post prostatectomy psa

[GMorz]

Hi all, honoured to be part of this group. I am in Australia . 52 yrs old

History of prostatectomy September 2021. strong family history both father and grandfather died from prostate cancer . Father diagnosed at 61 with gleason 9 but psa low at 1-2 area from memory.

My Pre-op PSA 1.4. Gleason 3 +4. 2 small tumours one 2-3 mm and other 4 mm. Nerve sparing Surgery went well no ongoing side affects . PSA 3 +4 ,margins all clear . , T2 staging but was perineural invasion.

Post surgery PSA journey was - 6 week post surgery 0.013 then 0.010 at 3 months post surgery then 0.014 at 6 months post surgery and yesterday 0.020 1 year post .

I appreciate PSA still low but concerned upward trend of psa. Just interested in everyone’s thoughts especially Tall Allen. Do I just keep monitoring? PMSA pet ( is there insufficient psa volume to likely show anything yet on a psma pet) ? Or do I see radiation oncologist to discuss salvage Radiation ?

Appreciate any guidance or others experiences.

Thank you.

[Tall_Allen]

That's good so far. Hopefully, it will stay there and you will never need salvage treatment:

prostatecancer.news/2021/10...

[GMorz in reply to Tall_Allen]

thanks so much . Does the rise in psa concern you or too unreliable at such low numbers? When would you see RO or have a PMSA pet scan ?

[Tall_Allen in reply to GMorz]

Read the article.

[GMorz in reply to Tall_Allen]

thank you kindly. No super clear . In my case wait until psa 0.1 or sooner. Sorry to waste your time

[santosjr59]

I advice you to have vegetables diet . I had prostatectomy Feb. 5, 2018. Same with you that was progressing .It started .03 , .04, .06 then .07 . I decided to diet for 6 months after that my PSA dived to .02.

[GMorz in reply to santosjr59]

thanks so much. Can you tell me more about your vegetable diet

[London441]

Looking good. I wouldn’t do anything unless it starts moving more than it has. I had very aggressive treatment post RP with a undetectable PSA, but I had the adverse features you didn’t.

Eat all the vegetables you can find, always great for health in addition to any treatments. Just don’t forget your ultimate goal is to die of something else first, probably heart disease -a very long time from now. I’m only half joking.

[Justfor_]

In order to obtain a non-nonsense PSADT you will need min 5, better 6 or more, monotonously rising time samples. You only have 3, either starting from 0.010 or discarding it. Keeping the 3 months sampling period you will get a better perspective in 6 to 9 months. If waiting is not your cup of tea move to 2 or even single monthly PSA testing.

[rscic]

In the USA here. As far as I know, most Doc's will not treat a rising PSA in a patient with Prostatectomy unless it has reached 0.10 or more. Many Doc's would like to see 2 or more readings at this level or higher. There are other areas in the body which make very small amounts of PSA which might account for your variability at a low overall reading. If this trend still concerns you, you might consider asking your Doc how closely PSA can be monitored ..... they might put you on as little as an every 3 mo. regimen. Check with your Medical Oncologist (you should have one of these & not just rely on a Urologist ...... many on this site will agree with this).

[Jmr11820]

Sounds like you’re in a pretty good spot. I had a similar PSA track to you post surgery but with a 4+3 Gleason and positive margin. My doc ordered a DECIPHER test and my results came back as high risk. Given that, we moved pretty quickly with RT. You can ask your surgeon to request a genomic test on your prostate tissue. Having that information might help guide you with any further treatment. I wish you the best!

[Monitoring]

I was on ADT to lower my T level to as close to Zero as possible in order to make my 25-session EBRT more effective. After two three-monthly hormone injections, my T dropped from 95 to 4.5 and my PSA went from 18.6 to <0.02. I am now 20 months since my last hormone injection and 28 months since my last radiation treatment. My T level has returned to 90.

I wanted to know if the cancer was still contained within the cap so asked my rad onc whether I should have a PSMA-PET scan. He told me that this is not done until the PSA reaches 0.2. Right now, I am 0.06, so I will just continue to monitor.

[survivur]

Hi - Have you seen this article ? ncbi.nlm.nih.gov/pmc/articl...

[GMorz in reply to survivur]

thank you. No I had not seen this article. It is really helpful. Thankyou for your kindness.

[survivur in reply to GMorz]

Great - I do agree with the concept of moving toward a more vegetarian diet as expressed above. Dr. Michael Greger (Nutrition facts.org) has short videos which you can subscribe to. Best Regards to you.

[GMorz in reply to survivur]

Thankyou . Will check that out now