PSA not undetectable after RRP

I downloaded the report myself, sadly is not <0,06... is 0,06 without the "<" sign. 

BTW, I would like to ask you if I may... I have seen in your profile that eventually you decided about having adt. I don't know anything, but I would like to be ready when the time come to take the best decision. WHat were the reasons to make you decide eventually to have adt?

Edited by member 05 Jan 2026 at 17:27  | Reason: Updating question

Thanks for answering.

I have mixed feelings about ADT... but today I am completely scared (I though I might have bcr but in a few years, not seeing psa in the first lab work after prostactectomy...) , so I can't have a clear idea. 

Hi,

I think the first thing to confirm is the undetectable level at your lab.  There have been cases of missing < and GP's systems are notorious for it.  Not only that but I've had psa going up and down a couple of times, particularly if I've been to the lab of a different hospital for a test.

The next phase might be what should you do about it.  You might read the profile of Ulsterman linked below.   He was young, had a quick recurrance, a psma scan and RT at very low levels.   We're all different and his case is his but it's not bad to follow.

https://community.prostatecanceruk.org/default.aspx?g=profile&u=20035

When you're younger you can usually tolerate more and they're more likely to pull out more stops.  

You might consider paying for a psma scan if you think it necessary although at 0.06 it's a low level for it to do any good.  Ulsterman's was low as well and they found something.

As said above 0.06 isn't that high, it's the rate of change that needs watching.   My own pet theory is follow the same routine as much as possible.  Use the same lab.  Breakfast with a decent quantity of liquid, drive to the hospital about 30 minutes and a test before 9am.

Good luck, Peter

Hi, Prostateless.

As I understand it. If your PSA is still detectable after RARP and is greater or equal to 0.1, it is BCP biochemical persistence, not BCR biochemical recurrence. To be BCR it must have been recorded as 'undetectable' then risen to 'detectable' levels.

At 0.06 you are at a very low PSA level. Too low to be deemed BCP, but a bit too high to be deemed undetectable.

What has your consultant said? Are they going to wait a while and do another PSA check? Or are they going to try and locate any possible rogue cells left behind? This could be difficult a such a low level.

Edited by member 05 Jan 2026 at 20:53  | Reason: Additional text

My surgeon said it is (obviously) all about the PSA numbers now, and that it needs to stay undetectable. He said if it got to 0.1, then in his opinion it would be BCR, and require RT. Having said that, I don't believe the NHS will act until it gets to 0.2.

Thanks. I have done extensive reading today and the consensus is that if there is psa means that there is something. There are papers that say that beningn tissue doesn't create detectable psa. I have learned today that a friend of a friend (I don't know gleason or things like that) had psa "never reaching undetectable" in 2007-2008 after RP. He had radiation but it never disappeared. He was with three monthly controls for 13 years. At this point the psa started to rise more (2020). At that point, a coline pet was done and a it detected a lymph node that had cancer. He had some kind of radiation to this node and after that it was the first time when the psa was undetectable. 

So even in cases where it doesn't rise there is something there generating this psa...

Edited by member 05 Jan 2026 at 22:49  | Reason: Clerical errors

Hi.

I know that an isolate measurement is not BCR, and I don't know what it is considered BCP. Anyhow, I have read several papers where it is stated that the posibility of BCR in the months/years to come is much higher when the first psa is not undetectable (<0,01, <0,02 or <0,03)... (75% in 4 years time in average or even more) and others talk about the nadir, which I know is different and might depend on follow up analysis.

ON the other hand, I didn't talk to my urologist yet, I only downloaded the report. But usually my urologist usually says that everything "is normal"  and that "you don't have to worry, it is nothing"... So, Let's see... 

Edited by member 05 Jan 2026 at 22:56  | Reason: Update

She was brilliant. I hope that she and her family are well. 'Matron', we still miss you. X

Aye up Lads and Ladettes. What a journey. I’ll follow this thread and post my own updates in parallel.  Prostateless, I think it’s too early for concern ….. next test pivotal imho.  It’s been 5 years (nearly) since Da Vinci did its business for me. Great margins, Gleason 3+4, etc etc. 4 years of <0.03 then boom.  0.04 last feb, 0.05 today. Very sensitive, same lab equipment.  

hey ho, mentally dealt with, 3 months ‘till the next test. Still very low numbers but a velocity is showing. 

Prostateless - you’re not alone

Edited by member 07 Jan 2026 at 22:36  | Reason: Incompetence all round.

Marty , sorry to see there has been a very small rise. I have had two vials of blood drawn at the same time and tested in the same lab and there was a difference of 0.01. While successive rises are a concern to us as patients the speed of the rise is still very slow. Although tested at the same lab they could have been tested on different or newer machines.

Thanks Chris 

Thanks for the swift responses! I’m reasonably reassured - At the time of my op, the surgeon nerve spared as the PCa was wel within the starboard lobe (erections back) and recommended zero further treatment. No Radio, No Chemicals. 

I’ll update in 3 months. Does Lynne(?) Still post?