Steve1961
Posts: 301
Joined: Dec 2017

From John Hopkins 

Study Explores AccuPSA Test

During one study, Dr. Partin and his colleagues examined blood samples from 31 patients whose PSA level had been undetectable for at least five years after radical prostatectomy. All these patients had PSA levels less than 0.1 ng/ml after surgery. However, one third of them later had biochemical recurrence, while the others continued to have an undetectable PSA level for many years after surgery. The study participants were similar in age and race and had negative surgical margins after surgery. Interestingly, patients whose PSA levels went up had a greater presurgical PSA, clinical and pathological stage and Gleason grade than the men whose levels remained very low.

When the investigators tested the samples with AccuPSA, they found that at three months after surgery, all patients who ultimately had a rise in PSA had an AccuPSA level of 0.003 ng/ml or greater. By standard measures, this number would be considered undetectable. Among patients whose PSA levels never went back up, 75 percent had AccuPSA levels less than 0.003 ng/ml.

Initial Findings Reveal New PSA Threshold

In addition to this pilot study, larger tests are needed to confirm the results. These initial findings suggest that you could have an AccuPSA test three months after surgery. If your PSA level is less than 0.003 ng/ml, you could be confident that all your cancer has been removed. On the other hand, if your PSA level is greater than 0.003 ng/ml, you might choose to be monitored more closely for PSA recurrence in the immediate years following your surgery.

 

 

thats pretty darn low ..never heard anyone on this board having PSA that low after surgery ,then again only 0.01% of men with PC post on this board .so who knows probsbly thousands of men out there less tha 0.003 

Clevelandguy
Posts: 552
Joined: Jun 2015

The New England Journal of Medicine had this for thought:

Nearly 600 patients who underwent radical prostatectomy were followed an average of 10 years; patients had PSA testing (using an ultrasensitive assay) every 3 to 6 months during the first 3 postprostatectomy years and annually thereafter. Among 187 patients with undetectable PSA (<0.01 ng/mL) at 3 years, only 2 patients had later biochemical recurrence (defined as PSA elevation to >0.2 ng/mL). Among 162 patients with undetectable PSA at 5 years, none had later biochemical recurrence.

COMMENT

This study suggests that if the PSA level, measured by an ultrasensitive assay, remains undetectable 3 to 5 years after radical prostatectomy, probability of biochemical recurrence is extremely low, and PSA monitoring could reasonably be stopped. The authors also remind us that biochemical recurrence is a surrogate marker: It doesn't necessarily predict clinically evident progression of prostate cancer during the patient's lifetime.

 

Dave 3+4

Steve1961
Posts: 301
Joined: Dec 2017

Well that's good news ..I guess I am still bitter with myself for not doing surgery ..all this data I see and read is always about surgery which I didn't do ..next month will be 18 long stressful months for me .if my PSA isn't below 1 ..from what I read the treatment will have failed ..I know they will say another six months I hope it will be down but after all the series of events that  happened to me .i just don't know 

hewhositsoncushions
Posts: 345
Joined: Mar 2017

Basically saying any psa at all after surgery means recurrence. I had a couple of 0.5 readings and then bcr.

Post SRT 0.5 -> 0.9 so again bcr soon likely.

Wonder what anecdotally other people here experience with higher numbers < 0.1.

 

 

Josephg
Posts: 220
Joined: Jan 2013

Helio.  My PSA was .05 3 months after surgery, and it rose to .11 at the 15 month mark.  I then underwent the salvage combination of hormone and radiation therapy.  My PSA was then undetectible (<.02) for 30 months, and then it started to rise again.

Steve1961
Posts: 301
Joined: Dec 2017

This is sooo nerve racking how does one not think about it always ..that's my problem 

Georges Calvez
Posts: 443
Joined: Sep 2018

Hi Steve,

Not thinking about it is a problem that most of us face with some of us being in a worse position than others.
I spend a lot of time running through the various permutations in my case.
Every so often a doctor gives me a prediction but it is just a guess, maybe more or less educated than someone else's guess but a guess none the less.
My case could see a range of outcomes from the very good where I could recover a great deal and live for another two decades or more to the very bad where things could take a rapid turn for the worse and I could move to mCRPC that would get me in about a five to ten year window.
I have managed to find about ten case studies with similar starting points to me, some of them are cured, others are holding out against the slow advance and others are looking at the wrong side of the daisies!
Really there is no way of saying what will happen.
I am off to see Dr Pooh the general practioner tomorrow afternoon to talk about general things!

Wish me luck as you wave me goodbye,

Georges

Georges Calvez
Posts: 443
Joined: Sep 2018

Hi there,

PSA is not prostate specific so levels up to around 0.1 can be normal for women or men who have had prostatectomies or if treated for bladder cancer, complete removal of the bladder, prostate and all the other associated gubbins.
Men who have been treated with radiation should be looking for a constant low PSA.
PSA levels do move up and down, doctors and patients seem to forget this all the time, you really need three results over a period of three to nine months to show a trend unless the line is rising at an extraordinary rate.
Stop panicking!!!

Best wishes,

Georges

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