Hello

[alfredoghi1]

After five weeks of my prostatectomy my psa is 0.05

I m steal with diapers,is comun

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Hi. Five weeks after surgery, having a PSA test seems a bit premature to me. Despite having your prostate removed there may still be some PSA in your system. I had my first post op PSA test after 3 months. It was zero then. Furthermore, it is possible that some prostate cells were left behind and these don't necessarily have to be cancerous. Presumably, you will be having it checked at 3 months, then every 3 months at first. If your next PSA is higher than now, you may want to worry then.

As I wrote, my PSA was zero after 3 months, stayed that way for a year then reappeared at one year. I am now 6 years after surgery PSA 0.07.

What is also significant is the histology report. You should be told if the cancer cells in the tissue that was removed went up to the edges of the tissue and hence beyond, this called positive margin. If they didn't - negative margin, they got it all.

Also, not surprised you're still using pads. More significant is how long it is since you had the catheter removed. Hope you are doing the exercises. You don't say how many pads you need in a day. You should find that the number may gradually diminish.

I understand it's all quite worrying, but you shouldn't be too worried just yet.

In the worst scenario, if cancer cells are still left then you can have salvage radiotherapy and can still possibly be cured. If incontinence persists there is a surgical remedy. So you have a plan B, if plan A hasn't worked.

Good luck

[Paulo1968]

Hi alfredoghi1,

I had surgery early April and 2 weeks ago (3 months after surgery) my PSA was 0,04. I had hoped for a lower level, but my doctor told me this was good.

The surgery report said everything was clean - lymph nodes, seminal vesicles, all around. It was a PT2, so confined "thing", but I had a 1 mm positive margin in the right side of the apex where the nerves were spared. This didn't leave me very happy but my doctor also said that according to a swedish study till 3 mm it is ststistical similar as no margins. Of course I am not entirely reassured, but I need to be confident of my doctors experience and wait for next PSA test in October.

Easier saying, but try not to worry and move on with next step as I also try to do.

About continence, I am almost almost 100% there. 1 month after surgery I felt awful about it as I leaked in the afternoons and nights. Never used more than a pad though and never needed diapers... So on the way to the 2nd month I started improving significanlly till now. Now I have most of the days zero leakages and I had already some days (4 today) that I dared not to wear any pad and I am fine. So you have to be a bit patient still.

Keep doing the kegel exercises while walking and walk a lot. For me they worked.

Good luck with yoru recovery,

Paulo

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Hi, I'm just curious about your PSA level. I thought PSA was measured in ng/m, i.e. nanograms per millilitre both in UK and US. The most sensitive test for PSA I'm aware of cannot detect anything less than 0.01 ng/mL. Where the test fails to detect any PSA it's reported as <0.0 1 or "undetectable".

So I'm curious to know where you got the number 0.0015 from and percent of what?

PSA after prostatectomy is normally undetectable after 3 to six months. It is unusual for it to be detectable after that. In the rare cases where it is detectable then there must be some prostate cells left in the body as only prostate cells produce the antigen, i.e. prostate specific antigen. They aren't necessarily cancer cells however.

A PSA of 0.04 after 3 months is good, if it subsequently goes down (preferably to <0.01) great. If it stays the same OK, but it does mean there are still cells there.

General rules are, if it starts rising and doubles in less than 10 months OR it rises on three consecutive tests, 6 weeks apart it is concerning. If it reaches 0.2 this is usually accepted as a biochemical recurrence and may mean further treatment.

Sorry, I have no idea what these figures will be in percentages.