Increased PSA after surgery

User

Posted 18 Apr 2023 at 22:34

Hi everyone

I just wondered if anyone else has had a similar experience to myself.

My PSA was 4.7 at the end of November 2022. After an MRI and biopsies my Gleason score was 4+3=7 and surgery was suggested.

I had a non nerve sparing prostatectomy in the middle of February. My post op histology results gave a revised Gleason score of 4+5=9. Lymph nodes were clear.

Just had my 8 week post op PSA results and the score is 6.1. The consultant was so surprised he ordered another test straight away. The retest has confirmed it is 6.1. He says he has never seen this before. So I have been referred to an oncologist and am having a petscan.

Has anyone else had a similar experience?

User

Posted 19 Apr 2023 at 00:26

So sorry to see this, DW - as you had non nerve sparing RP, it appears that they were already concerned that your cancer may be quite extensive in and around the prostate gland but clearly, it was already advanced and that just hadn't been recognised during the diagnosis stage.

Did you have a bone scan before they recommended surgery?

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

User

Posted 19 Apr 2023 at 08:09

David, I did come across a research paper from 2016, that reported just under 2 percent of PSA tests were reported as ten times the actual value due to implied decimal point errors. You would be unfortunate to have that same error twice and even 0.61 would not be great.

I am a little surprised the repeat test was exactly the same at that level of reporting, I would have expected a difference of at least 0.1.

I hope it turns out to be an error in the tests.

Thanks Chris

User

Posted 19 Apr 2023 at 09:19

David. That's worrying news. I do hope you can get to the bottom of it. Did the histology on the prostate indicate any positive margins?

User

Posted 24 Apr 2023 at 19:31

No bone scan or PET-CT scan. The consultant did say he thought it was quite advanced hence the non nerve sparing surgery.
PET-CT is Friday with results a week later.

User

Posted 24 Apr 2023 at 19:34

Hi Chris

Yes the histology did show positive margins. Lymph nodes were all clear.

David

User

Posted 24 Apr 2023 at 20:06

Hi David,

You could say your psa was 4.7 in November and they removed your prostate which should have taken it down to 0.

Your prostate would nominally be about 3 so your cancer could be about 1.7.

10(?) weeks later it was 6.1 which is an increase of 4.4 or about about 0.4 a week.

You had 2 tests a week apart that came to 6.1 when it seems it could be expected to be changing from 6.1 to 6.5.

The above might be completely wrong but it seems a high rate of increase and yet didn't increase in the week between tests. I don't know if that's too simplistic but I like to take inconsistencies as throwing something to cast some light.

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