Recurrence.

Hello again, mate. We haven't spoken for a while. I'm sorry to see that you have concerns over possible recurrence.

You say your post-op histology showed T3b disease which means there was seminal vesicle involvement. What your staging was pre-op?   

I always thought it was rare to have surgery with T3b disease, but according to AI is still an option?

Regarding your PSA levels I'd get them to double check your previous results. The 'machine' used to measure your PSA will have a detectable level, which is the lowest level it reads down to.  Anything below that will have a less than arrow infront of it and is deemed undetectable.

This level can vary from laboratory to laboratory. Which is why its always best to be measured by the same 'machine'

My PSA has been tested at two laboratories one measured down to 0.05, the other to 0.02.

You said that your first two readings had been undetectable at 0.03 and 0.01. If they were done on the same machine they both can't be undetectable. I can only assume that your laboratory lowest detectable level is 0.01? If so and your PSA was deemed undetectable, it should have been recorded as <0.01.

We are in a pretty similar situation. My post-op histology was Gleason 9 (4+5), T3a, however I was lucky and had negative margins. Up to now my PSA has remained undetectable.

Unfortunately our high Gleason score does increase the chances of BCR, so does my stage T3a staging, and your T3b staging and positive surgical margin.

As you know I'm not medically trained but to me it seems rational that your post-op, could have dropped from 0.03 to 0.01, as there may have been some PSA left in your system that was still decreasing. However, it seems questionable that then in the next three months, it's increased ten fold to 0.1. That's why I'd be asking them for another PSA check as soon as possible and recheck the previous readings.

We have had many cases on here where PSA result were incorrectly recorded and less than arrows missed off.

Even if your next PSA confirms a PSA rise, you should still be lower than the trigger point of 0.2  for further investigation/treatment for recurrence.

 Good luck mate, and please keep us updated. 👍

Staging was pre op, yes. Surgeon was happy to remove the prostate saying the SV's were coming out whatever happened. No chance of nerve sparing but I wasn't bothered. I was intent on avoiding HT which it now seems I might need anyway. 

Yes, I was lucky with the surgeon for sure. He wrote to my GP saying the small 6mm margin was a good outcome. Seems like bad luck it's raised it's head so quickly.

Thanks Peter.

I've got another test booked for 8 weeks. The CNS team don't want it sooner. Once, or if, I reach 0.2 it triggers a Pet scan. Just hoping the elevation from 0.01 to 0.1 slows up for the next test otherwise it looks likely to exceed 0.2 at that rate.