PSA rising after prostatectomy - Do I have a recurrence?
I had prostate surgery in 2004 with Seminal Vesicle involvement (pT3b). Surgeon recommended adjuvant radiation but my PSA fell to undetectable ,0.01 so I decided to wait. My last two tests were barely detectable 0.01.
Does barely detectable PSA 0.01 indicate a recurrence, and if so, what are my options?
Last edited by prostateguy; 09-20-2011 at 10:41 PM.
Very low levels of PSA can be produced by the penile urethra or by a little bit of benign prostate material left behind. The traditional threshold for a PSA relapse after prostatectomy is 0.20 ng/dl. Modern ultra-sensitive PSA testing can detect continuously rising PSA from a cancer relapse at a lower level. Some doctors use 0.10 and rising as the threshold. Salvage radiation can be an option in that case. One has to weigh the risks of side effects vs. the chances of long remission from salvage radiation. See the 2010 PCRI article "Nine Decisions Before Choosing Radiation Therapy After Prostatectomy" http://www.prostate-cancer.org/pcricms/sites/default/files/PDFs/Is13-2_p8-17.pdf
I am a 46 year-old male. Last year I had no symptoms but asked for initial PSA to get baseline PSA, so that I would have it for when I needed it in the future. To everyone's surprise, it came back as 9.8. Long story short, I had cancer. Rectal exam showed nothing. Biopsy was positive on 6 of 12 cores. Opted for surgery in Sept 2012 -- full removal of prostate. No radiation treatment afterward. Had to sacrifice 40% of one of my nerves at the time. Doctor felt confident cancer was pretty much confined to module. Nothing in Lymph nodes. Pathology report showed Gleason of 7. MY CONCERN NOW IS TREND OF uPSA. My uPSA has been 11/2012: .01; 2/2013: .007; 5/2013: 0.01; 9/2013: 0.026. Doctor has encouraged me to get tested again in 6 weeks. Is there any scientific explanation how how my uPSA could go from .007 -> 0.026 that does not include cancer???
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