6 month psa on rise

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Regular Member

Date Joined Jul 2009
Total Posts : 40
   Posted 11/25/2009 7:46 PM (GMT -6)   
My 6 month PSA is very slightly above 0.00 but it has risen to 0.03. I see my Dr on Dec 8th so I have to wait awhile. I am nervous since it should be 0.00. Does anybody have any info on this slight raise? should it be a concern? Thanks guys it has been awhile but I just need some reassuring
Tim confused
48 yrs old
Robotic RP
6-15 2009 Da Vinci surgery
Geason Grade 3+3
Gleason score 6 out 0f 10
8-10 2009 almost dry big step
9/9/09 Great day scored a 0 on my PSA test
Still ED / But getting better
Recovery is a process not a switch to turn on and off.
Using support groups like this and in person to make it through

Veteran Member

Date Joined Jan 2007
Total Posts : 762
   Posted 11/25/2009 7:50 PM (GMT -6)   
Hi Tim,
A quick reply. As you can see from my husband's signature (around same age as you),  we had same scenario with 0.01-0.03.  
0.03 is within the undetectable range. After some panic and stress and a consultation we are happy with this reading but discussion with your own doc is a good idea.  Good luck and good health to you. Lana
Creed_three - Husband 51 yrs (49 years at diagnosis)
PSA (2002) 2.1.  PSA (2006) 3.5.  1 x 5% core of 12 positive at biopsy. Open Radical Prostatectomy with nerve sparing April 2007. Gleeson 3 + 4 = 7.   Undetectable <.1 PSA since, specifically, June 2007-0.01, Oct 2007-0.02, April 2008-0.02: Oct 2008-0.03, Nov, 2008-0.02, April 2009-0.03. 

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 11/25/2009 7:57 PM (GMT -6)   
Tim, anything under .10 is considered a zero. Your .03 isn't positively a true rise, its within the tolerance of the testing lab, and can vary that much on a day to day basis for any numbrer of reasons.

That's why a rise isn't really consider a rise until you have had 3 in a row with your PSA.

Looks like you are getting tested every 3 months, so I would say wait and see what the next one brings.

Good luck
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place

Veteran Member

Date Joined Apr 2008
Total Posts : 1382
   Posted 11/26/2009 11:07 AM (GMT -6)   
Tim congrats on the ZERO and believe me those numbers are not a reason for concern at this time. Enjoy this great news and go out and live life to the fullest.

peace and love
My PSA at diagnosis was 16.3
age 47 (current)


My gleason score from prostate was 4+5=9 and from the lymph nodes (3 positive) was 4+4=8
I had 44 IMRT's
Currently on Lupron
I go to The Cancer Treatment Center of America
Married with two kids
latest PSA 5-27-08 0.11

PSA July 24th, 2008 is 0.04
PSA Dec 16th, 2008 is .016
PSA Mar 30th, 2009 is .02
PSA July 28th 2009 is .01
PSA OCt 15th 2009 is .11

Testosterone keeps rising, the current number is 156, up from 57 in May

T level dropped to 37 Mar 30th, 2009
cancer in 4 of 6 cores

Veteran Member

Date Joined Jul 2009
Total Posts : 504
   Posted 11/26/2009 11:18 AM (GMT -6)   
My Dr told me that all he cares about is that its under .10. Variations in the testing can result in scores deviation very easily

The same day that blood is drawn if sent to 2 diff labs can get readings of .03 at one and a .05 at another, sometimes an even bigger disparity is possible
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

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 11/26/2009 11:47 AM (GMT -6)   
You are exactly right. It wouldl probably be a greater service to all of us, if all PSA results were simply listed as <.10, until such a time it actually rises above that mark. We would all sleep better and not become PSA neurotics, lol.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys cath #8 33 days, 11/2- SP Cath #9 in place

Veteran Member

Date Joined Sep 2009
Total Posts : 3172
   Posted 11/26/2009 6:21 PM (GMT -6)   

If you are getting data to the “hundredths” place, then you are getting the “ultra-sensitive” PSA test done.  Like so many things, there is both an upside and a downside to the “ultra-sensitive” PSA test.


For low risk cases (PSA under 10 ng/mL, Gleason 3+3 or 3+4), most doctors do not prescribe the ultra-sensitive PSA test after RP simply because there is such a low probability of PC recurrence.  So, I believe the downside of ultra-sensitive PSA testing occurs because a little of the known day-to-day variation at the ultra-sensitive levels can cause some un-needed anxiety...you might be experiencing some of that now.


The upside occurs for RP patients who do have a biochemical recurrence; which occurs mostly from men who didn’t start out with such low risk stats.  As you may know, roughly 30% of RP patients end up having to get follow-up secondary treatment, with radiation treatment being the most common (and typically very successful in treating the recurring PC).  “Biochemical recurrence” is sometimes defined at different levels, but most doctors us 0.2 ng/mL (others use 0.3, I’ve also read of 0.5).  Those who started out with a more intermediate risk and do experience a recurrence will benefit by getting an advanced “heads-up” notice when their ultra-sensitive PSA result starts trending upward.  So, the upside benefit is because RT is most effective when done early; the earlier the better…so the ultra-sensitive test definitely has it’s place and has some advantages. 


By the way, you wrote:  "I am nervous since it should be 0.00."  You should be aware that after RP nobody’s PSA was never really “zero”, but on most tests, when it is very low, it is below the detection limits of the test.  The more common test has a lower limit of 0.1 ng/mL (the ultra-sensitive test has an extra decimal of accuracy).  Were your nerves spared in RP, for example?  If so, they are going to be the greatest source (albeit a small source) of PSA in your bloodstream for the rest of your life…but they should produce a relatively small but steady amount of PSA.  The notion of a “zero club” is a bit of a misnomer.  At less than 0.1ng/mL, your results are below standard detectible limits…coupled with your low risk starting point, your results are outstanding!




Veteran Member

Date Joined Mar 2009
Total Posts : 739
   Posted 11/26/2009 6:33 PM (GMT -6)   
Great Post Casey
Age 51yrs
6 out of 8 cores positive 3 X 60% / 3 X 10%
Gleason Score 3+4=7
Stage T1c
Robotic Surgery 24/12/08
Upgrade Gleason Score 4+3=7 Gleason Differential 60%/40%
Stage T2c
Three small foci total volume <10%
Neg Margins and Nodes
Nil - Extraprostatic Extentions
Dry less than 1 week.
ED- taking Meds- Its been 9 mnths now getting some action ! yay !
PSA 1/09  .03
PSA 2/09  .03
PSA 5/09  .03
PSA 9/09  .03
"Everyday in Everyway I get better"

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 11/26/2009 7:07 PM (GMT -6)   
What Casey has said is correct. There is no such thing as 0 PSA and it should not really be reported as such. 2nd generation detection equipment has a absolute lowest detection limit of 0.03 ng/mL. If PSA is not detected using this equipment it should in truth be reported as <0.03 (less than 0.03) meaning it is so low as to be undetectable by their equipment. If the lab uses  Generation 3 equipment (such as the Immulite 2000) then its absolute lowest detection limit is 0.003 ng/mL and if PSA is not detected the result should say <0.003. But at these minute levels the test equipment will give different results on the same blood sample (with detection below 0.01, multiple testing on the same sample can and does give results of .003 or .004 or.005). For this reason many labs even when using Gen 3 equipment will report with accuracy only to 2 decimal places i.e. no matter the actual 3 decimal reading they will state the result is <0.01 ng/mL. The trick with the ultrasensitive test as an early marker is to use it to watch for a definite trend even at low levels. A trend that went from  0.005 then to 0.009 followed by 0.01 then .012, to me says PSA is rising slowly and I would then begin to PLAN a course of action. If it goes up and then down or stays put then ignore the slight variations.

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

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

Veteran Member

Date Joined May 2009
Total Posts : 2692
   Posted 11/26/2009 7:40 PM (GMT -6)   

I would agree with the other posts, but as a G 9 patient, I am watching it like a hawk as well. I like to think of it as a yellow light that says hey, just don't forget to check me again in 3 months.

This PSA watching can be a real paranoia producer. Best of luck, and don't stay away so long. Check in and let us know how it is going.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks .
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injections

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 11/26/2009 10:57 PM (GMT -6)   
As everyone has said .04 is a ZERO. You have good pathology with a Gleason 6 and the odds are very high that all the PC is gone. That said, welcome to the PSA test roller coaster. I proudly said that I wasn't worried about my 6 months test, but when they phoned with the 0.0 result I realized that I had spent the last three days holding my breath!
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day

gold horse
Regular Member

Date Joined Nov 2009
Total Posts : 360
   Posted 12/1/2009 5:23 PM (GMT -6)   
Tim,simple there is no 0 psa after surgery.I had the same numbers as you, thanks God after five years psa=o.o4 relax. nono
PSA 6/05=0.04,0.04,0.04,6/06,0.04,0.04,0.04,6/07,0.04,0.04,0.04,6/08,0.04,0.04,1/09

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