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Rising PSA after surgery

Posted 11 Aug 2017 at 01:01
My husband had surgery last October. Cancer contained in prostate. First 2 PSA test were 0.05. Third test last month was 0.07, got results from one 2 weeks ago and it is 0.08. Dr said retest at appt in October. We are scared. Anyone else have this happen?
Posted 11 Aug 2017 at 06:42

Still very low numbers. There has been a lot of talk on here about the unreliability of the super sensitive PSA test. There can be variations for a number of reasons. But if it is creeping up due to some remaining cancer cells there will be options such as Salvage RT.
Your consultant will know more at your next test.
There are lots of men on here who had a rising PSA following RP were follow up treatment sorted it, me included. I had RT 6 month after the RP due to PSA rising. 4 years later my PSA is 0.02

Take heart (easier said than done) and see what happens in October


Posted 11 Aug 2017 at 06:48

It's not unusual, if you see my profile, after each different treatment my PSA has risen, I'm now on intermittent HT to keep the PSA down.

Posted 11 Aug 2017 at 06:53

Lots of us on here have been in the same situation. My PSA was 0.03 for about a year after surgery then started to slowly rise. I had salvage RT three years after surgery. I am 11 weeks post SRT and the PSA has gone down from 0.27 to 0.08. Not the route I wanted to take but there we are.

The variations are small and technically you are still classed as undectable,but it is good your consultant is on the ball.

Thanks Chris
Posted 11 Aug 2017 at 07:51

As Bri has said, the ultra sensitive test (to 2 or even 3 decimal places) has been brought into disrepute, so much so that in the area where I live the hospitals have stopped doing it. The problem with these tiny numbers is that the same sample can be tested twice on the same day on the same machine and give two different results. We actually tried it with one of my dad's PSA tests - one sample tested at 2 labs gave significantly different numbers.

However, the trend you are seeing is consistent rather than random so yes, you may be looking at a small number of cells left behind in the prostate bed. Do you have a written copy of the pathology results after the op? If not, can you get a copy from the GP? Things like whether or not your other half (OH) had positive margins or signs of perineural invasion (PNI) are important.

My OH had very similar results to yours but was in denial for quite a while and refused to accept that he needed salvage treatment until about 2 years post-op. He had the radiotherapy and some hormone treatment which brought the PSA back down to undetectable for another 5 years.

So yes you may have a biochemical recurrence but no, don't be scared.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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