PSA at 0.15 - 6 weeks post surgery - Prostate cancer treatment guidelines

User

Posted 18 Apr 2026 at 21:29

Going through a bit of an emotional roller coaster at the moment. PSA result at 6 weeks was 0.15 and was told by oncology nurse specialist that they prefer to be undetectable. When pressed as to what this then meant I was told that the surgeon may request another blood test in a few weeks or wait until 12 weeks. Have my post surgery follow up next week so will also find out about the histology results as from research on the internet this may explain why it is still detectable. We will see. Luckily not long to go. This is my second cancer diagnosis and am asking myself what next. First one was 10 years ago and now starting all over again. I wish I had this chance when playing the lottery.

User

Posted 27 Apr 2026 at 06:32

It happens a lot so don't take it personally, it's an unfortunate fact of life with prostate cancer.

On the positive side your RP was not a waste of time, you would have been unaware of your actual pathology and may have missed an opportunity to hit those remaining cancer cells hard.

User

Posted 27 Apr 2026 at 11:11

Originally Posted by: Online Community Member

Anyone else had this happen to them?

As Andy says prostate diagnosis, PSA tests, scans, biopsies and Gleason scores can still be woefully inaccurate.

I was initially diagnosed Gleason 6 (3+3), low volume, prostate confined, T2a. I was put on active surveillance. My PSA remained steady at about 6. However only 20 months later, when I chased them up for a follow up MRI it showed disease progression and a second biopsy gave me a combination of Gleason scores from 7 (3+4), 7 (4+3), 8 (4+4) to 8 (3+5). It also showed capsular breach. What the hell's going on I thought!

They eventually rounded it up to Gleason 8 (3+5). I believe when there are multiple grades they use the one with the highest which is obviously 5.

Anyway, I ended up having surgery, my final post-op result was T3a, capsular breach, Gleason 9 (4+5).

That was 3 years ago, fortunately since then my PSA has remained undetectable, touchwood. However, I am aware of quite a high chance of recurrence, sometime in the future.

Apparently it is very rare for an ACCURATE Gleason score to progress to a higher grade. It is usually inaccurate biopsies that miss the more cancerous cells.

For such a common and potentially lethal disease it seems ridiculous that the 'tools' to diagnosis it can be so flawed.

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User

Posted 19 Apr 2026 at 06:23

It's not ideal but it is too early to be overly concerned. You will know more after your consultation next week. Regardless of the final pathology you will need to wait a few months to see if this is a blip or something that needs further treatment.

User

Posted 19 Apr 2026 at 08:27

Hello, mate.

Welcome to the forum, you'll get plenty of help and support here.

I sense your disappointment, especially as this the second time you've had a cancer scare.

I'm not medically trained but believe that ideally, a few weeks after a prostatectomy PSA levels should be undetectable, meaning all the cancerous cells have all been removed. Sometimes a few rogue have been left behind this can cause very low detectable PSA levels. Low detectable levels can also be caused be benign prostate tissue left behind or also by PSA circulating in the bloodstream which has been slow to clear the system.

Recently, we had a fella on here with a similar result to yours and his next test came back undetectable.

I've looked at your profile but can't see what your PSA pre-op levels were, your Gleason score, or your cancer staging. These would be useful to know, along with your post op histology, when you get it.

Good luck with your next test and please keep us updated. 👍

Edited by member 19 Apr 2026 at 08:29 | Reason: Typo

User

Posted 26 Apr 2026 at 20:34

I had my follow up with the surgeon and from the histology my Gleason score and grade have been upgraded.

Before surgery

3+4=7 and T2

After surgery

3+5=8 and T3b

They found that the cancer had spread to the seminal vesicles. Now I am trying to understand how in the space of 3 to 4 months I went from localised cancer to locally advanced prostrate cancer and had a radical prostratectomy with all the side effects, wheras the normal treatment would have normally been radiotherapy and hormone therapy. Will have another PSA blood test soon and hopefully the result is non detectable but have already been informed about the possibility for radiotherapy. I hope at the next urologist appoint in a week or two they can explain this.

Anyone else had this happen to them?

User

Posted 26 Apr 2026 at 20:54

Sorry what you're going through.

About 40% of the initial diagnoses are found to be incorrect when the pathology report is done, mostly upgraded. We just aren't good at accurately diagnosing the staging and Gleason. Usually this doesn't matter, but in your case it might do.

Your cancer probably didn't change significantly in 3 to 4 months.

Did the pathology report mention positive or negative margins?

I suspect what they'll want to do is a PSMA PET scan. However, your PSA is still too low for that to have a good chance of finding something, so they might wait until the PSA is 0.2, which will also give an opportunity to see how fast it's changing. Alternatively, given the Gleason 5, they might want to do salvage radiotherapy without waiting.

User

Posted 27 Apr 2026 at 06:32

It happens a lot so don't take it personally, it's an unfortunate fact of life with prostate cancer.

On the positive side your RP was not a waste of time, you would have been unaware of your actual pathology and may have missed an opportunity to hit those remaining cancer cells hard.

User

Posted 27 Apr 2026 at 11:11

Originally Posted by: Online Community Member

Anyone else had this happen to them?

As Andy says prostate diagnosis, PSA tests, scans, biopsies and Gleason scores can still be woefully inaccurate.

They eventually rounded it up to Gleason 8 (3+5). I believe when there are multiple grades they use the one with the highest which is obviously 5.

Anyway, I ended up having surgery, my final post-op result was T3a, capsular breach, Gleason 9 (4+5).

That was 3 years ago, fortunately since then my PSA has remained undetectable, touchwood. However, I am aware of quite a high chance of recurrence, sometime in the future.

Apparently it is very rare for an ACCURATE Gleason score to progress to a higher grade. It is usually inaccurate biopsies that miss the more cancerous cells.

For such a common and potentially lethal disease it seems ridiculous that the 'tools' to diagnosis it can be so flawed.

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PSA at 0.15 - 6 weeks post surgery

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