I am 1 year post RP psa has been 0.03 yesterday result came back as 0.05.

[Dazstacy]

I have had flue like symptoms for about 3 weeks white cell count was raised at 12 so obviously reacting to infection. My consultant has said give it 2 months and let me get over infection and redo blood's. Should I be as concerned as I am? I am 50yrs old slightly overweight but exercise regularly. I just feel after a year when I had just started relaxing I am looking at more treatment again.

Is it usual for PSA to fluctuate or is this to do with doubling time. Very scared and upset over this so thank you in advance for any light that wjt can shed on this issue.

Thanks

Darren

[LearnAll]

In the setting of an infection, PSA reading can become unreliable. Let your doctor treat your bacterial infection with proper antibiotics and once infection is cleared , get PSA test done again in 2 to 3 weeks.

[Dazstacy in reply to LearnAll]

Thank you. I think I will wait till after Christmas now and try and relax.

[Magnus1964]

That is a very small movement in PSA. You will find these fluctuations all of the time. Watch for trends, 3 rises in a row could be significant.

[Dazstacy in reply to Magnus1964]

Thank you for your reply it is really appreciated.

[Tall_Allen]

Wait for at least 3 consecutive rises. Infection has no effect on PSA post-RP that I know of. What were your pathology results?

[Dazstacy in reply to Tall_Allen]

This is the info from my last letter. From start to 4 months ago.

1. Locally advanced prostate cancer, PSA (11.1.19) 38.6

2. MRI 22.1.19 - enlarged PI RADS 5 lesion, T3a N0 with anterior capsular breach

3. Template biopsy 23.1.19 - 23/24 biopsies, 25/27 cores Gleason adenocarcinoma 4+5, 64%

involvement

4. CT scan 13.1.19 - no metastatic disease

5. Bone scan 30.1.19 - no metastatic disease

6. Commenced LHRH agonist injections end January 2019

7. 6 cycles Docetaxel chemotherapy completed July 2019

8. MRI scan post chemotherapy - excellent radiological response with unrecordable PSA

9. Radical prostatectomy, 23 October 2019, ypT3a N0, Gleason adenocarcinoma 4+5, no

involved margins, 33 lymph nodes, all negative

10. Postoperative nadir PSA unrecordable

Thank you for your reply

[Tall_Allen in reply to Dazstacy]

Well, given the pT3a and the GS9, it would not be unreasonable to start talking to an RO if you have another rise in 3 months.

[leach234 in reply to Tall_Allen]

My thoughts exactly!

[Hidden]

A single PSA rise of 0.02 is nothing to freak out over. Your stressing over basically nothing.

[Dazstacy in reply to Hidden]

Thank you I guess I just needed to hear that.

[addicted2cycling in reply to Dazstacy]

5+5 here and already 1 BioChem so advice is to be cautiously concerned and research for a response if (with) a continued rise.

Just Be Prepared

[Gemlin_]

Detectable PSA is one risk factor for BCR as high Gleason score, positive surgical margin, EPE, PNI. Doctors do a weighted assessment of all risk factors. If this is the only risk factor I would no be worried.

[Dazstacy in reply to Gemlin_]

Hi thank you for your reply. This is my journey so far up to 4 months ago. Hopefully this is nothing to worry about.

1. Locally advanced prostate cancer, PSA (11.1.19) 38.6

2. MRI 22.1.19 - enlarged PI RADS 5 lesion, T3a N0 with anterior capsular breach

3. Template biopsy 23.1.19 - 23/24 biopsies, 25/27 cores Gleason adenocarcinoma 4+5, 64%

involvement

4. CT scan 13.1.19 - no metastatic disease

5. Bone scan 30.1.19 - no metastatic disease

6. Commenced LHRH agonist injections end January 2019

7. 6 cycles Docetaxel chemotherapy completed July 2019

8. MRI scan post chemotherapy - excellent radiological response with unrecordable PSA

9. Radical prostatectomy, 23 October 2019, ypT3a N0, Gleason adenocarcinoma 4+5, no

involved margins, 33 lymph nodes, all negative

10. Postoperative nadir PSA unrecordable

Thanks again.

[Dazstacy]

Thank you. I have tried to look through your posts but not easy on my phone as not sure what it is titled. Search doesn't seem to help too much.

Thanks.

[Justfor_]

Doctors are very apt in establishing ill defined rules. Take for example this 3 consecutive rises. Without defining the sampling period, it is just pure nonsense. I am GS 9 and pT3b and for this taking monthly tests. Although my PSA is slowly rising (8-9 months doubling time) I get three identical values (courtesy of the rounding error) before visiting the next reported level (currently 0.06). But, due to my frequent testing, I have visited all values from 0.02 to 0.06, so I know it is is steadily rising and not fluctuating. Just hoping that it will plateau somewhere around 0.1, but at the same time planning my next steps. I am an engineer and appreciate numbers a lot different than doctors. Take for example the 5 nines of the telco industry. They stand for the availability of their services to be superior to 99.999%. On the medical front a 90-94.5% for the new COVID vaccines is deemed fantastic. Two different worlds!

[Ralph1966]

You need monthly checkup of PSA level. If there is a 3 consequently rise then you will need Salvage Radiation as most of us did. SRT is best to start before your PSA pass over 0.2

[dhccpa]

After readings of 0.7-0.9 for 18 months after starting Lupron, my PSA rose to 1.3 and 1.4 in May and June, then dropped to 0.8 and then 0.7 in August, September, and October.

[Steve507]

I'd seriously consider additional treatment sooner than later with your unfavorable pathology.

I know of no one whose PSA comes down without treatment. Seen no evidence.

Did your PSA ever get to 0.01?

[j-o-h-n]

Greetings Dazstacy

Please tell us your bio. Age? Location? Treatment(s)? Treatment center(s)? Scores Psa/Gleason? Medications? Doctor's name(s)? Thank You!!!

All info is voluntary, but it helps us help you and helps us too. If you do respond copy and paste it in your home page for your use and for other members’ reference.

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 11/19/2020 5:31 PM EST