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First PSA after RP, reporting back after poor pathology

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Posted 11/6/2013 10:31 AM (GMT -8)
My PSA two months post RP came in at 0.1 which I'm not unhappy with or surprised about given my pathology. I still have incontinence and probably will wait until next PSA test to decide if RT is necessary. Fingers crossed!

Bob

Age 70 Jan 2014

BPH  since age 58 treated with finasteride and tamsulosin.

Low T since age 58 treated with Androgel

Biopsy 6/24/13 after PSA rose from 2.7 to 5.4 to 6.6; PC in 2 of 6 cores Gleason 4+5= 9 (10%, 40%)

open RP 9/7/13 by Dr. Ted Schaeffer MD Ph.D.  at Johns Hopkins

Pathology 9/9/13: Gleason 9, SVI, ECE and pos. margin at base ( Gleason 7), N0.

PSA 11/1/13: 0.1

Posted 11/6/2013 10:50 AM (GMT -8)
Certainly not ideal, but there still could be a surprise on the next one. Hoping for the best.
Posted 11/6/2013 11:07 AM (GMT -8)
When is your next PSA test? so we can help you fret...
Posted 11/6/2013 11:30 AM (GMT -8)
are you sure there was not a< in that psa. To get an exact 0.1 seems suspicious to me, tho possible. As they say in th islands. Check em…go… check em….
Posted 11/6/2013 11:43 AM (GMT -8)
Certainly not the report you wanted. At a G9, SRT might be a good thing to do. But like you say, the next PSA will tell. It still might be too close to surgery for a good PSA reading.

I find it best to start stressing over the PSA test about two weeks ahead of time.
Hang in there.
Andrew
Posted 11/6/2013 12:38 PM (GMT -8)
My first test came back as 0.26. It can get better.
Posted 11/7/2013 8:30 AM (GMT -8)
Hi Bob-

Sorry about the poor path report. I hope the incontinence clears up soon. Ideally, they'll want to wait as long as possible for that to clear up before beginning the SRT.

With your numbers going in, they probably did an extended pelvic lymph node dissection (ePLND). How did that come out? If they didn't do one, or there might be more still in there, they'll probably want to treat that area too.

- Allen
Posted 11/10/2013 9:46 PM (GMT -8)
Hi Break60 (Bob),

Was your result exactly 0.1 ng/ml? In case you have received your result over the phone, if you have not done so, it may be useful to check the printed lab report, just to make sure.

It seems that you are using the standard PSA test, which is the Hopkins preference.

Also, you are only 8 weeks (2 months) post-surgery, so it is still possible that there is some left over pre-op PSA circulating. Different sources claim PSA half-life in serum to be between 2 and 3 days, but could be as long a week. I am keeping my fingers crossed that this result is not coming from positive margins or any other source in the prostate bed.

Are you going to have another PSA test in 8 weeks or are you going to wait for 12 weeks?

I hope that your continence improves, as it seems to be quite important to have it in the best condition possible before undergoing RT.

All the best,

Joe.
Posted 11/11/2013 10:47 AM (GMT -8)
How was your experience with Dr. Schaeffer?
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