Post-Op PSA has risen.... is this a problem?

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Regular Member

Date Joined Oct 2006
Total Posts : 61
   Posted 9/30/2010 3:18 PM (GMT -6)   
Well, it's been a long time since I last posted.... This site was instrumental in helping me make my decisions relatively easy.... for that I am most grateful. I have been monitoring my health closely, especially paying close attention to my blood workups and making sure to get my PSA levels checked ever 6 months or so.
I was diagnosed with PC in 10/18/06, gleason score 3+4.... had the surgery done via DaVinci on 12/18/06. Post-op reports gave a positive prognosis. Every PSA since has been 0.10. Being someone with Type II diabetes I watch what I eat and pay attention to details of my diet. The first thing I look at on my blood workups is my PSA. Sure enough the last PSA done 9/18/10 shows a jump to 0.20.
While I'm not overly concerned, one has to ask ones self.... if I have no prostate how does one produce more PSA? Sometimes I don't want to think about the answer.
One more thing. As I read the posts on this board I continually see post-op people referring to their PSA as 0.01; when they jump they state the readings as 0.02 or higher. My post-op PSA readings has never shown itself as anything other than <0.1. What gives with that?
I have an appointment scheduled for 11/24 with my urologist, the one who did the original prostatectomy.... should I push up the date? Should I worry???
Interested in reading the responses to this post........... thanks in advance for your input.

Regular Member

Date Joined May 2010
Total Posts : 264
   Posted 9/30/2010 3:44 PM (GMT -6)   
If it were me, I would see my urologist as soon as possible if my PSA rose above .1

I would be pretty concerned if it were me. I am not trying to paint a gloomy picture and I hope your .2 is just a blip, but it is cause for concern. He may just say to keep an eye on it to see what the trend is, but checking it out sooner is better than later.

Did you get the .2 PSA at your general practitioner? If so, what did he (or she) have to say about it. It should have been a red flag.

Best of luck.

Here are some of my stats:
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

Veteran Member

Date Joined Jul 2008
Total Posts : 966
   Posted 9/30/2010 3:49 PM (GMT -6)   
Hey Jay,

Well...the definition of biochemical recurrence (BCR) is a read of equal or greater than 0.2 with one subsequent rise at least 3 months later. So is this something to worry about...not just yet. Get another reading in 3 months and go from there. Of course you Uro may follow a different protocol and want another test in 30 days.

You are on the standard assay PSA tests which only show in the tenths i.e. 0.X Many doctors that are tracking psa for those at risk will go down to the hundredths 0.XX using the ultra sensitive tests to follow psa levels more closely and detect recurrence often times as much as a year in advance. Only problem with the ultra-sensitive tests is it raises a lot of anxiety in men with fluctions below the 0.1 mark.

I don't see a need to push your appointment up from what is already scheduled.

Although you might want to make sure the same lab is performing your tests and using the same equipment. Different labs use different equipment and that will change the results.

Best of luck

Veteran Member

Date Joined Jan 2010
Total Posts : 1011
   Posted 9/30/2010 3:55 PM (GMT -6)   
Jay, it looks like you are not having an ultra sensitive test. That test gives you a reading down to .01. The lowest reading you current tesy gives you is .1. However, now that your PSA has risen to .2 you should be concerned as it is a indicator that PCa has returned. You may want to get another test at the same lab to confirm the rise, and push up the appointment with your Uro. Very sorry about the rise, but if you have had a recurrence radiation still holds a very good chance for a cure.est of luck, BB
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic Surgery March 2009 Hartford Hospital, Dr Wagner
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes negitive - tumor volume 9%, nerves spared, no negitive side effects of surgery.
PSA's < .01, .01, .07, .28, .50. HT 5/10. IMRT 9/10.
PSA's post HT .01, < .01

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 9/30/2010 4:15 PM (GMT -6)   
i would meet with your uro, and setup an appt with a good radiation or medical oncologist, salvage radiation might be in your future. if that .2 reading is accurate, its already on its way up to that decision point. hope there's a better answer. good luck.

david in sc
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

Veteran Member

Date Joined Jul 2010
Total Posts : 3887
   Posted 9/30/2010 6:16 PM (GMT -6)   
So now for the good news..Since your PSA stayed undetectable for 4 years, IF, and that's still an if, you are looking at re-occurrence, the next stage of treatment is usually successful be it radiation or hormone..
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
age 61: 5.2
age 64: 7.5, DRE "Abnormal"
age 65: 8.5, " normal", biopsy, 12 core, negative...
age 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
age 67 4.5 DRE "normal"
age 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP performed Sept 3 2010, pos margin, one pos vesicle nodes neg

Regular Member

Date Joined Mar 2010
Total Posts : 495
   Posted 10/1/2010 2:05 PM (GMT -6)   
Have you the pathology report from the operation? Yes? Good! If there is any mention of positive margin(s), extra capsular penetration (ECE) Extra prostatic extension (EPE), Seminal Vesicle invasion (SVI), bladder neck infiltration, or other mention of potential leak of cells outside the organ proper then you have a good chance of dealing with this with radiation. If the report was clean and clear in all aspects then the chance of radiation success is more questionable, though still possible. In any case you have other tools at your disposal such as Dutasteride, finasteride, vitamin D, diet, bio-curcumin, resveratrol and other mild supplements with some potential for succes in the near term. Get thee to an oncologist and a radiation oncologist. Once you do that then all we offer is for naught.

Regular Member

Date Joined Jul 2010
Total Posts : 33
   Posted 10/2/2010 4:06 AM (GMT -6)   
That in my best guess is still a zero and nothing to worry about.
Age 49 years old with no family history of PCa. but had testicular cancer in 1985.

PSA on 3-8-2010 was a 5.6
PSA re-take on 3-17-2010 was a 4.4
Biopsy collected on 4-17-2010 showed 2 of 12 cores malignant with Gleason scores of 3+3 Stage T1C.
RALP surgery 7-21-2010 at Hopkins.
Pathology report revealed that the cancer was organ confined, all margins negative and a Gleason score of 6.

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2217
   Posted 10/2/2010 5:56 AM (GMT -6)   
I too have only ever had tests to the nearest 0.X and not 0.XX. (But my situation has been so obvious that this has not been a problem.)
I jumped so much in jumping from 01. to 0.4 that there was no great problem in my case in working out that something was wrong and that I needed to do something about it

One small rise is not the same. The key thing is to wait till the next test before too many conclusions can be drawn. (But another test in 3 and not 6 months is clearly advisable - perhaps even in 2 months)

PSA anxiety ain't easy. With this rounding up of decimal places the problem is that a 0.1 can of course be anything between a 0.06 and a 0.14 and a 0.2 can be anything between a 0.16 and a 0.24. There are thus two extremes: If you've moved from a 0.14 to a 0.16 it's a very small change. If you've moved from a 0.6 to a 0.24 it's a bit more worrying. Thus there are situations where a more sensitive test can have its advantages.

Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr 10 CT
28 Apr 10 start RT 66Gy
11 Jun 10 end RT
BMs weird
14 Sep 10 PSA <0.1
Erections OK

mr bill
Veteran Member

Date Joined Sep 2010
Total Posts : 709
   Posted 10/2/2010 8:45 PM (GMT -6)   
I met with euro surgeon on 10/01/2010 twenty three days out from surgery. My PSA was .06. He was encouraged, even though it was less than four weeks. he subscribes to the half life theory. He indicated that should my PSA reach 10.00 (that's right 10.00) he would want to go to hormone therapy. Given my signature how do you folks feel about that?
Age 66
BPH since 2000. at least three negative biopsies Erie. Uro did not prescribe finasteride
2007 acute urine retention photoselective vaporize Clev. Clinic
8-9-10 Aug PSA rose to 10.14 with finasteride positive biopsy Cleveland gleason 9, cat & bone scan negative
9-8-10 Robotic prostatectomy at Cleveland. B iopsy 9 nodes, 2 positive,seminal & vas deferens positive invasive adenocarc
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