1. < Prostate Cancer

Post prostatectomy: What do rising PSA levels mean?

Posted by hoard @hoard, Sep 10, 2019

New to group! Wish I had checked this out 2 years ago while supporting my husband! Now over e years post prostatectomy, wondering what might make psa go from all 0 to 2.6...

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kujhawk1978 | @kujhawk1978 | May 21 7:07am
In reply to @robertmizek "Respectfully my personal experience partially refutes the opinion of your oncologist. My PSA was 0.44 after..." + (show)
@robertmizek

Respectfully my personal experience partially refutes the opinion of your oncologist. My PSA was 0.44 after RP. PET-PSMA clearly showed lymph node involvement. It is my understanding however that cancerous lesions may not show up on a scan if they are less than 10 cm in any direction.

I hope you’re being treated at a center of excellence. If you’re not or don’t have confidence in your own oncologist, I suggest that you consider investigating another care provider. Best wishes for success on your journey.

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Here's one chart, I'll add two others since the software only allows you to upload one at a time
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kujhawk1978 | @kujhawk1978 | May 21 7:08am
In reply to @robertmizek "Respectfully my personal experience partially refutes the opinion of your oncologist. My PSA was 0.44 after..." + (show)
@robertmizek

Respectfully my personal experience partially refutes the opinion of your oncologist. My PSA was 0.44 after RP. PET-PSMA clearly showed lymph node involvement. It is my understanding however that cancerous lesions may not show up on a scan if they are less than 10 cm in any direction.

I hope you’re being treated at a center of excellence. If you’re not or don’t have confidence in your own oncologist, I suggest that you consider investigating another care provider. Best wishes for success on your journey.

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A 2nd one

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kujhawk1978 | @kujhawk1978 | May 21 7:09am
In reply to @robertmizek "Respectfully my personal experience partially refutes the opinion of your oncologist. My PSA was 0.44 after..." + (show)
@robertmizek

Respectfully my personal experience partially refutes the opinion of your oncologist. My PSA was 0.44 after RP. PET-PSMA clearly showed lymph node involvement. It is my understanding however that cancerous lesions may not show up on a scan if they are less than 10 cm in any direction.

I hope you’re being treated at a center of excellence. If you’re not or don’t have confidence in your own oncologist, I suggest that you consider investigating another care provider. Best wishes for success on your journey.

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3td and final
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michaelcharles | @michaelcharles | May 21 8:21am
In reply to @michaelcharles "Challenging to respond w/o practicing medicine w/o a license. My 1st postop PSA was .19. Target..." + (show)
@michaelcharles

Challenging to respond w/o practicing medicine w/o a license.
My 1st postop PSA was .19. Target was < .01.
Referred to Radiation Oncology for salvage treatment of radiation to the prostate bed/floor and pelvic lymph nodes and short-term ADT (see SPPORT trial).
My understanding is that steadily rising PSA (2 or more consecutive tests) and negative PSMA PET scan suggest cancer cells most likely remaining in the pelvic region.
And treatment considered when the PSA rises to or above .2

Good wishes to you.

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Correction: Post RP PSA target < .1
(not < .01)
Following Salvage Treatment Rad Onc ordered Ultrasensative PSA testing and 6 and 9 mos uPSA has been < .02 (Quest Labs limit of detection therefore deemed "undetectable").
Coincidentally, had uPSA blood draw this morning for 3rd post treatment uPSA, now 12 months since Salvage Tx completed May/June 2023.
Best to all.

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robertmizek | @robertmizek | May 21 8:38am

Thanks for sharing the charts. As I have been on this journey with recurrent PCa and as a retired engineer/scientist, I try and read as many relevant publish medical papers as possible. I fully understand and appreciate that a when a scan is done on a patient having lower PSA, the scan may not be sensitive enough to reveal all the lesions present within a patient’s body, especially if the prostate is still present within the body. At any level of PSA, it’s one of the best tools that’s ever been available in helping to diagnose PCa and guide treatment protocol.

Best wishes for success on your personal journey.

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ecurb | @ecurb | May 21 11:36am
In reply to @robertmizek "Respectfully my personal experience partially refutes the opinion of your oncologist. My PSA was 0.44 after..." + (show)
@robertmizek

Respectfully my personal experience partially refutes the opinion of your oncologist. My PSA was 0.44 after RP. PET-PSMA clearly showed lymph node involvement. It is my understanding however that cancerous lesions may not show up on a scan if they are less than 10 cm in any direction.

I hope you’re being treated at a center of excellence. If you’re not or don’t have confidence in your own oncologist, I suggest that you consider investigating another care provider. Best wishes for success on your journey.

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38% chance of detection at .4 PSA per the internet. 87% chance of detection when > 4.0 PSA. Look this up . You got lucky.

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robertmizek | @robertmizek | May 21 1:18pm

I won’t call it luck but I will agree that I’ve been fortunate, even blessed. I’m fortunate that I found great care at Northwestern Medical in Chicago. I’m fortunate that my care team includes some of the most competent and compassionate people I ever hoped to meet. I’m fortunate that they’ve figured out improved ways to detect PCa beyond the 2019 study you cited. I’m fortunate that my known metastasis on recurrence was limited to two pelvic lymph nodes and that I was a candidate for salvage RP after failed focal brachytherapy 2020. I’m fortunate that the cancer that they were unable to reach and remove during salvage RP this January still showed up on the subsequent PET-PSMA scan with only a 0.44 PSA reading and is being used to guide my upcoming salvage RT.

I wish you success on your journey with PCa and hope you wish me the same success.

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Moderator
Colleen Young, Connect Director | @colleenyoung | May 26 4:55pm
In reply to @samadhi "New to group but feel the warmth to part of the community. Age 57, Prostatectomy in..." + (show)
@samadhi

New to group but feel the warmth to part of the community.
Age 57, Prostatectomy in 2020, gleason 3+4, margins were involved on pathology.
PSA levels are as follow
Date PSA
2/28/2020 0.10
4/13/2020 0.10
12/31/2020 0.10
1/6/2021 0.10
3/22/2021 0.10
6/10/2021 0.10
12/18/2021 0.11
8/13/2022 0.14
12/10/2022 0.22
01/07/2023 0.18
02/09/23 0.15
06/10/2023 0.14
11/11/2023 0.17
5/11/2024 0.26
-
PET scan was negative in Jan 2023.
-
I appreciate your input.
Thank You...

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@samadhi, you've received a lot of helpful replies from members. Is your oncologist concerned about the rise in PSA levels? Are you currently taking any treatment or is treatment being discussed at this level?

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