PSA. after surgery.

User

Posted 21 Apr 2021 at 10:59

I had surgery 4 Feb 2021.

Pathology report came back as negative margin. So that was a good start.

My first PSA test done may be a bit too soon was 0.164

Surgeon asked me to do another one 1 month later... ie 13th April. PSA result same .... 0.164

He said not too worry and to do another test in 3 months time. For him the concern would have been if reading was over 0.2.

Has anyone experience the same ?

User

Posted 22 Apr 2021 at 19:53

Sorry - I wouldn't be waiting for another PSA test in 3 months, regardless of what the surgeon or nurse said. If you were my husband or father we would be asking for a referral to oncology right now.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 21 Apr 2021 at 18:44

I'm a bit surprised it is the same right down to the last digit. I think someone has read the same result back to you twice. Have you seen the print out and checked the dates? If you got the result over the phone, it might be worth phoning again and asking them to read both sets of results with the dates back to you.

I'm not saying the chance of getting the same result down to three decimal places is one in a thousand, but I'd willingly bet £20 against £1 that you have been given the same results twice.

Dave

User

Posted 23 Apr 2021 at 22:00

Originally Posted by: Online Community Member

yes exactly that ... with a negative margin First PSA result should be 0 ( zero)... that I why I post this question to see if anyone else had this experience !.

No; no one gets a zero PSA as tiny amounts are made elsewhere in the body - even women can have measurable PSA. But with no prostate, your PSA should be undetectable - depending on the hospital this is usually reported as <0.1 or <0.04 or similar. I think that you have misinterpreted the significance of a negative margin - it doesn’t guarantee that the op was successful.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 27 Apr 2021 at 21:11

I found your thread after searching after a discussion re my most recent PSA test today.

I had my prostate removed in 2018.

I am have been on 6 month tests, my previous one was .03 but the latest one is .1

They are bringing my next PSA test forward to 3 months.

I’m still in the ‘undetectable’ range but worrying a little about the increase nonetheless.

Hopefully the next test won’t show a further increase.

It seems to be a waiting game.

User

Posted 01 Nov 2021 at 18:23

Originally Posted by: Online Community Member

My op was nearly 3 years ago and in that time my psa has risen slowly from undetectable to 0.7. My last test it had dropped to 0.6 which was good news!

My consultant has maintained during this time that he is not too concerned unless my psa jumps more than it has done previously or doubles within a test period (3 months), in which case I would have a petscan to pinpoint the area for treatment!

Viseo, are you saying that your urologist hasn't referred you to an oncologist yet? If so, that is shocking - you should ask for an oncology referral without delay!

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 04 Dec 2021 at 00:12

Originally Posted by: Online Community Member

Phil you are right to be vigilant PSA after prostatectomy should be stable and ideally a "less than". You need to keep an eye on it.

Goforarun, with that 4+3 +margin and 0.1 you should be under an oncologist not a surgeon.

Lyn is stuck in the past re USPSA... Rising PSA after surgery is a red flag that should not be ignored. Certainly don't let your GP tell you 0.1 is "normal"!!

No, I am not stuck in the past; responses like yours encourage hysteria. You know perfectly well that usPSA has been discredited and more & more hospitals are dropping it in favour of 1 decimal place readings. You have no idea whether Phil's GP practice has missed the < sign, whether Phil has missed the <, whether the person typing up the results didn't know that the < was significant, whether he just produces a measurable amount of PSA from elsewhere in his body, when his last vaccine was, whether there is any evidence that the vaccine affects PSA, whether the hospital / GP has changed lab provider, whether lab provider has recalibrated the machines, whether the two samples were processed at different labs or even whether both blood samples were taken at the same time of day.

So at this stage, many possible explanations other than a recurrence

Edited by member 04 Dec 2021 at 00:24 | Reason: Fat fingers

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 17 Feb 2022 at 13:25

Your figures are all basically identical at uspsa levels (assuming you have your decimal points in the right place).

You had a positive margin so that is a concern, I would want to know the G score at the margin location. If it was a 3 then it's less of a worry than a 4.

Either way just keep an eye on it, latest research suggests no benefit from early salvage therapy before 0.1 so try to stop worrying and concentrate on enjoying life.

User

Posted 17 Feb 2022 at 13:49

Franc’s reply is sage advice. You are doing the right thing by monitoring it. You may well find it will stay below a levels where further treatment is advised. The best thing you can do is to know you’re doing all your can right now and try and not think about it too much. Many of us have been in your shoes so understand what you’re going through.

The prostate UK helpline nurses are fabulous so a conversation with them might help put your mind at rest.

Take it easy and all the best

User

Posted 17 Feb 2022 at 22:46

It is good to keep an eye on it, because of the positive margin, but I think you are over-worrying at present - your 21/6/2021 PSA (0.009) could have been 0.0094 and your 7/1/2022 PSA (0.01) could actually have been 0.0095. Generally speaking, if there is a biochemical recurrence due to positive margin, it shows itself within the first two years and your PSA is still 20 times lower than the threshold for BCR.

Also, PSA isn't always completely static - I doubt very much that the 0.006 was a mistake, just a low reading day. Do you always have your blood taken at the same time of day?

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

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User

Posted 21 Apr 2021 at 18:44

I'm not saying the chance of getting the same result down to three decimal places is one in a thousand, but I'd willingly bet £20 against £1 that you have been given the same results twice.

Dave

User

Posted 21 Apr 2021 at 20:02

Yes... that make me think now !...

It was an over the phone result. I will call the nurse in the morning to check it again !....

Will post result asap...

Thanks

User

Posted 22 Apr 2021 at 09:54

Hi Dave.

Well,,,, you lost £20 ....

The nurse confirm that result is correct ... both reading at 0.164

And she said the same...no worry unless it was 0.2

So booked another PSA test in 3 month now.

Anyway , i am curious to know if anyone else as same sort or reading after a Negative Margin result from pathology ?

Cheers.

User

Posted 22 Apr 2021 at 11:34

0.164 is not a great post-prostatectomy PSA reading, and I am afraid that you will likely have adjuvant hormone and radiotherapies to look forward to ☹️.

On a more positive note, I and two friends all had prostate surgery about the same time three years ago, and whilst my PSA was and is still undetectable, they both had recurrence, but following the treatments mentioned above they are both cancer-free now.

Best of luck.

Cheers, John.

Edited by member 22 Apr 2021 at 12:22 | Reason: Not specified

User

Posted 22 Apr 2021 at 17:43

D'oh!!

Oh well, rather than go through all the hassle of sending you £20 I shall just take it to the nearest pub, and hand it to the barman. You can then walk into your local pub order £20 of beer and when he asks for the money just say it's on Dave.

Anyway as Bollinge says, it is not a great result. It does seem to imply that there are some prostate cells lurking somewhere. If you are lucky it will just hold steady for a while, but I think some additional treatment will be required soon.

Dave

User

Posted 22 Apr 2021 at 19:53

Sorry - I wouldn't be waiting for another PSA test in 3 months, regardless of what the surgeon or nurse said. If you were my husband or father we would be asking for a referral to oncology right now.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 23 Apr 2021 at 18:31

I had my op just over 2 years ago, psa was undetectable after 1st psa test but since then it has slowly started to rise - currently gone up to 0.5 recently, so due a MRI scan shortly but I'm not sure if it will detect anything. I think I will opt for RT even though my Oncologist said we could wait until my psa has risen to 1.0 when a PET scan will pick up any areas that need treatment.

User

Posted 23 Apr 2021 at 18:55

Viseoby ... Did the pathology report for you at the time was a Negative Margin ?

This is why I am curious if this happen to others !...

They said that below 0.2 it is not to be consider as a recurrence ! But a bit concern about it.... will ask to do another PSA sooner than 3 months to be sure it is not rising !

User

Posted 23 Apr 2021 at 19:10

No my path report said positive margin with staging of pT2c pN0, although I must admit to being unsure what the difference is between positive or negative margins - I guess it could be if the tumour is or isn't close to breaking out of the prostate but I could well be wrong!

User

Posted 23 Apr 2021 at 20:04

Just checked what positive margins relates to - seems I was wide of the mark, so no wonder my psa is rising after surgery!!

User

Posted 23 Apr 2021 at 21:02

yes exactly that ... with a negative margin First PSA result should be 0 ( zero)... that I why I post this question to see if anyone else had this experience !.

User

Posted 23 Apr 2021 at 21:56

Berni, you can have recurrence with a negative margin - it could have tracked along the seminal vesicles or the nerve bundles that control erections or it could already have reached a nearby lymph node before your op. I have to say though that with a post-op PSA of 0.16 it could be more than just a little bit left behind in the prostate bed. Hopefully the onco will check for micro mets in the bones or spread to the wider lymphatic system.

Edited by member 24 Apr 2021 at 01:39 | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 23 Apr 2021 at 22:00

Originally Posted by: Online Community Member

yes exactly that ... with a negative margin First PSA result should be 0 ( zero)... that I why I post this question to see if anyone else had this experience !.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 23 Apr 2021 at 22:03

Originally Posted by: Online Community Member

Just checked what positive margins relates to - seems I was wide of the mark, so no wonder my psa is rising after surgery!!

Yes, someone should have explained that to you Visoboy. Urologists have to publish their data on how often they leave a positive margin - it means that there is a strong possibility that some cancer has been left behind in the prostate bed. Your PSA confirms that.

The difference between you and Berni is that because you had a positive margin, they can work out fairly reliably where to target the radiotherapy. In Berni’s case they would need to run scans and hope that the active cancer cells show up.

Edited by member 23 Apr 2021 at 22:06 | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 23 Apr 2021 at 22:15

Hi, It is strange to have 2 tests the same result. I had 2 tests within a week at initial diagnosis and they were 0.01 different, the last one lower as I'd been very well behaved I think. It's a very small change granted but after a month I'd think it'd be more than that. If you could go another month unchanged and then another it would look promising.

I'm not sure about this, but the bit left behind doesn't need to be cancerous. 0.164 is about 5% of normal and higher than you'd expect but nothing is certain.

Also whether 0.1 or 0.2 are significant seems to be another rough guideline. I'd be worried if my psa was rising reasonably quickly if it was much less than 0.2. If went up by 0.1 every year I'd be worried but then think I could last 30 years at that rate. Rate of increase is important, and doubling often important.

One thing to note is take the tests at the same place as fractional differences are more likely. I'd be pushing for a test after 1 month and as said above be looking at contingency.

All the best, Peter

p.s. I've just read Lyn's new comments and haven't factored them in. I try to think of the better outcomes although I'm one of the world's worst worriers.

Edited by member 23 Apr 2021 at 22:17 | Reason: Not specified

User

Posted 27 Apr 2021 at 21:11

I found your thread after searching after a discussion re my most recent PSA test today.

I had my prostate removed in 2018.

I am have been on 6 month tests, my previous one was .03 but the latest one is .1

They are bringing my next PSA test forward to 3 months.

I’m still in the ‘undetectable’ range but worrying a little about the increase nonetheless.

Hopefully the next test won’t show a further increase.

It seems to be a waiting game.

User

Posted 27 Apr 2021 at 23:30

Mike, it can't be undetectable and 0.1 so can you confirm? Either it is <0.1 in which case they have just changed the reporting from 2 decimal places to 1 decimal place OR your PSA has risen to 0.1 and is now detectable.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User

Posted 28 Apr 2021 at 02:23

12/03/2021 u/k SERUM

PROSTATE SPECIFIC ANTIGEN 0.10 ug/L ( Comments :

Please note amended age specific thresholds in accordance with the Updated Pan London Suspected Cancer Guidelines. Effective from 05/12/2018

Here’s the latest test. They said it was still classed as undetectable.

Edited by member 28 Apr 2021 at 02:26 | Reason: Not specified

User

Posted 28 Apr 2021 at 08:39

Who are they? 0.1 is not undetectable. <0.1 is undetectable.

With a G9 and a rise of 0.07 over 6 months in the mix I would be asking to see the oncologist now.

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