PSA 15 months after prostatectomy

User

Posted 04 Nov 2024 at 20:41

So I had a radical prostatectomy in July 2023 with routine PSA follow ups, all coming in at <0.01 except for the latest one which was 0.01 (ie: without the magic '<' sign)

My post op histology was Gleason 3+4=7, T2c N0 (0/6), clear margins.

Been feeling quietly confident tbh, but latest PSA is a bit of an unwelcome surprise, not a massive jump obviously but a bit concerning. Is this the start of an upward trend or an anomaly / blip?

My CNS thinks things should be in my favour with my scores, clear margins etc and isn't unduly concerned. However, I flip between fearing the worst and telling myself it'll all be fine. Next PSA will be in January.

Does anyone have any thoughts, experience or other insights in this area?

User

Posted 04 Nov 2024 at 22:05

Hi John.

You state that your latest PSA was 0.01 unlike the others that were <0.01. Are you sure it isn't a typo and they've just missed off the <. It seems a remarkable coincidence, apart from the < , that your scores are exactly the same.

I had the op 21 months ago, my laboratory only measures down to 0.02.

I don't think you've got anything to worry about mate.

Keep getting your PSA tests. I think they class possible recurrence as 0.2 and you're a long way from that.

Edited by member 04 Nov 2024 at 22:13 | Reason: Typo

User

Posted 05 Nov 2024 at 12:18

Measuring down to 0.01 is lower than incredibly low. There is much said about psa levels and I've read that below 0.03 it's not very accurate, I've also read that if it's measured as lower than 0.01 then that's almost as perfect a result as you're ever likely to get and the likelihood of a recurrance is very low indeed. Many hospitals measure down to 0.1 which is 10 times more than yours.

Edited by member 05 Nov 2024 at 12:19 | Reason: Not specified

User

Posted 05 Nov 2024 at 15:54

Hi John

My diagnosis following biopsy was overall Gleason 3+4, T3a N0 M0 prostate cancer with presenting PSA of 17. All biopsies positive for prostate cancer with target lesions showing Gleason 4+3.

RARP performed on 02.08.2024.

The one month follow up pathology report post RARP showed negative margins.

My first PSA result post RARP on 18.10 was 0.02.

During the second post op phone consultation with the surgeon on 29.10 he said he was very pleased with the PSA result as anything below 0.03 was good.

I reckon you are doing well and as long as the PSA levels remain at this level you have nothing to worry about.

Hope this helps.

User

Posted 12 Jan 2025 at 00:41

Originally Posted by: Online Community Member

‘ normal life expectancy is 87 ‘.

I would settle for that - according to the national news a couple of weeks ago the average life expectancy for a man living a few miles from me , in Blackpool , is 73 !

Who'd want to live in Blackpool for 73 years?

Only joking.....only joking. 😬

My in box will now be full of complaints from geriatric Blackpudians.

Edited by member 12 Jan 2025 at 00:43 | Reason: Typo

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User

Posted 04 Nov 2024 at 22:05

Hi John.

I had the op 21 months ago, my laboratory only measures down to 0.02.

I don't think you've got anything to worry about mate.

Keep getting your PSA tests. I think they class possible recurrence as 0.2 and you're a long way from that.

Edited by member 04 Nov 2024 at 22:13 | Reason: Typo

User

Posted 05 Nov 2024 at 12:18

Edited by member 05 Nov 2024 at 12:19 | Reason: Not specified

User

Posted 05 Nov 2024 at 15:54

Hi John

My diagnosis following biopsy was overall Gleason 3+4, T3a N0 M0 prostate cancer with presenting PSA of 17. All biopsies positive for prostate cancer with target lesions showing Gleason 4+3.

RARP performed on 02.08.2024.

The one month follow up pathology report post RARP showed negative margins.

My first PSA result post RARP on 18.10 was 0.02.

During the second post op phone consultation with the surgeon on 29.10 he said he was very pleased with the PSA result as anything below 0.03 was good.

I reckon you are doing well and as long as the PSA levels remain at this level you have nothing to worry about.

Hope this helps.

User

Posted 11 Jan 2025 at 12:14

Lots of Positives but.....

Hi John,

hope no-one minds if I jump on this thread as it has some relevance to my situation. I am a 75 year old, otherwise fit and healthy male ( lots of running and walking). I was diagnosed in Spring last year, Gleason of 7 (4+3) and M0, N0. Because of my general good health, I was offered surgery as an alternative to the normal radiotherapy for someone of my age and took it to address the cause of the cancer.

RARP in mid August, after which histology reported a single adenocarcinoma of 20mm on LHS and some extra capsular extension. The seminal vesicles were tumour free and Stage was ranked pT3a+.

My first postoperative PSA was undetectable ( expressed as <0.1 at my Hospital) and described as 'excellent' by them. The Surgeon managed to save nerves on the RHS so another positive.

Managing continence is a work in progress - lots of kegels and exercise and I'm no longer Tena Men's best customer, down to 1 pad/day, clear at night and , I guess, 85-90 percent controlled continence. So all good. I've just had my second PSA, this time a result of 0.1 (so detected). Hospital team say this is 'acceptable' and wait till next follow up in 3 months to see if anything adverse is going on.

This feels like an issue and I've looked across the boards and see similar experiences. We will not put our lives on hold waiting for the next test result and then the one after that and so on so interested if anyone has any comments/thoughts.

Broomfield (aka Bill)

User

Posted 11 Jan 2025 at 13:38

75 tends to be the age where surgery is no longer offered. I think the main factor is normal life expectancy is about 87 and once you are within ten years of that, they don't want to spend as much. Hopefully you've noticed my maths is either wrong or there is something else to consider. The other thing is that at 75 there are usually other comorbidities making surgery unsafe. So the NHS definitely thinks you're in good health.

Having a tumour upgraded is always a bit disappointing, it means the surgeon has to do more work and hope he has got everything.

People do debate how sensitive PSA tests should be 1 decimal place which is what your hospital uses or 3 decimal places. Small readings of PSA even with no prostate are normal, and these readings will fluctuate, so 3 digits almost always causes unnecessary worry. Even if a 3 decimal place test did indicate a rise, it is too small and too early to do any treatment, so I am inclined to think 1 decimal place PSA tests are best.

If the first post op PSA is large (greater than 1) it implies that a lot of cancer cells were nowhere near the operation site (i.e. you had mets before the op). If the PSA is very small and starts to rise slowly it implies there aren't many cancer cells, and they are probably very near the prostate site. Salvage radiation has a high chance of working in that situation.

None of us on this site know if we are cured, some of us just keep getting consistently good test results. You are right you can't put your life on hold, just get the next result and go from there, but in your case if you do get a bad test result, there are still plenty of options.

Dave

User

Posted 11 Jan 2025 at 13:55

‘ normal life expectancy is 87 ‘.

I would settle for that - according to the national news a couple of weeks ago the average life expectancy for a man living a few miles from me , in Blackpool , is 73 !

User

Posted 12 Jan 2025 at 00:41

Originally Posted by: Online Community Member

‘ normal life expectancy is 87 ‘.

I would settle for that - according to the national news a couple of weeks ago the average life expectancy for a man living a few miles from me , in Blackpool , is 73 !

Who'd want to live in Blackpool for 73 years?

Only joking.....only joking. 😬

My in box will now be full of complaints from geriatric Blackpudians.

Edited by member 12 Jan 2025 at 00:43 | Reason: Typo

User

Posted 12 Jan 2025 at 14:29

I've now worked the Site out a bit more and reverted to an online name but, thanks for the comments and experiences. In my area, 71 is the cut off date for Surgery which might reflect life expectancy around Middlesbrough. It's reassuring though to know that someone with knowledge thinks I'm worth 10 years.

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