Another Article on Post-RP rise in PSA

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Veteran Member

Date Joined Aug 2007
Total Posts : 1015
   Posted 7/16/2009 7:08 PM (GMT -6)   
For all of us with a little rise in Post-RP PSA. 
I search and search for the above article, David in SC, because I thought you may wish to see what one article considers to be biochemical recurrence.   I think this validates your current plan.
The article has helped me and I hope that it helps others.
These quotes from the article were of interest to me:
(1) " developed an elevated PSA (defined as being higher than 0.2 nanograms/milliliter)." 
      I thought the 0.2 threshold was interesting.
(2) "On average, it took eight years from the time a man's PSA first went up until he developed metastatic disease -- which suggests that there is no need to panic at the first sign of a rise in PSA."
      I liked the "no panic" advice.  Sometimes easier said than done.  confused
'Hope this helps!
Da Vinci LRP July 31, 2007… 54 on surgery day
PSA 4.3 Gleason 3+3=6 T2a Confined to Prostate
6th PSA 06/09 still less than 0.1

Elite Member

Date Joined Oct 2008
Total Posts : 25382
   Posted 7/16/2009 8:29 PM (GMT -6)   
Barry, good article, thanks for thinking of me and sharing it, I had read part of it from Walsh's book, but not the newer study.

I think what concerns my doctors, not so much that I am a Gleason 7, and btw, I was downgraded from 4+3 to 3+4 which is a bigger deal than some realize, it was because of the incredible velocity of my PSA pre-surgery, in the final year before dx., it had tripled or more.

I reel in horror sometimes thinking, what if I wasn't being checked since age 50 by choice, or if I never had agreed to the 3rd biopsy which found the PC, what would it be like now if either I didn't know or chose not to do anything. Academic of course, because they did find it, and I didn't waste any time getting my primary treatment.

This Hopkins study is confirming some of my thoughts that my situation is not a dire emergency to force me into salvage radiation. If I need it, I need it, not arguing that point. My PSA is still a long way from even the most conservative of the salvage threshold levels, so I still feel "safe" waiting till early August for another PSA test, and see if there is any real rise.

Thank you again,

David in the Palmetto State
Age 57, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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 capsule, one post. margin, clear lymph nodes 
First PSA Post Surgery   2/9 .05, 5/9 .10, 6/9 .11, 8/11 ?
Lastest 7/13 met with Rad. Oncl, they want to start radiation, 70 gray, I am still considering all options and opinions

Veteran Member

Date Joined Aug 2007
Total Posts : 1015
   Posted 7/17/2009 12:22 AM (GMT -6)   
You welcome, David.

Getting that third biopsy was really important. That gave you a chance to attack the real cause of your pre-surgery PSA increase earlier.

I like the downgrade on your post-surgery Gleason score as well.

All the best,

Da Vinci LRP July 31, 2007… 54 on surgery day
PSA 4.3 Gleason 3+3=6 T2a Confined to Prostate
6th PSA 06/09 still less than 0.1

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