PSA .3 5 weeks after prostatectomy

User

Posted 21 Jan 2025 at 01:10

My first PSA result after radical prostatectomy by open surgery (New Zealand) has come back at 0.3, 5 weeks after the operation.

I will be having my first followup with my surgeon in a few days so I do not have any histology information about the margins of the removed prostate.

How concerned should I be at that PSA level for five weeks after surgery please?

User

Posted 21 Jan 2025 at 10:43

Hello mate.

Unfortunately, as far as I'm aware, a reading of 0.3 indicates a very small amount of cancer may have been left behind. Your histology results may shed more light on this.

User

Posted 21 Jan 2025 at 14:03

Kiwi, just clarify 0.3 or 0.03 or even <0.03. we have had many mis reported post op psa values and people getting unnecessarily anxious. In the UK the guidance is to wait at least six weeks for the first PSA test. Check that result, who gave it to you and was it in writing.

As already said your histology will hopefully reveal more.

Thanks Chris

User

Posted 21 Jan 2025 at 16:08

My Surgeon recommended an 8 week wait before first PSA test. I imagine will be a retest.

User

Posted 21 Jan 2025 at 21:50

Definitely 0.3 ug/l . Will update after visit with surgeon tomorrow.

User

Posted 22 Jan 2025 at 00:01

Originally Posted by: Online Community Member

Definitely 0.3 ug/l . Will update after visit with surgeon tomorrow.

Good luck! Make a note of any questions you want to ask and maybe ask to record the consultation. It’s very easy to forget things in the heat of a consultations,

User

Posted 22 Jan 2025 at 00:01

That’s very soon post op. My consultant said 10 weeks is optimal. Had mine at that point which came back as undetectable.

User

Posted 22 Jan 2025 at 05:42

As others have suggested a PSA check five weeks post op is on the early side. This is what our site says:

At four to eight weeks after surgery, your PSA level should drop so low that it’s not possible to detect it (less than 0.1 ng/ml). This is because the prostate, which produces PSA, has been removed. A rise in your PSA level may suggest that you still have some prostate cancer cells.

Best of luck with you consultation today and please keep us updated.👍

User

Posted 22 Jan 2025 at 15:37

As everyone has already said five weeks for the first PSA test seems a bit early by UK practice. In terms of how concerned you should be depends on your staging at diagnosis. If you are in the T3 category then there is a chance that some could have been left behind outside of the prostate but it's no good surmising about anything until you have seen your consultant and had your histology report. I was in a similar situation to you with a PSA of 0.28 six weeks after open surgery. In my case it turned out some cancer was left behind. I had salvage RT six months later which got rid of the remaining cancer in the prostate bed. So even if it turns out to be positive it is still treatable and curable. Good luck.

User

Posted 22 Jan 2025 at 22:09

Had my consultation with the surgeon today. As many of you surmised, the result is slightly ambiguous. The histology showed clear margins, which was inline with pre-surgery scan and biopsy (gleason 3+4) which showed the cancer contained within the prostate.
So the 0.3 psa might be cancer cells that traveled outside the prostate pre-surgery or perhaps the test was just too early at 5 weeks.
Need to wait for another 6 weeks for a retest, which will be 12 weeks after surgery.
With the risk of saying something many of you already know, it is hard to make that mental adjustment when reality does not quite match with expectations.

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