6 month post surgery PSA

[Jmr11820]

Just had my 6 month post op PSA and the result was .03. This is after a 1 month and 3 month PSA both at .01. I’m concerned this is the star of a trend, anyone have any thoughts or advice. I see my urologist next week to discuss my result. Thanks all, stay safe.

[Magnus1964]

I would not worry about a small increase of 0.01. That could be caused by inflammation or irritation of the prostate. You will want to watch for trends i.e. three rises in a row.

[Jmr11820 in reply to Magnus1964]

Thanks. Thing is I don’t have a prostate. That’s why the concern.

[Magnus1964 in reply to Jmr11820]

I should have said the prostate area. It could happen.

[Jmr11820 in reply to Magnus1964]

Got it. Thanks again.

[Hidden]

So minute. I would tell myself that they got it all and you are cured .. live healthy ... 😎

[Jmr11820 in reply to Hidden]

So minute??

[Jmr11820 in reply to Jmr11820]

So I’ve read that . 03 is a number some use to identify BCR. Others say at such a low range, it’s not yet significant. All I know is I’m pretty bummed out going from .01 to .03 in such a short time. Hoping some of the experts can shed some light.

[Hidden in reply to Jmr11820]

The medical minds here will tell you ... the main thing is not to put stressors on self..next test you’ll know more. Don’t sweat it. Get to living. Peace

[Hidden in reply to Jmr11820]

The amount of change in PSA is very small. It hopefully is nothing. Like Magnus said” don’t worry “..

[Jmr11820 in reply to Hidden]

Thanks. Sound advice. I’ll see what the doc says Wednesday.

[Hidden in reply to Jmr11820]

Please get back to us ? Good luck

[j-o-h-n in reply to Jmr11820]

(my-NOOT) got it? Took a minute to look it up.....

Good Luck, Good Health and Good Humor.

j-o-h-n Friday 04/10/2020 11:58 PM DST

[Jmr11820 in reply to j-o-h-n]

That’s really funny, didn’t even register when I saw m-I-n-u-t-e. No need to look it up, I get it. Thanks for setting me straight on that!

[j-o-h-n in reply to Jmr11820]

You're welcome.... Humor is my hobby...... Your PSA is very low for you to be concerned... Warning: Every time you're scheduled for a PSA test your balls will be in throat until you get the results.....Reminder: Don't swallow...

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 04/11/2020 8:02 PM DST

[Jmr11820 in reply to j-o-h-n]

Very nice! I’m really liking this site and the folks contributing. Many knowledgeable guys here. Thanks!

[Tall_Allen]

It is way too low for concern. If it increases 3 times (3 months apart), or hits 0.1, you might want to talk to a radiation oncologist.

[Jmr11820 in reply to Tall_Allen]

Thanks Allen. In your opinion, since I was .01 the first few months and now .03, do you agree that some type of inflammation could cause that rise as Magnus suggests? Since I had positive margin, that’s enhanced my anxiety. Also at such low levels is that considered a tripling of PSA in clinical terms. Finally, have you heard that .03 is sometimes used as criteria to “define” BCR? Thanks for your insight.

[Tall_Allen in reply to Jmr11820]

It has nothing to do with inflammation. Your uPSA level is VERY low, well within normal fluctuations. PSADT (or tripling) is not valid for uPSA. Our current best info is that there is no reason to see an RO until there have been 3 consecutive raises (every 3 months) or reaching 0.1 ng/ml:

pcnrv.blogspot.com/2019/09/...

[Jmr11820 in reply to Tall_Allen]

Once again... thanks and take care.

[GoBucks]

Did you use the same lab for all 3 tests? I would be more worried about your text test rising.

[Jmr11820 in reply to GoBucks]

Yes. Same lab.

[ron_bucher]

I've had two separate recurrences at low PSA levels after prostatectomy. Most doctors declare BCR has occurred at 0.20.

On my first recurrence in 2007 a year after RP, PSA went to 0.12 then 0.20. Effexor helped control my anxiety and depression that resulted from disappointment in Plan A not being a cure. Salvage radiation of the local area then gave me a 7.5 year remission with minimal side effects.

My 2nd recurrence was in 2016 when PSA went from 0.02 to 0.06. I thought about waiting for the cancer to grow large enough to see on a scan, but felt uneasy giving it a long time to advance to that stage. With doubling approaching six months, and consultation with Mark Scholz in Marina Del Rey, I had more lymph nodes radiated + Taxotere + Lupron. I'm in remission again with "undetectable" PSA. The worst side effects I had were from Lupron. I tolerated the radiation and Taxotere very well with minimal side effects.

"Undetectable" is defined differently from one lab to another, depending on which assay is used for the test. It is important to stick with one lab so you compare apples to apples. Some labs have more fluctuations in their results than others.

Important factors for me included life expectancy (grandparents lived to 80's and parents lived to late 80's), general health (excellent until I met Lupron and gained 20 pounds that seem impossible to shed) and how aggressively my cancer behaved from the beginning. Gleason 3+4 at biopsy, 4+3 at surgery, and two recurrences have convinced me to jump on each recurrence ASAP.

Every case is unique. I try not to offer advice, just my experience and facts I've learned along the way.

[Jmr11820]

Thank you for that. With my high Decipher I’m not going to be too conservative in my plan. I’m relying on my urologist so far for advice. I believe he’s solid and has lots of experience but not an oncologist. Take care.

[JR0912 in reply to Jmr11820]

I had the same issue of PSA rising after RP. When it hit .1 my urologist in Oregon wanted to start radiation but I was experiencing incontinence issues and had heard that radiation could make incontinence worse. I wanted to understand if I could wait to see if my PSA might go back down so I made an appointment with an oncologist in Seattle at the Seattle Cancer Care Alliance. He told me I could wait until I was .5. At .36 I started radiation without hormone therapy and have been undetectable since completing radiation in December 2018.

My incontinence increased after radiation so my urologist recommended sling surgery which I had. It was 85% successful so I now have my life back.

My recommendation after all of this is to follow your urologist's recommendations but know that you want to see a trend instead of one data point. There are also a lot of factors in a PSA change so it may take 4 or 5 PSA tests before you can tell the trend. Hopefully you won't need radiation. Until you know for sure enjoy every day. Good luck!

[j-o-h-n]

Not to worry......... we all had a slight increase..... enjoy your "confined" life.....

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 04/11/2020 12:02 AM DST

[rscic]

I had Surgery May 15, 2019 with RT ending mid Oct. MO said he expected PSA to settle a little higher than my initial post-RT of 0.05 & would not do anything unless it got to 0.1.

[Jmr11820 in reply to rscic]

Thanks for the info. What was your post surgery PSA pattern?

[rscic]

0.03, 0.05, 0.05 next test later this month.

[Horse12888]

There are bodily processes that generate PSA other than cancer. Don't sweat this.

[Hidden]

As long as your PSA remains undetectable, smile and quit worrying yourself to death. Undetectable is defined as <0.1...... a world class researcher in metastatic prostate cancer told me when I queried about uPSA scores and why he did not use them. His response was simple. “They serve to panic those, patients and physicians, who do not have sufficient knowledge about what the numbers mean. In some environments in the academia or research field, yes. But, generally, no.” He went on to ask rhetorically, “What treatment purpose do the uPSA score, serve?’

Me? I am pleased when’re my quarterly tests come back <0.1 or even 0.0.

Gourd Dancer

[HopingForTheBest1]

You should consider genetic testing to identify if you have any mutations that would be treatable via precision medicine.

[Jmr11820 in reply to HopingForTheBest1]

I had a DECIPHER geonomic test but not genetic testing. Did that change your treatment plan?

[HopingForTheBest1 in reply to Jmr11820]

Absolutely. I was found to be BRCA2+. Have since been on Olaparib, a PARP inhibitor. PSA has been undetectable for over a year.

[Jmr11820 in reply to HopingForTheBest1]

Where did you have your genetic testing done?

[HopingForTheBest1 in reply to Jmr11820]

I had two. One from color.com ( uses your saliva), and the other from Foundation Medicine (used sample from removed prostate).

[Jmr11820 in reply to HopingForTheBest1]

Last question... similar results from each test?

[HopingForTheBest1 in reply to Jmr11820]

Both tests confirmed BRCA2+. The Foundation report is much more comprehensive and costly.

[garyi]

What was your Decipher score?

IMHO, and experience, your minuscule PSA reading is cause for rejoicing not concern...but if you must, then obsessing should further increase your inflammation.

[Jmr11820 in reply to garyi]

Decipher score .83

[Bcgkelly]

It’s important to know that different labs have different levels at which they consider that you have a biochemical re-occurrence or not undetectable. The one that does mine says under 0.05 is okay but if I have one PSA above 0.1 or two consecutive tests above 0.05 further treatment is required. Probably radiotherapy. My advice is live for today and don’t worry about it until you need to. It may be a bounce. Time will tell and until then make the most of now.

[Hidden]

Jesus says chill ! This is great news. These could be simple variations . Please get back with what the doctor says ? Give thanks for this good news🙏 Thanks for sharing it . Here we celebrate any good news. A cure is possible for you. Think positive. Be well .

[Jmr11820]

Appreciate those words. On a different issue, what is the current thinking on DECIPHER GRID. I posed this question a few months ago and the consensus was to not use it for clinical decision making. However, seems I continue to seem more studies validate not only DECIPHER but also the GRID. In my case, DECIPHER is high risk and the GRID shows relatively low response to both radiation and ADT. Seeing urologist this week for6 month follow up. Plan was to start RT at 6 months given the high risk DECIPHER, without regard to GRID. I am ready to move forward with a plan but the GRID treatment probabilities give me pause. Welcome any information out there.

[Unasmaneddie]

My three months post-op, in 2013, was 0.5. It then dropped, progressively to 0.03, jumped up a bit, down again several times over. Last check in January this year was 0.14 the highest since 2016. My specialist nurse said, "well, that's still pretty stable"! Relax take it easy, enjoy your life; you can influence that. Don't worry about what you cannot control, such a waste of time, effort and emotion.