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Badwater
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 3/13/2010 2:20 PM (GMT -6)   
Almost a year ago, I had Robotic surgery at the City of Hope.  In all follow ups until
this week, my PSA was <0.01.  This time it was 0.10.  This has me tremendously worried.
Should I be?
 
My next testing is in May.
 
Final Gleason score: 7
Staging: pT2 organ confined
PSA: 5.9

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 3/13/2010 2:29 PM (GMT -6)   
Welcome Badwater.

It could be the start of recurrance, or it could just the reading on the test. Your next test will be real important in May, if it is .10 or has risen higher, then if it were me, I would begin to find a good radiaton oncologist to talk to. Usually, it takes 3 tests in a row where your PSA is at .10 or above to consider it recurrance. But that varies too. Keep a close eye on the next two tests, it may have just been a one time fluke, and you can feel relieved again.

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, no problem post SRT
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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, Caths #13 & #14 same time, 3/6 Cath #13 out - 4 days


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 3/13/2010 4:33 PM (GMT -6)   
Welcome to the forum, hate you're here but glad you came.... You might quiz the doc as to what generation testing the lab used on that last sample. The one in May will tell the tale, most likely. Keep us informed. smilewinkgrin
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man: www.youtube.com/watch?v=a6cX61oNsRQ&feature=channel
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 3/13/2010 6:28 PM (GMT -6)   
Badwater,
I think David hit the nail on the head, but hopefully it is just a blip on the screen.
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
Margin slightly involved
2 pads per day, 1 depends but getting better,
8/5 1 depend at night only, now none
 started ED tx 7/17, slow go
Post op dx of neuropathy
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5
Starting IMRT on 1/18/10
Great family and friends
Michael


Bootheel
Regular Member


Date Joined Oct 2007
Total Posts : 300
   Posted 3/13/2010 6:45 PM (GMT -6)   
badwater,
I agree with David. I would wait until the next test to see if it rises. I know it can cause a lot of anxiety but PSA tests, at least for me, cause some anxiety. I think it goes with the territory. Try to relax. you don't have any positive margins or adverse pathology so it will probably be okay next time around.
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Post-op
Gleason 7 (3+4)
1 positive margin (.3cm)
T2C
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable
05/13/09   PSA .18 (ouch)
Started IMRT June 13, 2009
Completed 37 treatments July 31, 2009 (66.6gy)
11/23/09 Post IMRT PSA .18
2/12/10   Post IMRT PSA 0.00


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 3/13/2010 8:06 PM (GMT -6)   
Don't panic, do what David suggested and hopefully it is just a blip and not a real recurrence.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11.5 months test 1/21/10 result 0.004


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 3/15/2010 6:13 AM (GMT -6)   
Ed, take a look at my signature. We have since found out that if the external nerve bundles were spared during surgery (which was the case with my husband), it is not uncommon to leave benign prostetic tissue behind which can generate trace amounts of PSA.

I know it's easier said than done but try not to worry at this point. Your surgical path report was good, and hopefully your next PSA will bring a big fat donut for you.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs 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!


Badwater
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 3/15/2010 8:30 AM (GMT -6)   
Thanks for all the replies. I'm feeling more calm and probably will stay that way until the next test!

Badwater
New Member


Date Joined Mar 2010
Total Posts : 6
   Posted 6/7/2010 11:49 AM (GMT -6)   
My May test has come and gone. My PSA remained 0.10. Can't complain. Next test in Nov.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 6/7/2010 11:59 AM (GMT -6)   
Good news. Hang on to that .1

60Michael
Veteran Member


Date Joined Jan 2009
Total Posts : 2222
   Posted 6/7/2010 2:29 PM (GMT -6)   
That is great to hear!!!
Michael
Dx with PCA 12/08 2 out of 12 cores positive 4.5 psa
59 yo when diagnosed, 61 yo 2010
Robotic surgery 5/09 Atlanta, Ga
Catheter out after 10 days
Gleason upgraded to 3+5, volume less than 10%
2 pads per day, 1 depends but getting better,
 started ED tx 7/17, slow go
Post op dx of neuropathy
T2C left lateral and left posterior margins involved
3 months psa.01, 6 month psa.4, 6 1/2 month psa.5 on 11/28/10
Starting IMRT on 1/18/10, Completed 39 tx at 70 gys on 3/12/10
6 week Post IMRT PSA .44 a drop from .5 but maybe more
Great family and friends
Michael


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 6/7/2010 7:38 PM (GMT -6)   
Hi Badwater,

Hopefully your PSA will remain at this relatively low level. I had PSA tests every 3 month after my RRP and could easily see the slow but steady increase (see my signature). I made arrangements for SRT when it reached .08. At the start of SRT it was at .1. Keep a close eye on your PSA level and when you and your doctor are convinced that it is a recurrence, start RT sooner rather than later. The RT outcomes are apparently best when done while the PSA is very low.
All the best to you.

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 6/7/2010 7:45 PM (GMT -6)   
Thats goood news to hear, hopefully it wont raise any more for you in the future, give you some breathing room.
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


In This Together Wife
Regular Member


Date Joined Dec 2009
Total Posts : 135
   Posted 6/7/2010 8:02 PM (GMT -6)   
Thanks for keeping us updated
(Bear's stats) Age 49
 8-4-09    Family Practioner for back pain  PSA 4.9
8-20-09  Consult with urologist                PSA 4.89
9-2-09    Biopsy          3 cores positive 7% 3+3 (6) gleason
11-13-09 DaVinci
11-23-09 Cath removed  Path report cancer contained neg. margins
 2-22-10  PSA 0.01 !!!


Kark60
Regular Member


Date Joined Jun 2008
Total Posts : 91
   Posted 6/7/2010 9:52 PM (GMT -6)   
My PSA seems to be doing the same as yours. I was 0.0 nearing the two-year mark post surgery and then got a 0.1. The nurse assured me this reading was accurate and would have read ".13" if the level was .13. My next test a month later was still at 0.1. The nurse reassured me they consider this level "undetectable" and the level was stable. The doctor is not concerned until it reaches 0.2. She told me to test again in six months, but I think I will go back in August (three months).
Husband and father of two (current ages 6 and 8). Age 47 when diagnosed (currently 49).
Pre-surgery PSA: 13.7 Pre-surgery Gleason: 4+3=7
CT Scan, Bone Scan, PET Scan: Clear
Laproscopic Surgery on May 28, 2008, at Barnes Hospital in St. Louis.
Right nerve bundle spared; left bundle removed.
POST-SURGERY PATH REPORT: Gleason: 4+3=7;10% of prostate with all quadrants involved; extraprostatic extension at left base and apex; extensive perineurual invasion present. Bladder neck, lymphvasular space, seminal vesicles, 17 examined lymph nodes, and all surgical margins FREE of tumor. T3a.
Four-week post-surgical PSA = 0.1; Seven-week post-surgical PSA = .01;October 2008 PSA = 0.0; January 2009 PSA = 0.0; April 2009 PSA = 0.0; July 2009 PSA = 0.0; October 2009 PSA = 0.0; January 2010 PSA= 0.0; April 2010 PSA =0.1 (anxiety starts); May 2010 PSA still = 0.1.


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 437
   Posted 6/8/2010 4:38 AM (GMT -6)   
Badwater,
 
You have already been given great insight and advice...    Hang in there.    Hopefully you have stablized.   They usually look for 3 consequtive increasss to really suggest action which happened in my case.  My signature has the details,  but I can say that for me,  the SRT was not difficult at all.
 
Wishing you the best, 
 
pasayten
After 3-4 years of annual PSA 4-6, biopsy recommended
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 
12/2/2008 3rd Post-OP PSA at 20 months...   0.03
10/30/2009 4th Post-OP PSA at 31 months...   0.13 (moved and diff lab)
11/3/2009 Retest at my original lab...  0.11  (followup with Doc sched 11/10)
11/10/2009 Discussion indicated biochemical reccurrence and need for salvage radiation treatment. 
1/21/2010 Another PSA test at 34 months...  0.14
1/26/2010 IMRT Salvage Radiation Treatment started
                  32 sessions for 64 gys total.
3/12/2010 Finished 32 sessions...  No side effects to date except a little
tiredness.  Slight changes in bowel movements the last week...  
4/8/2010  Some rectal prostitis, but no change in urgency.  No urinary effects at all.  Now just waiting for the upcoming PSA test in June.
6/7/2010 First 3 month PSA result after SRT = 0.02   WAHOO!  as good as could ever be expected at the 3 month mark!  Thank You Jesus!
 


hangin-in
Regular Member


Date Joined Sep 2008
Total Posts : 78
   Posted 6/8/2010 3:45 PM (GMT -6)   
This might sound too obvious but are you sure the tests were Ultra Sensitive? Otherwise the test can only show .1 as the lowest. Only the ultra sensitive PSA test can give results lower than .1
 
The reason I mention this is because that happened to me until I discovered (luckily only after a few days) that they used the wrong test.

Rising PSA 12/06=1.6 12/07=2.1 5/08=2.6
Biopsy 6/4/08 12 core 4 Positive 15%,15%,8%,3%
Diagnose @ Age 51 Gleason 3+3=6
Bone & Cat Scans Normal
Lapro Surgery 8/18/08 at Memorial Sloan Kettering
Pathology report stage T2c organ confined with positive apical margin Gleason 3+3 = 6 (with tertiary grade 4)
Catheter removed 8/26 - reinserted 8/29 - removed 9/2
No continence or potency problems from the get-go.
First post op PSA 10/2/08  < 0.05
2nd  post op PSA 12/30/08 < 0.05
3rd  post op PSA 3/30/09 < 0.01
4th  post op PSA 6/25/09  0.01
PSA 9/25/09 0.01, 12/28/09 0.01, 4/2/10 .01

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