5 years post op

User

Posted 21 Mar 2026 at 13:05

My husband had his RP March 2021. Since then all PSA's have been undectectable. Until the one done this ssmonth. Urology nurse rang to say it was 0.2. Sure you can appreciate the blow this is. They want to check again in 4 months. Not happy about that & considering having a private blood test in 6-8 weeks.

Nurse has told us not to panic which is easier said than done. Any advice gratefully received

User

Posted 21 Mar 2026 at 20:32

I am sorry to hear that and so understand the panic you feel. There are numerous topics on here about PSA results and there meaning. You don't mention what the previous test results and it seems it's more about a trend. If the results have been climbing then that can be a bit more of a concern. A jump that doubles over a short period is a major factor. I can understand your thoughts on having a private test and think this has to come down to your own peace of mind. The one thing to keep in mind is that tests analysed at different labs might have results that vary due as much to the labs equipment and/or methods used. These are very low readings and we have only recently developed equipment and processes sensitive enough to go down to 0.01. I am not an expert on this and am only repeating what I have read elsewhere on this forum.

I hope that helps and so hope that your husband gets good news of a drop in his PSA whenever that next test takes place.

User

Posted 21 Mar 2026 at 22:49

Hello.

Have your husband's PSA tests always been done at the same place? If so, what is the lowest detectable level they measure down to.

Prior to this test. When was his last test and what was it?

If he has been undetectable since his surgery all his previous PSA results will be the the lowest detectable level preceeded by less than arrow < .

Laboratories lowest detectable levels can vary. Some only measure down to 0.1, some much lower. In the past, mine have been done at two different laboratories. One measures down to 0.05, the other to 0.02.

I believe biochemical recurrence can be classed as three consecutive rises below 0.1 or a reading of 0.2 or above. At this point many hospitals consider further treatment.

We have had cases where PSA levels were subject to laboratory errors or incorrectly recorded.

I had RARP over three years ago. I'm currently being PSA tested every 6 months. Fortunately my PSA has always been undetectable, either <0.05 or <0.02 dependent on which laboratory tested it.

If my result went from undetectable to 0.2 in six months. I'd strongly be expressing concern and asking the hospital for a PSA retest asap, rather than waiting another four months.

Best of luck.

Edited by member 21 Mar 2026 at 23:52 | Reason: Typo

User

Posted 22 Mar 2026 at 12:04

Massive apologies. In my concern I put the wrong figure. The result is 0.02 NOT 0.2.

Yes his tests have always been done at same hospital.The last one back in September 2025 was < 0.04. All results prior to this since the op in 2021 have always had the less than & undectectable. The reason I am so concerned was that although he cancer was contained when his prostate was removed one of the margins was a minute area of Tertiary 5 & the surgeon said that it could a) never do anything or b) activate in time. The fact he had gone 5 years we were very hopeful it was the never do anything.

Having talked about it my husband has said he wants to go back to the surgeon for a discussion & we are going to get a private appointment. Its worth the money for peace of mind. The nurse who rung yesterday stated that on the NHS in our area my husband would not be referred back to the surgeon without 2 more PSA results.

Thank you for the advice. Very much appreciated.

User

Posted 22 Mar 2026 at 14:07

The fact that it is 0.02 rather than 0.2 makes a massive difference.

Firstly, whereas 0.2, if accurate, would mean that there was a high probability of recurrence, 0.02 is a very low figure and on many tests that level of PSA would still come back as "undetectable" because the test does not even measure down to that degree of accuracy.

Secondly, although the test has been done at the same hospital, they must have changed the lab that they use because the previous test in September only measured down to 0.04 and anything below that was recorded as "undetectable". This is very important because it means that at the moment you cannot even be sure that the PSA is going up. The previous test result was "less than 0.04" so the PSA could, for all anybody knows, have already been 0.02 or even 0.03 back then. This would be an example of what Adrian was saying about the meaning of "undetectable" varying according to where the test was done.

So the nurse that you spoke to was probably correct. I know it's no use saying not to worry but hopefully you will at least now worry a bit less.

Best wishes

Kevin

User

Posted 22 Mar 2026 at 21:22

I would ask why the PSA cut off has changed from .04 to something less than 0.02. Something doesn't make sense.

If you are now truly "detectable" you need an opinion from an oncologist now not a surgeon / urologist.

You are right to be concerned about the G5 in your pathology it may require earlier salvage treatment than a lesser Gleason score. The oncologist could advise on this.

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