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P S A levels

Posted 16 Jan 2019 at 22:56

My partner was diagnosed 18 months ago with Prostate cancer 18 months ago following a raised psa level of 5.5 He had a bone scan which showed no signs of the cancer having spread there and decided on a radical prostatectomy following a lesion being found inside the prostate. After the operation all the signs were good and the cancer had not spread to the outer lining of the prostate it was encapsulated  After surgery the psa went down to 00.00 However on the second follow up it had risen to 0.008 and now with the followup approaching it has just been tested again and is 0.034. Should we be worried and if it is a sign the cancer is still there whatis likely to be recommended if anything at his next appointment .? I wouldbe grateful for any feedback Thanks

Posted 17 Jan 2019 at 02:59
I think more 3 monthly tests need to be done and if there is a consistent increase over several tests, your oncologist might look into further treatment.

Biochemical recurrence is not officially recognised until the PSA reading exceeds 0.2!

Cheers, John.

Posted 17 Jan 2019 at 08:02
I agree - he should still be on 3 monthly testing at this stage.

The levels of PSA are tiny and could simply be non prostate related, there are other parts of the body that produce PSA so he may be settling into his new normal. It could also be that a) the hospital has changed their testing equipment b) the second and third test were done at different labs.

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

Posted 17 Jan 2019 at 08:04
Biochemical recurrence is defined in the UK as a PSA of 0.2 or more OR three successive rises over 0.1
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

Posted 17 Jan 2019 at 09:38

Thank you all so much for your reassuring messages. My partner is 65 with a 14 year old so has been understandably worried by the rising trend but these messages and advice will give him some peace of mind  , so thank you again ! 

Posted 17 Jan 2019 at 15:17

Originally Posted by: Online Community Member
Biochemical recurrence is defined in the UK as a PSA of 0.2 or more OR three successive rises over 0.1

Thank you Matron, for your very apposite correction to my post. I’ll be looking for those incremental increases when and if I have my future PSA tests and when and if I have any rise (some hope😂😂😂😂).

Although I think I’m due another PSA shortly - am I bovvered? Not really, but maybe just a little bit.

Cheers,  John.

Posted 17 Jan 2019 at 15:38


Please read my profile for a good understanding of a likely outcome, I am due for a PET scan next month because my PSA is rising again, that  said you are on a journey living with PC ,  don’t let it get you down.

Best Wishes

Posted 18 Jan 2019 at 09:26
Hi Nitajoy

You don't say what your other halfs staging and Gleason score was?

I would recommend plotting the uPSA scores on a graph, if it's natural "regeneration" of any remaining healthy prostate tissue left behind (this can happen at the bladder neck apparently) the graph will tend to flatten over time with the odd blip due to the vagaries of uPSA testing.

If it's a prostate cancer coming back the graph will not flatten and will tend to rise exponentially.

Either way provided you didn't have any adverse pathology in the removed prostate you will have time to wait for more 3 monthly tests to confirm. Fingers crossed the next test is the same or less.

Posted 18 Jan 2019 at 09:50

If you register for the EMIS Patient Access app, you can view all your medical records and your PSA levels are shown on a graph automatically.

Moreover, any test results appear on the app as fast as they do in your doctor’s surgery.

Cheers, John


Edited by member 18 Jan 2019 at 09:51  | Reason: Not specified

Posted 18 Jan 2019 at 14:17
Hi Nitajoy

It may be worth considering that the PSA assay may not be totally precise. Recently I had two separate blood draws within a minute for PSA testing: one blood sample was assayed at 0.43, the other at 0.47 (so a variation of 0.04 or 10%). The blood draws were from the same needle and using the same type of vacutainer etc. etc. The implication being that the assay is accurate but only up to a point. So it is easy to understand why, as Lyn said above, one of the elements for diagnosing recurrence is three successive rises.

Good luck to you both


Posted 20 Jan 2019 at 13:36

Thank you all for your helpful comments .we really appreciate them In answer to one of your queries Lynn(Welsh) had an initial diagnosis of a Gleason Score of 4 plus 5 and stage 3/4 ,He had a radical prostectomy no sparing After operation the biopsy showed that the cancer cells had not  had not moved outside the prostate and  were incapsulated . There was no sign of cancer found in his bone scan.

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