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Psa after Prostate operation.

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User
Posted 08 Dec 2020 at 15:35

Hi I am 71 and had my prostate removed in March 2018 .After the opp I was informed that the cancer had spread to the seminal vessels which they removed .My staging was increased to stage 3 with no mix.Initially after the opp my Psa was 0.02 which my consultant thought was to high but he said we would monitor it. Last June it increased to 0.04 but remained stable up until 2 weeks ago when it was 0.06. I presume this means there are still some cancerous cells somewhere in my body?. In November last year they said if keeps rising you will have Radiotherapy. Waiting for an appointment at the moment. Has anyone else been in a similar situation? 

User
Posted 08 Dec 2020 at 16:23
These are very low figures. In many test labs your PSA would simply be reported as "<0.1". An increase of 0.2 is widely considered to be the margin for biochemical recurrence.

Salvage RT is extreme common following surgery. An increase this slow and this small perhaps just indicates a few stray cancer cells in the prostate bed.

Best wishes,

Chris
User
Posted 08 Dec 2020 at 16:37

Hi Chris  I agree I thought they were low but my consultant who I have  never seen since my operation said he was looking for an extra zero before a number . He said the operation was a success but wasnt able to save my nerves and then said I had seminal vessels invasion .He was able to achieve a positive margin. Initially I was going to have treatment but the consultant was very positive so decided have the operation. Never discussed the impact of losing the nerves a mistake in hindsight and also have some level of incontinence. Never had any symptoms and a Psa of 5.4 which I had to persuade my GP to let me take.  He wanted me to wait until I had systems ! Glad I didnt .


 

User
Posted 08 Dec 2020 at 16:37
Greeng, can you just check and confirm that the PSA is as you report above and not 0.2, 0.4 and now 0.6? If the numbers you gave are correct, I think it is really sad that the urologist gave you (possibly unnecessary) cause to worry at 0.02 - this is ten times lower than the threshold for recurrence!
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Dec 2020 at 16:44

Hi Lynn yes definitely 0.02 0.04 0.06 On my third consultant now which doesnt help .He wrote to me beginning of the year and said provided my Psa remained below 0.1 they would continue to monitor me . I feel I am in a worse situation that prior to my operation because I thought ou with the prostate out with the cancer . Which hopefully may still be the case .


Geoff. 

User
Posted 08 Dec 2020 at 18:24
Indeed- just focus on the positive. At the moment there is absolutely no reason to suspect that the cancer is back and even if it is, the rise is so slow that you may not need to do anything for years. John's PSA has climbed to 0.1 and then settled there for about the last 7 years. My dad's PSA has climbed higher than the 0.2 threshold (crossed that bridge about 3 years ago) but the urologist has calculated that at this rate it will be 25 years before it kills him so Dad decided not to go for salvage radiotherapy yet.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 08 Dec 2020 at 20:05

Thank you .Hopefully appointment will come through shortly .

User
Posted 09 Dec 2020 at 01:58
As others have suggested, our billion-pound super hospital here in Coventry (chosen for the much-vaunted, televised, roll-out of the plague vaccine this morning), only tests PSA to 0.1, so all your PSA results like mine over the last two and a half years, would be ‘undetectable’.

So stop worrying and come and have your bloods done in Coventry!

If the tests get to 0.2, that’s when further treatment is triggered, or successive increases over 0.1.

Best of luck.

Cheers, John.
User
Posted 09 Dec 2020 at 07:23

Thanks John . I must admit when they wrote to me to last year and said I would have to have Radiotherapy if it kept rising with my Psa just 0.04 seemed abit premature to say the least. Seeing g a different consultant every time you go is not helpful. I nearly transferred to Coventry before the operation because we dont have a robot in Birmingham. 

User
Posted 14 Dec 2020 at 01:40
Hi GreenG !

Your urologist(s) suggesting radiotherapy if it keeps increasing from (even if only 0.04 now) is not that unusual these days and is simply mentally preparing you.

I am in the same boat, but a different part of the world. Over about 2-3 yrs mine has gone from just detectable to the present 0.03. I was always detectable post operation even if just a tiny amount. The first time it did hit 0.03 - about 18 months or so ago - my urologist was saying he would advise radiotherapy if it reached between 0.05-0.1. BUT, it all depends on the rate of increase. Mine stabilised at 0.03 the past yr so nothing was done. But if there is an increase beyond that, it's usually just a matter of time.

So the key is more the rate of increase, rather than the actual number (when it's in the area of 0.03 or lower).

Good luck and merry xmas !
User
Posted 14 Dec 2020 at 08:10

Hi White river    yes it is to do with the rate of increase.Mine has risen from .04 to .06 since June last year it doubled from .02 to ..04 .


Still waiting for an appointment. 


Merry Christmas. 

 
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