Post Surgery PSA 0.9

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Fairwind
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Date Joined Jul 2010
Total Posts : 3887
   Posted 10/25/2010 6:18 PM (GMT -6)   
My six week post surgery PSA came back 0.9 Has anybody else ever had their first post surgery test come back this high??

I don't know what this means but it certainly can't be good..I'm still fighting a hospital acquired abdominal staph infection so I haven't given much thought to my PC...But in a week or two this is all going to come to a head..
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 Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9

compiler
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Date Joined Nov 2009
Total Posts : 7269
   Posted 10/25/2010 6:26 PM (GMT -6)   
Is it possibly due to an infection?


I think Sonny had a pretty immediate BCR.



As you know, I'm also sweating it out.



Mel

julios
Regular Member


Date Joined Jun 2010
Total Posts : 38
   Posted 10/25/2010 6:32 PM (GMT -6)   
Mine was 0.54. I think I still have pelvic nodes that are cancerous.
Age 52

At Diagnosis of PCa, had Gleason 9 and normal PSA

Radical Prostatectomy on July 7th, 2010 by Dr. Fagin using daVinci

25% to 50% nerves spared on left, 100% spared on right.

Continent from day one.

Pathology showed postive margins and extension beyond gland, including seminal vesicals and lymph nodes. Stage upgraded to T3b.

geezer99
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Date Joined Apr 2009
Total Posts : 990
   Posted 10/25/2010 8:28 PM (GMT -6)   
Not good, but not definitive. My uro doesn't do a PSA until 3 months --

Remember that even if the surgery leaves some cancer cells, they may slowly die because they are cut off from their blood supply.

Ed C. (Old67)
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Date Joined Jan 2009
Total Posts : 2460
   Posted 10/25/2010 9:25 PM (GMT -6)   
How many weeks after surgery did you have the test? It should be at least 8 weeks. In any case, the .9 is not good, you may want to check it again in 1 month and if it is still high then you probably have some cancer left behind.

goodlife
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Date Joined May 2009
Total Posts : 2692
   Posted 10/25/2010 10:01 PM (GMT -6)   

I think I would advise finding a good radiation oncologist to start getting opinions.  You most likely will need to consider adjuvant radiation within the next 3 months or so.  The sooner the better most likely, once your continence issues are ok.

Good luck.


Goodlife
 
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 injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

roville
New Member


Date Joined Oct 2010
Total Posts : 4
   Posted 10/25/2010 11:25 PM (GMT -6)   
You should wait three months and repeat the PSA at that time. I had some detectable PSA at 6 weeks, and after three months it had dropped to undetectable level. My doc said that I for some reason had taken longer to clear the residual PSA from my body. Relax and wait three months. Oh, by the way, I was totally anxious after that test - had to do meditation, and anxiety meds for awhile.

Roville

Squirm
Veteran Member


Date Joined Sep 2008
Total Posts : 744
   Posted 10/26/2010 12:24 AM (GMT -6)   
Are you sure it isn't .09?

Steve n Dallas
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Date Joined Mar 2008
Total Posts : 4848
   Posted 10/26/2010 6:12 AM (GMT -6)   
Ditto to six weeks being on the early side...My first test was at 3 months.
Age 55 - 5'11" 215lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6
06/25/08 - Da Vinci robotic laparoscopy
05/14/09 - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
05/18/10 - 24 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.
Growing old is mandatory; growing up is optional..

LV-TX
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Date Joined Jul 2008
Total Posts : 966
   Posted 10/26/2010 7:33 AM (GMT -6)   
When you have a positive margin or node involvement, the first test is usually 5-6 weeks to get a base line. Then retest at the three month and go from there. No treatment, primary or secondary is done on the basis of one single test.

Good luck Fairwind...keep a very close eye on this while you heal up from the other issues.
You are beating back cancer, so hold your head up with dignity

Les

Signature details in Sticky Post above - page 2

cooper360
Regular Member


Date Joined Jul 2010
Total Posts : 161
   Posted 10/26/2010 8:01 AM (GMT -6)   
I have read that psa can naturally occur in the body,specifically from the parathyroid gland. Could this be in psa readings pre and post surgery? If this is true are there test to tell where psa is originating? The parathyroid gland regulates calcium throughout the body [maybe see if calcium levels are also higher than normal] My brother had quite a few issues with the parathyroid that stumped the doc's for quite a while,he was in his early 20's so psa wasn't in the forefront to check.I think it would be something to investigate or at least do some research on. Just a thought..............Cooper

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 10/26/2010 8:22 AM (GMT -6)   
Six weeks would be very early according to my uro. He does first PSA normally at eight weeks.

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 10/26/2010 10:26 AM (GMT -6)   
I agree with all the retest comments of course.  I also understand that 6 weeks is a little early, but, if it is truly .9, that is a little too high, particularly with a Gleason 9.  Time is of the essence in my opinion.
 
I would have step two in place now, and when retesting occurs, I would say 30 days, then I would be ready to go.
 
I am sure John T will talk about determining local or systemic  now as well.  If it is determined it is systemic, HT may be the next step, in my uneducated opinion.
 
There are a lot of things to consider with e Gleason 9 that may be a little more forgiving with a Gleason 6 or 7.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7269
   Posted 10/26/2010 10:34 AM (GMT -6)   
Goodlife:
 
The big question is, how do you know when a BCR is local or systemic.
 
I think the reality is they do not.
 
That will be one of my questions when I see the medical oncologist (Monday)
 
Mel

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 10/26/2010 12:25 PM (GMT -6)   
Mel,

It can be more difficult after the prostate is removed. Color Doppler, prostacint, or Combidex can help an oncologist to make that determination.

I think that the elevated PSA after surgery is some indication that there may be a tumor that was outside of the capsule. Hopefully, it is still close to, or in the prostate bed, and the expanded reach of the radiation can get to it. Obviously bone scans can find larger concentrations of PSA producing cells. I would say that a .9 would be a large enough concentration to be able to be seen on a scan.

My main point is tho, to try and determine that prior to the radiation if possible. I may elect to do radiation anyway just in case it is close to the bed. These are really tough decsions. Somewhat a roll of the dice, but we can make some educated decsions.

Hope all goes well with Dr. H. I did like her, and may be visiting her again of/when my situation changes.
Goodlife
 
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 injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

tarhoosier
Regular Member


Date Joined Mar 2010
Total Posts : 495
   Posted 10/26/2010 1:56 PM (GMT -6)   
Fairwind:
Did the pathology indicate G score for tissue? Surely so. If there was any G 4 or 5 this is cause for concern. Was there any prostate tissue at the margin, which would indicate that there was potential for some of the gland to remain in your body? If so this could account for some psa. I know a man with substantial margin issues and a tiny amount of cancer in a lymph node who had a post RRP psa of 1.14. He had 3 years Lupron and radiation and he has now been 3 years free of ADT, full recovery of testosterone and zero psa.

maldugs
Veteran Member


Date Joined Jun 2007
Total Posts : 789
   Posted 10/26/2010 6:40 PM (GMT -6)   
Fairwind, check out my signature, I am still going ok.

Regards Mal.
age 67 PSA 5.8 DRE slightly firm Rt
Biopsy 2nd July 07 5 out of 12 positive
Gleason 3+4=7 right side tumour adenocarcinoma stage T2a
RP on 30th July,

Post op Pathology, tumour stage T3a 4+3=7, microcsopic evidence of capsular penetration, seminal vessels, bladder neck,are free of tumour, lymph nodes clear, no evidence of metastatic malignancy, tumour does not extend to the apical margins.

Post op PSA 0.5 26th Sept. Totally dry since catheter removed
PSA 23rd Oct.0.5 seeing Radiation Onocologist 31st Oct.
Started radiation treatment on 5th Dec, to continue until 24 Jan. 08.
Finished treatment, next PSA on 30th April.
PSA from 30th April 08, until now range- 0.5 to 0.6, I am now 70

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3887
   Posted 10/26/2010 10:38 PM (GMT -6)   
Hey, thanks for all the encouraging words, I needed that! There are some circumstances that may have affected the test..That blood was drawn when I in the hospital suffering a raging staph infection (post surgery complication) and abdominal abscess..(infected) which is STILL draining..I was on HEAVY IV antibiotics and my blood counts where all printed in red ink! My kidney and liver function had been compromised by the infection and then the antibiotics..My U-doc said to disregard that first test because my liver, the organ that breaks down PSA in the blood may have been compromised enough to make the test meaninglessness... He said "we will get a good test when you are over this"...So that 0.9 might not be as bad as it looks...

And yes, I will start HT & RT ASAP....
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 Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7078
   Posted 10/26/2010 11:01 PM (GMT -6)   
Fairwind,
 
Now it is my turn - it is a good thing that we all know that PCa is more conjecture and black magic than science- as others say, the Twilight Zone.
 
Test again when things are settled down a bit.
 
If you go the RT route, been there, done that, happy to help if I can.
My IGRT journey -
www.healingwell.com/community/default.aspx?f=35&m=1756808
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