Raised PSA post op

User

Posted 03 Dec 2022 at 08:30

Dear all

my dear husband had radical prostatectomy last Xmas (9 Dec) last year and sailed through all PSA monitoring in past 12 months with ‘PSA undetectable < 0.01%’.

Unfortunately, yesterday, he went for 1 year PSA test results and was told that the PSA is now detectable at 0.05%, which is not good. I understand that biochemical reoccurrence is normally suspected at 0.2%, so he’s not at that level yet.

Does anyone have experience of PSA going up post surgery?

Can the PSA go down again? Can it fluctuate?

or - if you have a raised PSA - is it generally expected to stay raised?

Obviously my lovely husband no longer has a prostate so the PSA must be coming from somewhere - are there other explanations for raised PSA?

many thanks in advance for any comments

Best wishes

wiggers (aka Kate)

User

Posted 03 Dec 2022 at 09:46

0.05 is nothing to worry about and certainly doesn't mean further treatment is inevitable. His reading may just settle at / around 0.05 as his 'normal' level - small amounts of PSA are generated in other parts of the body as well. In fact, a woman might have a PSA reading of 0.05 immediately after a good orgasm!

My husband's PSA has been between <0.1 and 0.11 for nearly 10 years now but the doctors think he maybe just generates a lot of non-prostate PSA.

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

User

Posted 03 Dec 2022 at 10:40

Wiggers, what was his pre op figures and stats, what was his histology of the prostate. Hopefully he is in the two thirds of men who have successfull surgery.

A variation of 0.01 can be put down to the machine or his sample, the next few results will give a better picture, You can't alter them so don't worry about them.

My PSA fluctuated but the overall trend was up, but I did have a poor histology.

Thanks Chris

User

Posted 03 Dec 2022 at 20:17

Wiggers, the good thing is that having had the prostate removed PSA is detectable at the very low level of 0.05. It can now be monitored, and if rises continue above the generally accepted threshold of 0.2 a decision will need to be made (I write as someone who has had salvage radiotherapy this year).

If your husband had had another therapy (RT the most obvious example) there would be a residual PSA level which would make it difficult to distinguish a 0.2 change from natural fluctuations. Much better to spot changes early should action be needed.

User

Posted 04 Dec 2022 at 09:01

Yes it's a concern as it should be <0.01.

To understand how much of a concern you need your final pathology. T score and G score?

Whatever your final pathology there is nothing to do or worry about now BUT make sure you have the next scheduled PSA test and this should be in no more than 34 months time.

If it goes up again you need a second option from an oncologist if it doesn't you need to keep monitoring.

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