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PSA Increase after surgery for Enlarged Prostate

Posted 29 August 2017 15:49:46(UTC)



I have recently been diagnosed with Prostate Cancer, Gleason 3+4, the timeline as follows


16th March PSA reading of 6.3

27th March PSA reading of 7.4

28th March operation for enlarged prostate, about half prostate removed.

10th April diagnosis of cancer Gleason 3+4 after examination of material removed during operation.

25th June PSA reading of 0.56

22nd August PSA reading of 0.81 - an increase of 50%


While I appreciate that the absolute level is very low, it is still an increase of 50%.  Should I be heading back to the consultant as quickly as possible ?



Posted 29 August 2017 19:05:44(UTC)

Just bumping you Shetland.

I don't think I've come across anyone on her who has had half a prostate removed due to enlargement. My first thought was why didn't they take it all?

I hope somebody can answer you

We can't control the winds - but we can adjust our sails
Posted 29 August 2017 20:47:21(UTC)

I think Shetland has probably had a TURP and the prostate cancer diagnosis came as a result of the removed tissue being analysed in the lab.

Shetland, you will need to see a specialist about the prostate cancer regardless of the PSA rise - I would expect them to be sending you for scans if they haven't already done that. When you were told about the cancer, what discussion was there about treatment options? Have you actually seen the urologist since you were diagnosed?

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

Thanked 1 time
Posted 30 August 2017 22:11:49(UTC)

I wouldn't worry unduly at this stage Shetland.

Following my HoLEP in 2015 when a Gleason 6 was discovered in the recovered tissue (I had a third removed), my PSA rose from .3 to .7 in the space of 3 weeks but then the rate of increase slowed quite considerably and has now been stable at 1.1 for over a year.

Pre HoLEP my PSA had bounced around between 6 and 10 for almost a decade, so to see it stabilised at its current 1.1 is very satisfying and I'm currently on AS with regular PSA tests and a yearly MRI to check what if any progression may be taking place.

Once your PSA settles down which hopefully it will, then it will be decision time and with lots of guys on here having gone the same path you are currently going down, you can rest assured a lot of good advice will come your way.

Good luck 

p.s. I forgot to add that there is a possibility that all of the PCa was removed during the TURP and if that were the case, any increases in PSA may be down to a degree of regrowth of normal prostate tissue and nothing more sinister.  This is what was explained to me following my HoLEP by the surgeon at Addenbrookes and although I'm not counting my chickens yet even after almost two years, one can only hope that may be the case but still keep a watchful eye on things, just in case.

Posted 05 September 2017 21:42:55(UTC)


I totally agree with Lynn ? What scans are being scheduled ?

- see my profile  (ie my brother had TURP, and PSA did go high (18) and low (3))  I had LRP)

   However both off us always in 'control' ..  ie  Brother had mpMRI, I made decision on rising PSA

As Lynn states : PSA is irrelevant in many ways at this stage.  

Bottom line : - you have had (or have) Gleason 7, agree ?


NOTE : There's a huge difference in my opinion (and many others) between Gleason 6 (ie re . Roger profile above) and Gleason 7






Posted 25 September 2017 11:39:31(UTC)

Many thanks for the responses.


Yes my diagnosis of cancer came from the analysis of material removed from the TURP.

I saw the consultant after the diagnosis and had scans which confirmed the prescence of cancer in what is left of the prostate.  They also confirmed it has not spread.  I saw the consultant again following the scans and he has recommended no treatment at present.  I will have PSA tests every three months and return at end of November to review the situation.  He is aware of the last PSA test with an increase from 0.56 to 0.81 and confirmed having an appointment in November following another PSA test.  Yes my Gleason was 3+4

Posted 26 September 2017 00:02:24(UTC)

That's good news - as you still have some of your prostate, the healthy cells will give off some PSA and this is expected to rise a little as the healthy cells recover from the shock of surgery. Your consultant is happy, so relax until November.

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

Posted 26 September 2017 00:50:43(UTC)

Hi Shetland,

The only additional comment I would add  (as me and my brother discussed issues very similar to this )

ie My brother had TURP - yet nothing sinister found.  Subsequent mpMRI indicated potential lesion 

Therefore :

Have you asked what detail of scan has actually confirmed the cancerous lesion(s) in what is now left of your prostate

Do you know what % of prostate was actually removed ?


Their position and size  ?   Had TURP actually removed part of a larger lesion ?

PSA may be a double edged sword, maybe Lyn can explain better than me. A value at or near 0.8 in Nov.  could be masking a problem ?

ie Grade 4 cancer has been present in your prostate, ie intermediate risk.  Not a low risk., so in theory this has 100% been removed by the TURP.   However your consultant  indicates  cancer is present ?  Do you talk through this in detail ?       

(I agree you should have a new baseline now)  - will further scans be done in November, or a biospy then ? or is next decision solely made on PSA value ? 

Has TURP affected bladder 'end' to possibly negate option on RP in future   ?    (this was not the sole reason my brother choose RT, by the way)












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