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cave88
Regular Member


Date Joined Jul 2008
Total Posts : 76
   Posted 2/16/2009 8:46 PM (GMT -6)   
  I had my 6 month post-op test last week, saw the Dr today.  It had risen from 0.11 to 0.12.  Dr was not concerned at this point.  He said it could be from residual tissue and or just the testing accuracy.  I did use the same lab. Also mentioned that at my age the prostate is not as defined from the bladder, etc. as in older men. First I had heard of this. These could be some of the reasons there is still some psa present. Anyway,  we will check again in 3 months. 
  I do feel pretty good from these results.  Now I have two tests to compare.  If there is cancer present the psa is rising at a slow level.  As long as the psa does not continue to rise I will feel ok.  Hope my thinking/feeling is sound.  I just wanted to what is going on.  Wanting to know if others have had similar results.  Dr said there is a 25% chance that the psa will continue to rise and some radiation would be needed.  I do feel comfortable knowing that based on these numbers if there is cancer present than it most likely confined to the prostate bed area.
age:  44
1st psa Apr 08 3.06
2nd psa 6/16/8 4.02,  DRE showed nothing abnormal
biopsy 7/10/08 positive 5 of 12
Da Vinci 8/04/8 Parkview Memorial in FT Wayne IN 
gleason 3 + 3 = 6
prostate 27 g, 4 x 4 x 3.1 cm
Stage:  pT2cNXMX
margins:  apical margin involved
no extraprostatic extension of tumor
seminal vesicle involvement: absent
1st post-op psa  0.11 11/08
2nd post-op psa 0.12 2/09/09
 
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 2/17/2009 8:22 PM (GMT -6)   
cave88,
I don't think you should really consider a reading of .11 and .12 as having any difference and view it as a rise. It really amounts to a difference of .01 which is minuscule and insignificant and could well be due to equipment calibration and/or lab temperature issues. The problem with ultrasensitive tests are they are just that, ULTRAsensitive..... and minute variations should not really be interpreted purely as a sign of increasing PSa.
This link from "yananow" explains some of the pitfalls of ultrasensitive testing
www.yananow.net/UltraPSA.htm.
While the reading of .1 may be a cause for concern following surgery the docs explanation of residual benign prostate tissue (quite possible with nerve saving surgery) is pretty reasonable. On the other hand there is also a valid protocol that advocates radiation as an additional treatment when PSA is present after surgery. Your reading is essentially unchanged so the doc is probably correct in watching the PSA carefully and not subjecting you to extra treatment that comes with the inevitable side effects.
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)

Post Edited (BillyMac) : 2/17/2009 10:15:16 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/17/2009 9:45 PM (GMT -6)   
I agree with Billy on this one, the difference between .12 and .11, is well within normal tolerances of a sensitive test like these. Even day by day, there can be minor flucuations of what is a very minute portion of a number. In fractions, you are talking about the difference between 11/100th of a PSA "point" and 12/100th of a PSA "point". Now if it continues in an organized and consitent rise over the next 3, 6, or 9 months out, that could be a noteworthy trend.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


cave88
Regular Member


Date Joined Jul 2008
Total Posts : 76
   Posted 2/17/2009 9:52 PM (GMT -6)   
Bill thanks for the feedback. I lurk here now and again and sometimes post. I see a lot of posts of psa results of <0.1 and <0.01. With my psa results being slightly higher I am kind of curious as to how many others have had rp surgery with the same psa numbers post-op. I feel comfortable at this point but maybe I shouldn't.
jon
age:  44
1st psa Apr 08 3.06
2nd psa 6/16/8 4.02,  DRE showed nothing abnormal
biopsy 7/10/08 positive 5 of 12
Da Vinci 8/04/8 Parkview Memorial in FT Wayne IN 
gleason 3 + 3 = 6
prostate 27 g, 4 x 4 x 3.1 cm
Stage:  pT2cNXMX
margins:  apical margin involved
no extraprostatic extension of tumor
seminal vesicle involvement: absent
1st post-op psa  0.11 11/08
2nd post-op psa 0.12 2/09/09
 
 

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