Just received my PSA results. Fifth (5th) over the last 12 months. The numbers went from <.02 four months after RT to .04 today. I had no further intervention since RT except for exercise and diet. I am trying to figure out the way ahead. Any thoughts??
My numbers:
<.02 (07/22)
<.02 (08/22)
.02 (11/22)
.04 (02/23)
.04 (05/23)
You should feel comfortable watching your PSA. It's only necessary to have salvage radiation if your PSA exceeds 0.1.
hi Allen, what would cause these small rises? Residual prostate tissue? My confusion is why is there psa at all? Thanks in advance
Most prostate cancer is pattern 3, which doesn't have to be treated.
sorry for my poor grammar. I meant to say after a prostatectomy what can cause the sometimes small amounts of residual PSA 0.01-0.05 besides cancer . Mine never got to 0 and two year post op sits between 0.01-0.022 . Could this be residual prostate tissue or just other cells producing psa like material that the ultra sensitive picks up
It's prostate cancer, but most prostate cancer is pattern 3, which doesn't have to be treated.
Thankyou. Could small residual healthy Prostate tissue left behind produce the psa
My pathology shows positive margins, so it’s quite possible
For the third time, it’s prostate cancer.
I understood that the first time when you answered that and sorry but that wasn’t the question I was asking in my last two comments . The question was whether residual healthy prostate tissue left behind can also produce psa .
If you do not want to hear this answer, don’t ask the question.
TA - if it's pattern 3, then it shouldn't have been able to spread outside of the prostate, so do you think it's in the prostate bed?
That's the hope.
Forum guideline - Be kind, respectful, and understanding of one another
listen & have in mind that everyone deals with their own private challenges
This attitude hurts rather than helps us
Sometimes patients are in denial. If you don't understand that it is cancer after 3x, you probably are incapable of understanding. It is NOT benign, although I'm sure you can get some fool to tell you so. There have been studies about this, and it is cancer.
Ill question - simplified answer. Apart from any residual prostate gland there are 3-4 other organs that put out miniscule quantities of PSA. BUT, there is a qualifying distinction between these benign sources and their cancerous counterparts. The latter increase with time, while the former stay within limits. Consequently, it is the PSADT that can shed light into your query, not the PSA.
PS: I once read they trialed an assay that had LoD (Limit of Detection) in the 5th decimal place, claiming it could measure PSA in female blood samples. It didn't get market traction though. With currently popular ultra sensitive assays, LoD to the 2nd or 3rd decimal place, a female blood sample diluted by 10 is considered PSA free.
HiSorry but what is defined as pattetn 3
I am waiting for a PSA test next month, six months after radiotherapy treatment for a small tumour on a lymph node adjacent to mph prostate (brachytherapy treatment was carried out in 2012)
Malcolm
Gleason patterns are only used for the prostate. Prostate tumor tissue sometimes sloughs off and gets caught in nearby lymph nodes. But any cancer found in pelvic lymph nodes is staged as N1, not characterized by Gleason pattern.
Your question: Could small residual healthy Prostate tissue left behind produce the psa. My answer: Unlikely because there should be no “small healthy prostate tissue” left behind. The surgical specimen removed is the prostate and a surgical margin comprised of fat tissue. The surgical specimen microbiology will discover whether prostate cancer was confined in the prostate or confined in the surgical margin or was not confined in the surgical margin. Given there is a rising PSA post surgery it is likely prostate cancer was not confined in the surgical margin.
I don't want to enter the debate, but my surgeon felt that nerve sparing has the possibility to leave behind benign prostate tissue that if it connects to a blood supply can produce a tiny amount of PSA, however, I read statistical reports that suggest there is no clear evidence for that. Just Googling I can't find a definitive study, and really it seems to me it does not matter. Our bodies fight potentially carcinogenic cells every day - it probably doesn't matter if the PSA is from benign cells or canceros cells that are not multiplying at a fast enough rate to push the PSA to a level where further action is required. It's certainly clear that many trained authors of articles don't have a full grasp of statistics, and also that many commentators assume an individual PSA result is accurate to the stated number of d.p.s - better to use that last number to round up or down the number before it, and to look at trends and not just an individual result. .
Does that translate to any Gleason score 6 or less doesn’t need to be treated? (patterns 3 + 3)
Not necessarily:
prostatecancer.news/2017/11...
That is an excellent article. So I’m confused as to why you state pattern 3 never needs to be treated. That seems to imply a person with pattern three will never see progression which isn’t in line with that article. I was Gleason 6 but in my 50’s so I opted to to get treated rather than wait for progression since there is a high chance it would have and that seems to be supported by what I read in the article.
It has to be actively watched, not treated. In the longest running trial of active surveillance in North America, about 60% of low risk men had no progression after 15 years, and the same after 20 years. It seems that if there is no progression in 15 years, it probably will never progress. But 40% did have some progression, so it has to be actively watched.
I see where you’re going now. I don’t like the definitive statement that “low risk” men should not be treated. That should be the decision of the patient weighing other factors. 40% is way too high to hope it never progresses while leaving the cancer in your body. RP seems too extreme in that case but RT is pretty exact these days with minimal side effects which is why I went that route.
What I wrote is "Most prostate cancer is pattern 3, which doesn't have to be treated." That is true.
2.0 above nadir (.2) is when further intervention is recommended. Talk to your Dr.
I was also at 0.04 one year after RP. My experience is that if you see the 0.06 the odds of a BCR are more than 50%.
Can't compare RT and RP. You should and will always have some PSA after RT because you still have a prostate. Not so with RP.
The OP had an RP not an RT. He wrote RT in his post, but RP with positive margins is mentioned in his bio. It would be a world first if he had <0.02 some months after RT.
ah, sorry, didn't read the bio!
The overall slight increase you see is withing the statistical variability of the test. If it continues to rise your Rad Onco will react most likely react as TA suggested.
For now don't worry.
🙂😇
Beware of exercise prior to PSA test! I have proven that this raises you results! Refrain for @72 hours.
Rising PSA
Rising PSA after prostate removal
PSA rises to 0.32 in 18 months 
Rising PSA 1 year after RALP
