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Monitoring PSA Levels

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User
Posted 29 Jan 2024 at 22:28

Hi all,

I had a Prostatectomy in Mar 2023, after which my readings were low and in October 23 were 0.01; my latest test Jan 24 sure any readings are 0.03 should I be concerned by this rise? 

Thanks in advance for any thoughts or experiences, Gaz.

User
Posted 30 Jan 2024 at 07:16

Hi Gaz, 

Welcome  to the forum. It's a shame you've had to join us, but I'm glad you have.

I'm in a similar position to you. I had RARP last February. Three PSA checks since, <.02, <.05 and <.02 again. The slight central rise was due to being tested at a different lab. All results were classed as undetectable all were lower than the lowest level the labs could test to.

I'm due another result this week. I hate PSA test times, they do my head in. 

Psychologically any rise, no matter how miniscule, is disconcerting. However, I was told that they would only consider other treatment, if I got three consecutive rises, or it reached 0.2. 

Dave, as usual, has explained everything clearly. As he says, it would be helpful if we had a few more details of your results. If you intend contributing regularly it might help if you completed a more detailed bio on your profile.

Anyway, nice to meet you and best of luck for the future.

Adrian

User
Posted 29 Jan 2024 at 22:28

Hi all,

I had a Prostatectomy in Mar 2023, after which my readings were low and in October 23 were 0.01; my latest test Jan 24 sure any readings are 0.03 should I be concerned by this rise? 

Thanks in advance for any thoughts or experiences, Gaz.

User
Posted 30 Jan 2024 at 02:39

The most important thing we need to know is was there a 'less than' symbol '<' in front of these numbers. If they were read to you over the phone you won't know. You need to see a printout, or see it on a computer/phone screen. If their is a < in front of the <0.03 you have nothing to worry about. If there isn't a < you don't have anything to worry about yet, but you may have in a few months.

Do you have a post op histology report? if it says you were T2 with negative margins it would be very reassuring.

It is too early to say if you have a rise in PSA because these two numbers are close to the limit of detection. Do not switch to six monthly testing, stick with three months in case it continues to rise.

Your medics are unlikely to be concerned about this until PSA exceeds 0.1 or 0.2 

Dave

User
Posted 30 Jan 2024 at 07:23
It's really all about the < symbol. If you have one great the numbers are irrelevant.

If you don't it's probably bad news that you have had a rise from 0.01 to 0.03.

User
Posted 30 Jan 2024 at 07:53

Hi Dave, Adrian.

Thanks for your reply. I was diagnosed at T3+ but they found a shadow in my rib, so I had a nuclear due dye injection which showed 'believed' metastatic on my rib and pelvis, I then became T4 (5-7 years expectancy). My cancer was believed to be in the fatty tissue towards the outside if the prostate.

After a second opinion at the Christie's (which are fantastic) they completed the prostate removal. On biopsy it showed that the cancer was within the prostate and not as close to the edge as believed. They believe (80%) that the  metastatic findings could be something else but of course not sure. So whilst they haven't reversed the T4 prognosis, they are confident (to a level) it hasn't spread) so I am being monitored.

All my other readings have been <0.01 but at the 10 month point it has now become 0.03 (not sure exactly of it's < as I've not seen the paperwork) but readings are from the same lab.

I was on hormones so was told the PSA readings could be suppressed for max 12 months (at that stage now) so this technically is the first true reading , hence this rise has got me somewhat in a flat spin and concerned. 

I plan to ring the Dr today and try to speak to Christies only as reading up 0.03 can be classed as a reoccurrence. Assumption is this is not 0.3 so 0.03 is lesser, so not a concern? It can be confusing because you read alot online and it seems to class 0.3 and 0.03 as the same?!

Cheers for the contact guys, from a worried 52 year old bloke! 

Edited by member 30 Jan 2024 at 07:57  | Reason: Typos

User
Posted 30 Jan 2024 at 09:25

Hi again Gaz, firstly you're bound to be  worried, plus you're a lot younger than most of us old fogies.

As you are aware 0.3 is ten times greater than .03. In my case .3 could indicate a possible recurrence .03 would be fine.

From what you're saying it appears that you've had two opinions as to your cancer staging that vary enormously. As Dave said the histology of your removed prostate would seem to contain the most accurate information as to your cancer staging and prognosis. 

Were you put on hormone tablets to suppress the cancer, whilst they were sorting out their differences of opinions? They did this to me whilst deciding if I was 'fit enough' for surgery.

It seems you've been downgraded from T4, (in your bones) to T3b (in fatty tissue around the prostate) to T3 or even T2  (if it's fully confined to your prostate)

Wonderful though this downgrading is, it must have been awfully worrying time for you.

Adrian

 

Edited by member 30 Jan 2024 at 09:49  | Reason: Additional text

User
Posted 30 Jan 2024 at 21:18

Originally Posted by: Online Community Member
I was happy with this but to be sure they said the PSA would show more details, which is why I'm in tender hooks with each result. the start was great at <0.01 but this jump to 0.03 has me worried.

Gaz obviously I'm not medically qualified and if it puts your mind at rest, ring up one of your care team.

As I understand it, your PSA has risen over 10 months from < .01 to .03.  The figure that may show possible recurrence is usually .2 so you're a long way from that. In an early post you mentioned 0.03 shows recurrence, which isn't the case. I think you're confusing .03 with .3?

Try not to worry too much mate.

 

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User
Posted 30 Jan 2024 at 02:39

The most important thing we need to know is was there a 'less than' symbol '<' in front of these numbers. If they were read to you over the phone you won't know. You need to see a printout, or see it on a computer/phone screen. If their is a < in front of the <0.03 you have nothing to worry about. If there isn't a < you don't have anything to worry about yet, but you may have in a few months.

Do you have a post op histology report? if it says you were T2 with negative margins it would be very reassuring.

It is too early to say if you have a rise in PSA because these two numbers are close to the limit of detection. Do not switch to six monthly testing, stick with three months in case it continues to rise.

Your medics are unlikely to be concerned about this until PSA exceeds 0.1 or 0.2 

Dave

User
Posted 30 Jan 2024 at 07:16

Hi Gaz, 

Welcome  to the forum. It's a shame you've had to join us, but I'm glad you have.

I'm in a similar position to you. I had RARP last February. Three PSA checks since, <.02, <.05 and <.02 again. The slight central rise was due to being tested at a different lab. All results were classed as undetectable all were lower than the lowest level the labs could test to.

I'm due another result this week. I hate PSA test times, they do my head in. 

Psychologically any rise, no matter how miniscule, is disconcerting. However, I was told that they would only consider other treatment, if I got three consecutive rises, or it reached 0.2. 

Dave, as usual, has explained everything clearly. As he says, it would be helpful if we had a few more details of your results. If you intend contributing regularly it might help if you completed a more detailed bio on your profile.

Anyway, nice to meet you and best of luck for the future.

Adrian

User
Posted 30 Jan 2024 at 07:23
It's really all about the < symbol. If you have one great the numbers are irrelevant.

If you don't it's probably bad news that you have had a rise from 0.01 to 0.03.

User
Posted 30 Jan 2024 at 07:53

Hi Dave, Adrian.

Thanks for your reply. I was diagnosed at T3+ but they found a shadow in my rib, so I had a nuclear due dye injection which showed 'believed' metastatic on my rib and pelvis, I then became T4 (5-7 years expectancy). My cancer was believed to be in the fatty tissue towards the outside if the prostate.

After a second opinion at the Christie's (which are fantastic) they completed the prostate removal. On biopsy it showed that the cancer was within the prostate and not as close to the edge as believed. They believe (80%) that the  metastatic findings could be something else but of course not sure. So whilst they haven't reversed the T4 prognosis, they are confident (to a level) it hasn't spread) so I am being monitored.

All my other readings have been <0.01 but at the 10 month point it has now become 0.03 (not sure exactly of it's < as I've not seen the paperwork) but readings are from the same lab.

I was on hormones so was told the PSA readings could be suppressed for max 12 months (at that stage now) so this technically is the first true reading , hence this rise has got me somewhat in a flat spin and concerned. 

I plan to ring the Dr today and try to speak to Christies only as reading up 0.03 can be classed as a reoccurrence. Assumption is this is not 0.3 so 0.03 is lesser, so not a concern? It can be confusing because you read alot online and it seems to class 0.3 and 0.03 as the same?!

Cheers for the contact guys, from a worried 52 year old bloke! 

Edited by member 30 Jan 2024 at 07:57  | Reason: Typos

User
Posted 30 Jan 2024 at 09:25

Hi again Gaz, firstly you're bound to be  worried, plus you're a lot younger than most of us old fogies.

As you are aware 0.3 is ten times greater than .03. In my case .3 could indicate a possible recurrence .03 would be fine.

From what you're saying it appears that you've had two opinions as to your cancer staging that vary enormously. As Dave said the histology of your removed prostate would seem to contain the most accurate information as to your cancer staging and prognosis. 

Were you put on hormone tablets to suppress the cancer, whilst they were sorting out their differences of opinions? They did this to me whilst deciding if I was 'fit enough' for surgery.

It seems you've been downgraded from T4, (in your bones) to T3b (in fatty tissue around the prostate) to T3 or even T2  (if it's fully confined to your prostate)

Wonderful though this downgrading is, it must have been awfully worrying time for you.

Adrian

 

Edited by member 30 Jan 2024 at 09:49  | Reason: Additional text

User
Posted 30 Jan 2024 at 19:52

Hi Adrian,

I was out on the hormones immediately after they gave me the Stage 4 diagnosis, to as you say suppress the cancer, this was due to the believed spread to my bones. They where then going to do radiotherapy. 

On going for a second opinion, Christies said I should go for RALP. Whilst I waited for the appointment they removed me from the hormones, to allow the prostate to go back to normal size, so easier to operate.

On completion of the operation they discovered it was not outside the fatty tissue so good news, but unsure about the spread to bones, so I now am being monitored. I was seeking a downgrade as but they have told me that due to the potential spread in the bones I will remain T4.

Cheers Gaz and thanks for the warm welcome 

User
Posted 30 Jan 2024 at 20:12

Gaz, have you had a CT scan and a bone scan?

My CT scan showed anomolies. Lytic areas in my legs, hips and pelvis. Fortunately the follow up bone scan revealed these were something to do with arthritis and degenerative disease, and nothing to do with the cancer.

I got the impression that my surgeon would not have operated had these lytic areas been cancerous.

Edited by member 30 Jan 2024 at 20:51  | Reason: Spelling

User
Posted 30 Jan 2024 at 20:21

Hi Adrian,

Yes I've had x-ray, MRI (not sure about cat scan) and the nuclear dye scan; They showed up an orange colour on the scan when they would expect them to be a red colour. So the team think it could be anomolies such as arthritis etc or the rib could be an old boxing injury and arthritis etc. 

I was happy with this but to be sure they said the PSA would show more details, which is why I'm in tender hooks with each result. the start was great at <0.01 but this jump to 0.03 has me worried.

User
Posted 30 Jan 2024 at 21:18

Originally Posted by: Online Community Member
I was happy with this but to be sure they said the PSA would show more details, which is why I'm in tender hooks with each result. the start was great at <0.01 but this jump to 0.03 has me worried.

Gaz obviously I'm not medically qualified and if it puts your mind at rest, ring up one of your care team.

As I understand it, your PSA has risen over 10 months from < .01 to .03.  The figure that may show possible recurrence is usually .2 so you're a long way from that. In an early post you mentioned 0.03 shows recurrence, which isn't the case. I think you're confusing .03 with .3?

Try not to worry too much mate.

 

 
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