Post surgery PSA levels

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Bill_Houghton
New Member


Date Joined Feb 2009
Total Posts : 8
   Posted 1/7/2010 12:59 PM (GMT -6)   
I'm roughly one year out from radical prostatectomy (January 20, 2009 - I was able to hear the inaugural speech before going to the hospital). I've had three post-surgery ultrasensitive PSA tests, four months apart, with the first about seven weeks post-surgery. The first two reported less than 0.01 - essentially zero. The third reported 0.01 - implying some level of prostate cell activity.

I know that tests are variable, and that two points do not make a trend. Should I be concerned about this change in test results? I'll be seeing my regular doc soon, and may be seeing the surgeon (his office is currently dithering on whether they called me for an appointment or not, and, since their retail cost is $950/visit, I don't want to push to meet if it's not necessary), and sure plan to ask about this.
Age 60 at diagnosis, robotic laparoscopy January 20, 2009 at Univ. of California San Francisco
Gleason 4+3 (from pathology), T2A, tumor growing into wall but not extending beyond
Last pre-surgery PSA 4.4
Post-surgery PSA at six weeks 0.01 - looks like it's gone!


Sleepless09
Veteran Member


Date Joined Jul 2009
Total Posts : 1250
   Posted 1/7/2010 1:04 PM (GMT -6)   
Hi Bill --- your readings look the same to me. Am I missing something, or is there a typo in the most recent one you report?

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9, so far, so good
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
Oct 1st 09 -- dry at night, during day some stress issues, but better every week. 
Feel free to email me at:  sheldonprostate@yahoo.com    


MrGimpy
Veteran Member


Date Joined Jul 2009
Total Posts : 504
   Posted 1/7/2010 1:07 PM (GMT -6)   
Bill,

You say that all 3 of you Ultrasensitive PSA results are 0.01, they all seem perfect

Did you mean the last one to be 0.03 ? If so that is such a tiny variation that it could very well be the lab
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 1780
   Posted 1/7/2010 1:07 PM (GMT -6)   
Bill it still looks like it is undectable, but other who are more up to date on the ultrasensitive test will chip in soon.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Consulting with Primary Urologist for further tx.
Great family and friends
Michael


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7584
   Posted 1/7/2010 1:12 PM (GMT -6)   
Bill,
You look to be doing well, and I know that team at UCSF to be an excellent group. I considered them when I was choosing surgery. As long as things are working well, you probably won't need to see the surgeon again. I know that after my surgery at the City of Hope 3 years ago, I have not seen my surgeon in person since I checked out of the hospital. No need to. I am under the care of an oncologist now and he runs all the tests close to my home in Las Vegas.

Good luck and good healing!

Tony
Prostate Cancer Forum Co-Moderator


Bill_Houghton
New Member


Date Joined Feb 2009
Total Posts : 8
   Posted 1/7/2010 4:18 PM (GMT -6)   
It's a subtle change.

My first two tests were "LESS THAN 0.01." The surgeon says that the technology used in the lab tests can't really measure zero in an absolute sense, so this means, in effect, "the meter didn't budge," or "undetectable," and is treated as "zero."

The third test read "0.01," implying that there was a reading of some, very tiny PSA.

I recognize that it's a low grade issue compared to some folks here - am trying to figure out whether to go see the surgeon for a one-year follow up.
Age 60 at diagnosis, robotic laparoscopy January 20, 2009 at Univ. of California San Francisco
Gleason 4+3 (from pathology), T2A, tumor growing into wall but not extending beyond
Last pre-surgery PSA 4.4
Initial post-surgery PSAs very positive.


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1821
   Posted 1/7/2010 4:49 PM (GMT -6)   
Bill,
Your surgeon is right. The test equipment no matter how sensitive cannot give a zero reading. I would assume from the result that the equipment delivers an ultrasensitive result. The lowest this can show is 0.003. Strictly if undetectable this will give a result as <0.003 undetectable. But results at this three decimal point level can have a quite wide variation (running the same test again on the same sample is liable to deliver a different result) so many labs will simply report it as <0.1 undetectable. The difference between <0.01 and 0.01 could be as little as .001 (your earlier reading could have been 0.009) so it is meaningless. Make sure you always get them done at the same lab as the equipment needs to be calibrated and this in itself can lead to small variations from one lab to another. Realistically all your surgeon will say is "you've healed up nicely, your PSA is great, that's $950-00, here's a receipt, goodbye". All I do is have my PSA test ordered by my GP and have the results faxed to my surgeon's office as well simply for their records. Looks like our age, stats and results are pretty similar. Congratulations on another zero,
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)
PSA February 09 <0.01
PSA August 09 (2 year mark), <0.01
PSA December 09 <0.01

My Journey: www.yananow.net/Mentors/BillM2.htm

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