Brutal increase in PSA level in 3 months

User

Posted 07 Feb 2026 at 08:04

Hello Murdock

You mentioned Nanoknife in one of your posts ... is this still an option? You will still have the catheter aspect to deal with - but the surgery aspects are minimal...

Courage

Crispin

User

Posted 07 Feb 2026 at 10:03

Originally Posted by: Online Community Member

I definitely need psychological help, as I've only just begun this journey, and aside from the panic, I feel completely exhausted. I'm on disability leave from work. I can't sleep well; my mind is constantly racing with post-surgery pain, the catheter, incontinence, ED, biochemical recurrences, radiation, more toxicity, and more long-term effects.

Hi again, mate.

I'm so sorry that you are really struggling. You are worrying about every possible bad outcome. No wonder you can't sleep.

There are a few younger blokes on here, who've recently had surgery. They are making very speedy recoveries, no pain, and minimal side effects.

Perhaps they'll join the conversation to reassure you.

As Crispin has pointed out there may be other treatment options open to you. This video, is London based, but it gives you an idea of these treatments and their possible side effects.

https://youtu.be/zYTU94-8pTc?si=1Z29_l8rbTwF6DHl

User

Posted 07 Feb 2026 at 22:37

Hi Murdock

Sorry you’re in this situation and feeling so anxious.

Maybe once you have treatment you might find yourself in a better place, as instead of the constant anxiety AS is causing you, you’ll actually be treating the problem.

I hope it might help you to know my husband decided AS wasn’t for him, and chose RT.

He followed a low residue diet for a week before and throughout treatment, and found the RT to be fine, the worst part was finding a parking space at the busy hospital.

Sometimes doing something is better than doing nothing.

Good luck whatever route you decide. Please consider seeking help and support for your anxiety.

User

Posted 07 Feb 2026 at 23:16

Focal therapy now not is a option for me. I have new small focus gleason 6 (20%) too in left lobe.

User

Posted 15 Feb 2026 at 08:07

Well I had an appointment with a prestigious uro-oncologist at LYX in Madrid. He recommended RALP instead of radiotherapy, and also a BRCA genetic test because he says that if it comes back positive in the future, it's better to know and treat the disease with target treqent. Furthermore, the RALP will be performed with real-time histology (histolog scanner) in the operating room to avoid positive margins and see if the left neurovascular bundle can be saved. I'm incredibly anxious.

https://www.immedicohospitalario.es/noticia/54649/nueva-tecnologia-permite-detectar-restos-de-tumor-durante-la-cirugia.html

User

Posted 15 Feb 2026 at 08:42

Dear Murdock, Sounds like you found an outstanding medical team. Madrid is world renowned for oncology research. I hope the plan brings you some comfort and peace of mind especially knowing that there are a lot of further options after the surgery. It's brilliant they will test you now for the BRCA mutation. They won't test where we are until a certain point in recurrence. Really glad you found this doctor.

User

Posted 15 Feb 2026 at 08:45

hello mate

I'm very worried about everything. On the other hand, knowing you're a BRCA carrier can be a huge concern for the rest of your life.

Originally Posted by: Online Community Member

User

Posted 18 Mar 2026 at 23:18

Hello, my RALP is next monday. I am very stressed and terrified for Pain, catheter, incontinence and ED and for Cancer cure.

thanks

User

Posted 19 Mar 2026 at 08:01

Hello again, mate.

I suspect most of us had pre-op anxiety. What helped me prepare for surgery, was to focus on the certain, and much worse outcomes, if I didn't have it done.

Good luck, buddy. You'll be okay. 👍

User

Posted 19 Mar 2026 at 08:12

Good morning Adrian

yes un are right… not treat is very dangerous

User

Posted 25 Mar 2026 at 06:50

Hi everyone, two days ago I had a RALP 13 mm tumor, Gleason score 7 (3+4), located in the posterolateral segment of the lower third of the left peripheral lobe. It was possible to perform bilateral intrafascial right and interfascial preservation on the left. I understand that bilateral intrafascial preservation is ideal. Does anyone understand what this entails? Histolog scanner margins negative.

all the best

User

Posted 25 Mar 2026 at 08:54

Hi, mate.

Its all in here.

https://www.mdpi.com/2072-6694/14/7/1601

It seems that your nerve sparing went well.

Did you have Neuro-safe surgery? Were your margins checked during the operation? Most of us had to wait weeks for histology results in relation to whether our margins were positive or all clear.

How are you feeling generally?

User

Posted 25 Mar 2026 at 09:03

Hello adrian histolog scanner margin checking intraoperative is negative for cáncer anyway must be wait for pathologic final examen

User

Posted 25 Mar 2026 at 13:10

Originally Posted by: Online Community Member

Well, it definitely needs raising quickly with urology.

Did you have a biopsy during this period?

It might be prostatitis (inflammation of the prostate), and the discomfort might also suggest this. PSA results are invalid if you have prostatitis.

They said I'd got prostatitis with an elevated PSA of 13.5. During biopsy the urologist did a DRE and said my prostate was inflammed, and put it down to prostatis again, it certainly did feel like it was inflammed during the DRE (ouch) antibiotics resolved the symptoms I presented with. However, much to my shock the biopsy confirmed T3bN0M1so clearly both conditions can coexist together.

User

Posted 25 Mar 2026 at 13:32

Friend this is history. I have RALP 2 days ago

User

Posted 25 Mar 2026 at 14:42

All the best with your recovery. Just sharing from personal experience that GPs and urologists are maybe too keen to point to proctatisis as a reason for an elevated PSA. I have most likely had prostate cancer for many years without any symptoms, it was only due to a bout of proctatisis in 2025 that I found out I had prostate cancer.

All the best,

hawkz

Edited by member 25 Mar 2026 at 14:45 | Reason: Not specified

User

Posted 25 Mar 2026 at 16:04

Yes elevated psa not is only by cancer

User

Posted 17 Apr 2026 at 06:35

Hello… today not happy

This is my final parhology report after RALP, positive margins is present.

Pathology Summary (Post-Radical Prostatectomy)

• Final diagnosis: Prostate adenocarcinoma

• Gleason score: 3+4 = 7 (Grade Group 2)

• Tumor volume: Approximately 6–10% of the prostate

• Pathological stage: pT2 (tumor confined within the prostate)

• Extraprostatic extension (EPE): Absent

• Seminal vesicle invasion: Absent

• Lymphovascular invasion: Absent

• Perineural invasion: Present

• Surgical margins: Positive

• Location: Left apical margin

• Two foci of involvement:

• 4 mm (considered more significant) pattern 3

• 1.2 mm (pattern 3)

⸻

Overall interpretation

This is a favorable-intermediate risk prostate cancer:

• Tumor is organ-confined (pT2)

• No evidence of spread outside the prostate

• No high-grade aggressive features (no Gleason ≥8, no pattern 5)

However:

• There is a positive surgical margin at the apex, which increases the risk of biochemical recurrence, but does not mean recurrence is certain

⸻

Next step

• Close follow-up with postoperative PSA testing

• Further treatment (if needed) depends on PSA evolution

User

Posted 17 Apr 2026 at 07:28

Hello again, mate.

It is a bit disappointing to have a positive surgical margin, especially as they were checked during the operation. However the rest of the results are good.

Your post op PSA test will be telling, if your PSA is above detectable level, it could be due to the positive margin.

Good luck, mate and please keep us informed of the result.

Apart from this, how is your recovery in general? Are they operation 'entry wounds' healing well? Has your catheter been removed, if so, how is your incontinence?

User

Posted 17 Apr 2026 at 07:36

Hi Adrian i am very concern and very sad.

Incontinence is good only 1 pad for day.

I manage to stay dry all night, incisions are ok.

It seems that salvage radiotherapy is on the horizon, with more toxicity, incontinence, and erectile dysfunction. This damn problem won't let me live in peace. The surgeon told me he's not worried (but I am, very much so). He said that up to 70% of patients with T3a don't need salvage radiotherapy and that I'm T2. I don't know if he said that to reassure me and is hiding something.

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