Monitoring Rising PSA

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rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 1/17/2010 6:55 PM (GMT -6)   
I know someone that has rising PSA after prostate removal?  It is in the montoring stage now and he said doctor said to come back in 6 months.  Wouldn't you go back in three months to determine the increase in PSA vs 6 months?  Just checking to see if anyone else was told come back in 6 months vs 3 months after PSA increased.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 1/17/2010 7:34 PM (GMT -6)   
It depends how fast the PSA is rising. Mine is rising slowly (see stats below) and I too am on a 6-month cycle.
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
19-month: 0.09 (maybe)
ED:
After a learning curve, Bimix injections (0.2ml) worked well. From 14 months, occasional nocturnal erections. Have "graduated" to just the pump.


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 1/17/2010 7:41 PM (GMT -6)   
Hi Rob,
 
Sorry about the rise in his PSA.
In my unprofessional opinion, I would not wait for 6 month if my PSA was on the rise. I would definitely get it tested at least every 3 month and take further action as soon as as the recurrence is confirmed. At least that's what I did as you can see by my signature.
Hopefully the rise in PSA is just a blip and not a recurrence.
 
Magaboo


Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09=0.05; July 09=<0.04; JAN 10=<0.04


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/17/2010 7:44 PM (GMT -6)   
When my started to rise, both the uro/surgeon and the radiation oncologist both wanted to monitor at 3 months intervals. As a patient, I would insist on it.

David in SC
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
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 1/18/2010 9:22 AM (GMT -6)   
When my husband's PSA rose from 0.0 to 0.1, the urologist had him come back in 1 month for another test. The results of that came back at 0.3; "come back in 1 month" and that test came back at 0.0. Urologist then wanted another PSA test within 2 months which John had in December - thankfully, another zero. He is now back on his 3 month schedule (next test in March - 2 years after surgery).
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (single small EPE in posterior left). Perineural tumor infiltration present. Apex margin, bladder neck and SV negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009- 0.1, September 0.3, October back to 0.0, December 0.0. Thank you God!


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/18/2010 9:26 AM (GMT -6)   
Still so happy that you and John got that well needed break, one of the few times I have seen a rise turn back around on its own considering the circumstances.

David in SC
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
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 1/18/2010 12:08 PM (GMT -6)   
Rob...I am in the same boat as Piano...on a six month schedule now. Will wait and see what happens in a few more months.
You are beating back cancer, so hold your head up with dignity
 
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 


cpb
Regular Member


Date Joined Jul 2007
Total Posts : 34
   Posted 1/18/2010 1:01 PM (GMT -6)   
Your posting in very timely  - I just had a rise in my PSA to 0.16 after two years of less that 0.1 using Ultra Sensitive PSA. Surgeon is suggesting radiation therapy. Thinking I should have another PSA to see how accurate test was and then monitor with another PSA next month. OR should I be agressive and start some type of therapy. Any advice or comments based on your experiences would be appreciated. What concerns me is that there was perineral invasion with extracapsular extension with clean margins which did not seem to concern me after surgery. After reading about this - now concerned PC may be outside prostate bed.
 
Thanks
 
CPB

Gleason 6 (3+3) - PSA-2.7 - T2a - Age 66
Diagnosed July 23, 2007
Da Vinci surgery - Oct 22, 2007
Doctor David Lee - Penn Health System - Philadelphia
Surgery Oct 17, 2007
Post surgery bioposy - Gleason 7 (3 =4)
No positive margins
Extracapsular extension and perineural invasion
Negative Lymph nodes
Pathologic Stage - pT3a NO Mx
Two years PSA less than 0.1
Recent PSA .16 (8 months after last PSA)


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 1/18/2010 6:54 PM (GMT -6)   
Thanks for the help.

CPB -I would probably go to the oncologist and get another PSA test done. It could be nothing but at least I would rather know now.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better


cpb
Regular Member


Date Joined Jul 2007
Total Posts : 34
   Posted 1/18/2010 8:30 PM (GMT -6)   
Thanks Rob2
Spoke to my doctor this evening who is ordering another PSA this week to verify results and another next month to see if any progression - Will meet with radiation oncologist as well for input. Makes life interesting. Just have to wait and see.
Gleason 6 (3+3) - PSA-2.7 - T2a - Age 69
Diagnosed July 23, 2007
Da Vinci surgery - Oct 22, 2007
Doctor David Lee - Penn Health System - Philadelphia
Surgery Oct 17, 2007
Post surgery bioposy - Gleason 7 (3 =4)
No positive margins
Extracapsular extension and perineural invasion
Negative Lymph nodes
Pathologic Stage - pT3a NO Mx
Two years PSA less than 0.1
Recent PSA .16 (8 months after last PSA)


cpb
Regular Member


Date Joined Jul 2007
Total Posts : 34
   Posted 1/25/2010 10:49 PM (GMT -6)   
As a follow to my last posting - I had another PSA taken a week later - PSA is now 0.09 down from 0.16. While it is good news -cannot understand such a variation in one week. Will keep monitoring over next 3-6 monts on a monthly basis but will still consult with radiation oncologist for input as well.
Gleason 6 (3+3) - PSA-2.7 - T2a - Age 69
Diagnosed July 23, 2007
Da Vinci surgery - Oct 22, 2007
Doctor David Lee - Penn Health System - Philadelphia
Surgery Oct 17, 2007
Post surgery bioposy - Gleason 7 (3 =4)
No positive margins
Extracapsular extension and perineural invasion
Negative Lymph nodes
Pathologic Stage - pT3a NO Mx
Two years PSA less than 0.1
Recent PSA .16 (8 months after last PSA)


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 1/26/2010 6:19 AM (GMT -6)   
Take the good news and as they say "trust but verify". keep us posted on your next PSA.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
20 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better


MaxBuck
Regular Member


Date Joined Jan 2010
Total Posts : 75
   Posted 1/26/2010 6:34 AM (GMT -6)   
cpb said...
As a follow to my last posting - I had another PSA taken a week later - PSA is now 0.09 down from 0.16. While it is good news -cannot understand such a variation in one week. Will keep monitoring over next 3-6 monts on a monthly basis but will still consult with radiation oncologist for input as well.
It's probably not really a "variation in one week." Labs have inherent inaccuracy in reporting. It may not be a bad idea to have another blood draw and have it analyzed by a couple of different labs.
Dx at age 56: Oct 09; PSA 5.8, followed up by 9.9 two weeks later (reproducibility of test - ?)
Biopsy ind cancer in 8/12 cores: Gleason 8 (4+4)
open radical retropubic prostatectomy Dec 4 09
Post-op pathology: 56 g weight, cancer in 21%, Gleason 7 (4+3, tert 5); margins clear, no lymph node involvement (0/9), perineural invasion present, T2c N0Mx (but showed clear from distant metastasis in pre-op bone scan and CT scan)
Continence data: 1 "panty liner"/day, with minor leakage when I get up from long seated position
ED pretty complete: some erection possible but current non-functional

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