4 weeks is earlier than most do as I understand it, but it is still something like 9 to 14 PSA half lives, which means the level should have decayed by a factor of somewhere between about
500 to 16000 from pre-op.
My local uro with whom I have been following up since my surgery, wanted to do it at 4 weeks but by the time I got in it was 6. It came back as .01, which both he and Dr. Burnett at Hopkins say is excellent, but frankly I think someone in the lab may have forgot to transcribe a less-than sign as it should have been down by at least 14 PSA half lives and, while it is possible that there is still PSA coming from Cowpers glands or a bit of benign prostate tissue that is still in there, it just seems unlikely that it would be exactly .01.
My local uro wants to do another in Oct (about
20 weeks) but I believe that is just his standard policy not because mine was not undetectable.
While anything over 0.1 (by contrast to 0.01) at 4 weeks would be a real concern (but very unlikely unless you have positive margins), I still don't think you would rush into radiation without further testing over time. Sometimes tumor cells at positive margins die off in the aftermath of surgery.
Jan '13: PSA 1.23, small nodule on DRE (1st screening @ age 40)
Mar '13: Biopsy 2 of 12 cores GS 3+3: rt mid 10% and rt apex 20% w/ PNI+ Stage cT2a
Apr '13: Biopsy confirmed by Dr. Epstein @ Hopkins
open RRP by Dr. Burnett @ Hopkins. Both nerves spared.
Final Path: GS 3+3, organ confined (tumor extent moderate), SV and 11 nodes all negative (pT2a), negative margins!
PSA: 0.01 @ 6 wks
Post Edited (njs) : 8/21/2013 4:28:39 PM (GMT-6)