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Regular Member

Date Joined Sep 2007
Total Posts : 28
   Posted 1/20/2009 8:20 PM (GMT -6)   
After my latest PSA test@ ~14 months coming back @ 0.15-0.20 (3 tests @ 3 labs, see profile) I asked my doc "what is going on?"  His explanation was that there may have been some residual prostate cells that migrated into the uretha and or the bladder neck.   Thus, a very low residual PSA reading.
He has kept me on a 3 month schedule for now and is watching for any doubling of the reading.  He says that I may continue to have this low grade reading for some time but as long as it stays low that I will be OK.
Has anyone else had this experience and if so, how long has it been since your operation and what was the outcome?
Age- 59 @ Diagnosis
Diagnosed July 2007   PSA-4.0 (Free psa 11%)
Biopsy August 2007 - 2 of 4 on Right Side with 20%, Stage T1c
Gleason (3+4)   Cat Scan & Bone Scan both Clean
DaVinci Surgery Nov. 26th RWJUH Cancer Center, New brunswick, NJ
11/27/07  Home & on the road to recovery
12/4/2007 Catheter Out!
Pathology Report:  Gleason 3+3=6  Stage T2c  Organ contained Negative Margins
1/1/08  Back to Officiating Wrestling
2/27/08 1st Post Op PSA...<0.1 Undetectable (Quest Labs)
Still using a pad everyday for minor leaks
4/1/08 Trying Levitra every other day  very little response :(
Response to stimulation getting better for Mr. Happy
5/30/08  PSA...0.1 (Lab Corp Labs)
9/22/08  PSA...0.1  Still minor leakage  ED better (Lab Corp Labs)
12/15/08  PSA...0.2 (Lab Corp Labs)  Still minor Stress Leakage
1/14/09   PSA ...0.16  (Quest Labs) PSA 0.15 @ annual physical

Regular Member

Date Joined Jan 2009
Total Posts : 180
   Posted 1/20/2009 8:39 PM (GMT -6)   
Hi Wayne.
It was either contained or not. The word residual after a radical means 'Opps' didn't get it all.
A PSA of .1 on the standard test is considered undetetable.  Are you having the standard test or the ultrasensitive test?
Have you had any other diagnositcs.  If a total body scan is negative except for the prostate region then in my opinion the Dr has failed.
I have had a persistance of PSA and eventually discovered the Dr. left a good bit of the gland.
Diagnosed @ 48yo 04/07
focal low volume tumor gleason 6
RRP 07/30/07
Persistance of PSA
IMRT 11/07-01/08
Emerg, cysto obstructed bladder 01/08
Persistance of PSA
08/08 learned Dr. left significant amount of prostate
12/08 saturation biopsy 36 cores 24 having normal prostate tissue
12/08 referred whole to med malprac attorney

Veteran Member

Date Joined Dec 2008
Total Posts : 3149
   Posted 1/20/2009 8:53 PM (GMT -6)   
You were smart in getting verification from different labs, to make sure lab errors which happen can be eliminated from your scenario, verify is wise. Let others think about such, verify, even if you have to see another doc, or different test, you need to know.


Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 1/21/2009 2:06 PM (GMT -6)   

With the shift back and forth between .2 and .15, I'd watch and wait on this one for a while. It may turn out to be tissue left behind causing the slight PSA. As you know, the prostate has poorly defined edges making it difficult to remove virtually all tissue. Many studies say small tissue remains can indeed produce small amounts of PSA.


Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 1/21/2009 2:25 PM (GMT -6)   
It's not like the prostate unbolts from the back of the bladder with a little gasket behind, wish it were that easy.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3, 9/8 14.9, 10/8 16.4
3rd Biopsy 9-2008 Positive 7 of 7 cores positive, 40 - 90%, G 4+3 & 3+4
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, Catheter out on 12/15/8. Stopped flowing, new catheter put in 12/16/08, Catheter out 12/29/08. Emergency room put in Catheter # day 45, 1/5/9 - Cath #3 out, dr. did cycloscope, saw potential blockage, put in Catheter #4, 1/13/9 - removed blockage, put in Cath #5, 1/19/9 -out
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grams, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery  Scheduled now for 2/9/9

Veteran Member

Date Joined Jun 2007
Total Posts : 789
   Posted 1/21/2009 6:34 PM (GMT -6)   
Hi Wayne, as you can see below, even after salvage radiation, I seem to be stuck around 0.4 PSA, it has been this way since the operation, my Urologist said a few cells may have escaped, as there was microscopic evidence of escape from the capsule, also said the cells should be in the prostate bed, and the radiation should have got them, apparently the radiation has long term effect, and takes a while to kill the cells, my next PSA is in March, so we will see what happens.

Regards Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7  right side tumour adenocarcinoma stage T2a
RP on 30th July,
Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck, free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.
Post op PSA 0.5 26th Sept.
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA 30th April 0.4
PSA 30th July 0.5
PSA 27th Oct 0.4 (I am now 68)

Regular Member

Date Joined Jan 2009
Total Posts : 27
   Posted 1/21/2009 7:36 PM (GMT -6)   
Rp in 1995. Pre op Psa 7.2. Gleason 2+1.  Psa 0.2 in 1997. Psa is now 0.5. So far I have received no additional treatment. As you can see my gleason is low and not as typical for PC as your 3+3 is. Best wishes, Al
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