PSA 0.08 after having surgery in 2004

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New Member

Date Joined May 2009
Total Posts : 8
   Posted 6/19/2009 10:03 PM (GMT -6)   
Since having surgery in  2004, my PSA has risen from 0.04 to 0.08.  Should I have additional treatment? Is this rise cancer?
Not sure what to do

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 6/19/2009 10:42 PM (GMT -6)   

Here is how I see it (I am sure many here on this forum will provide their opinion).

First, you need to determine if this is a recurrence. Yours is still a very low ("undetectable") reading. Some other parts of your body make very small amounts of PSA (uretra does). The healthy prostate tissue left behind after prostatectomy grows and produces PSA, so you really need to see the dynamic of the PSA growth and act only if it reaches a "detectable" level of 0.1. I think you need to look at few more variables. PSA doubling time from the last two or three tests, your age, Gleason score and pathology. And, of course, talk to your docs. (BTW, if you go to control panel and update your stats, it'll make it easier - no need to repeat your stats to everyone).

Then, if it is a recurrance, you need to figure out the way to deal with it. With low Gleason and high PSA doubling times, doing nothing (watchful waiting) is an option. Radiatin is an option too. Depending on your age, hormonal therapy is an option. There probably are some more. But first things first - you need to know this is a recurrence.

As you see from my signature, my case is a little different. It is undoubtfully a recurrence, but the question is whether it is local or systemic. I am betting on local and going for radiation treatment.

Previous 5 biopsies over 4 years negative

PSA going from 3.8 to 28

Father died from PCa @ 78 - normal PSA and DRE

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)















followed by RRP at Duke (Dr. Moul) on 6/16/2008


Gleason downgraded 4+3=7

  Duke: T2c N0MX, one positive margin

  Sloan Kettering: T3a N0MX, extraprostatic extension, two positive margins

PSA undetectable for 8 months, then









6 Months ADT started 6/12/2009

IMRT to start mid-Aug

Regular Member

Date Joined Aug 2007
Total Posts : 118
   Posted 6/20/2009 12:30 AM (GMT -6)   
Yes, please provide your stats following surgery. There are various nomograms online where you can plug in your numbers and get the probability of a recurrence x number of years after treatment. That being said, I doubt many would recommend taking action immediately unless your pathology was poor. Even if your PSA continues to rise to 0.1 and beyond, it will probably not do so very fast based on your history, giving you time to work on a salvage therapy. If your pathology was good, you may find that your likelihood for a recurrence could be very low.
I have been interested (obsessed?) with the ultrasensitive PSA test since my surgery. Some men are lucky and have a very low number that never fluctuates. Others have to deal with anxiety that goes along with fluctions that may only be noise. Due to my excellent pathology, I have decided to switch urologists and go forward with the "standard" PSA test with a minimum sensitivity of 0.1. This is also the general recommendation from Johns Hopkins. I have had a very small increase from <0.008 to 0.02 over about 18 months, which is probably insignificant, but I still find myself thinking about it. I know some will say that I will lose information about PSA velocity, but I cannot see how this would change my course of action in the event of an eventual recurrence.
Please provide your pathology statistics.
Age:45 (44 when diagnosed)
Father diagnosed and cured at age 52.
08/21/07: Diagnosed with T1c cancer
1 of 12 biopsy cores positive; 10% tissue
Gleason score: 3+3=6
PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)
10/19/07: da Vinci prostatectomy by Dr. Vipul Patel
              Difficult surgery due to prostate inflammation.
              Both nerve bundles spared.
              Spongy erections began within 24hrs of surgery!
10/24/07: Catheter out; down to 1 Serenity pad/day next day.
              Final pathology: neg margins, no capsular penetration,
              Gleason 3+3=6, 5% tumor involvement, multi-focal.
11/04/07  First usable erection with Cialis
11/22/07  Thanksgiving - Bye-bye, pads
01/17/08  First post-surgery PSA result: < 0.008 ng/ml
03/17/08  Erection quality mostly back to pre-surgery levels with Cialis;
              have not tried without meds yet.
04/23/08  Second post-surgery PSA result: < 0.008 ng/ml
07/30/08  Third PSA: 0.01 ng/ml
11/04/08  One year PSA: 0.01
              Still taking 10mg Cialis every other day - enjoying the results
              too much to stop yet.
02/07/09  Taking 5mg Cialis every other day - having too much fun to try
              to stop for now.
03/23/09  PSA: 0.02

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 6/20/2009 4:12 PM (GMT -6)   
Greetings, Burgh.  Maybe I'm naive and too trusting, but my doc only uses a scale in tenths and my PSA report alwasy comes back less than .1 which he calls zero.  There are several reasons why your PSA can vary just slightly between tests.  As long as it is less than .1 I would monitor but not be too concerned.  David

Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

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