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PSA six weeks after radical prostatectomy

Posted by dwb1 @dwb1, Feb 29 8:40am

My PSA was 7.75 and MRI showed prostate lesion with extension into left nerve bundle, no other areas affected. I decided to have radical prostatectomy. Gleason score was 4+3=7 with minor tertiary gleason pattern 5. Pathology came back clear of additional spread to surrounding tissue. At my six week follow up my PSA was 9.9 and my urologist stated he had never witnessed in over a thousand cases a PSA being higher six weeks after surgery and ordered another test. One week later it was 10.3. He and the oncologist said they had never seen this before. I am now being scheduled for a PSMA Pet scan. Has anyone experienced a similar outcome or seen a similar case?

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dwb1 | @dwb1 | Mar 16 9:21am
In reply to @hammer101 "dwb1, not sure where you had your initial radical prostatectomy, but would highly recommend using the..." + (show)
@hammer101

dwb1, not sure where you had your initial radical prostatectomy, but would highly recommend using the best possible center of excellence for your second opinion. I was treated at Mayo-Rochester -- Sorry, I don't have any experience with virtual services at this location.

Best of luck with your follow-up treatment!!

Jim

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Thanks Jim. I'm in southwest virginia and not real close to any of the high rated facilities. The virtual route seems to make sense. Both Cleveland and Cedars are top rated and they obtain your records, evaluate them and deliver a written report usually within two weeks. You'd probably be months getting the same results in person.

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dwb1 | @dwb1 | Mar 16 9:30am
In reply to @ozelli "Did you have any symptoms prior to diagnosis such as urinary flow issues, pelvic pain, bloody..." + (show)
@ozelli

Did you have any symptoms prior to diagnosis such as urinary flow issues, pelvic pain, bloody urine, etc. or was it totally out of left field? It does seem to be a very, very unusual result.
Wishing you the best.

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No symptoms at all. My PSA was elevated at my yearly physical and that's what started it all.

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perrychristopher | @perrychristopher | Mar 16 10:58am
In reply to @dwb1 "Had my psma pet scan yesterday. It shows spread to two areas that seem atypical for..." + (show)
@dwb1

Had my psma pet scan yesterday. It shows spread to two areas that seem atypical for prostate cancer.
1. Uptake in multiple retroperitoneal lymph nodes.
2. Nonspecific uptake in hilar mediastinal lymph nodes, metastatic disease cannot be entirely excluded.
I have my follow up with urologist next Wed. These results lead me to a couple questions.
1. Has anyone here received similar results?
2. I want a second opinion. Has anyone used a virtual service like offered by Cleveland Clinic or Cedar Sinai?

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I have not used a virtual service, but this seems like a good idea. You have a lot of data they can review. Also, their second opinion may be useful to an Oncologist you choose for treatment. I'm sure you have a list of questions for your Urologist next week but if you're like me sometimes after getting home and digesting the consult I have further questions. A virtual meeting with a second party would be a good place to ask these new questions in addition to your Urologist. Good luck and I pray your future treatments will be successful.

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1 reply
dwb1 | @dwb1 | Mar 16 2:16pm
In reply to @perrychristopher "I have not used a virtual service, but this seems like a good idea. You have..." + (show)
@perrychristopher

I have not used a virtual service, but this seems like a good idea. You have a lot of data they can review. Also, their second opinion may be useful to an Oncologist you choose for treatment. I'm sure you have a list of questions for your Urologist next week but if you're like me sometimes after getting home and digesting the consult I have further questions. A virtual meeting with a second party would be a good place to ask these new questions in addition to your Urologist. Good luck and I pray your future treatments will be successful.

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Thanks Perry, good feedback

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ron58 | @ron58 | Nov 15 1:14pm
In reply to @dwb1 "Had my psma pet scan yesterday. It shows spread to two areas that seem atypical for..." + (show)
@dwb1

Had my psma pet scan yesterday. It shows spread to two areas that seem atypical for prostate cancer.
1. Uptake in multiple retroperitoneal lymph nodes.
2. Nonspecific uptake in hilar mediastinal lymph nodes, metastatic disease cannot be entirely excluded.
I have my follow up with urologist next Wed. These results lead me to a couple questions.
1. Has anyone here received similar results?
2. I want a second opinion. Has anyone used a virtual service like offered by Cleveland Clinic or Cedar Sinai?

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Hi went to receive my results from my PSMA hoping that I had no more than the 3 small lesions had not grown or increased as to allow targeted radiotherapy. It was not to be as I now have spots to lymph nodes , peritoneum & one rib. My Oncologist was as gobsmacked as I was. Straight on the chemotherapy next week which hopefully buys me some time. Good luck to all who are hit with this horrible disease. First detection was 2013 & after 9 good years my luck has certainly deserted me of late. All the best & keep the faith.

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2 replies
perrychristopher | @perrychristopher | Nov 16 10:53am
In reply to @ron58 "Hi went to receive my results from my PSMA hoping that I had no more than..." + (show)
@ron58

Hi went to receive my results from my PSMA hoping that I had no more than the 3 small lesions had not grown or increased as to allow targeted radiotherapy. It was not to be as I now have spots to lymph nodes , peritoneum & one rib. My Oncologist was as gobsmacked as I was. Straight on the chemotherapy next week which hopefully buys me some time. Good luck to all who are hit with this horrible disease. First detection was 2013 & after 9 good years my luck has certainly deserted me of late. All the best & keep the faith.

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Geez. What lousy news. I've seen plenty of posts on this site with people who have had spread who keep it in check via chemotherapy and other drugs. I wish you the best of luck in your treatment and keep fighting this lousy "C".

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VancouverIslandHiker | @vancouverislandhiker | Nov 17 8:52am
In reply to @ron58 "Hi went to receive my results from my PSMA hoping that I had no more than..." + (show)
@ron58

Hi went to receive my results from my PSMA hoping that I had no more than the 3 small lesions had not grown or increased as to allow targeted radiotherapy. It was not to be as I now have spots to lymph nodes , peritoneum & one rib. My Oncologist was as gobsmacked as I was. Straight on the chemotherapy next week which hopefully buys me some time. Good luck to all who are hit with this horrible disease. First detection was 2013 & after 9 good years my luck has certainly deserted me of late. All the best & keep the faith.

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Ron were you on active surveillance at the time , or had you completed some form of treatments, or had ongoing treatments? You say you had 9 years where things were not an issue ...how you doing now . Keep the faith ... I had a friend similar to this , he is very good now and lives 1/2 the year in SE Asia and is having the time of his life and feels great ! SO Hang in there . James on Vancouver Island .

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1 reply
ron58 | @ron58 | Nov 20 6:52pm
In reply to @vancouverislandhiker "Ron were you on active surveillance at the time , or had you completed some form..." + (show)
@vancouverislandhiker

Ron were you on active surveillance at the time , or had you completed some form of treatments, or had ongoing treatments? You say you had 9 years where things were not an issue ...how you doing now . Keep the faith ... I had a friend similar to this , he is very good now and lives 1/2 the year in SE Asia and is having the time of his life and feels great ! SO Hang in there . James on Vancouver Island .

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Hi James I had 28 or so radiotherapy sessions which held my PSA down near undetectable before my recurrence which eventually led to a salvage prostatectomy that left me with tears to my bladder & bowel. Abiraterone & steroids seemed to work for a while but PSMA reveals the truth. Chemotherapy & Pluvicto seem to be the best options going forward & enjoying the life I have left.

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1 reply
VancouverIslandHiker | @vancouverislandhiker | Nov 21 11:34am
In reply to @ron58 "Hi James I had 28 or so radiotherapy sessions which held my PSA down near undetectable..." + (show)
@ron58

Hi James I had 28 or so radiotherapy sessions which held my PSA down near undetectable before my recurrence which eventually led to a salvage prostatectomy that left me with tears to my bladder & bowel. Abiraterone & steroids seemed to work for a while but PSMA reveals the truth. Chemotherapy & Pluvicto seem to be the best options going forward & enjoying the life I have left.

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Ron , with the advances in PC, things change yearly it seems now... keep positive . With PC we all get some good news with bad it seems. This is a set back , but one can overcome this . You have man many years left , you have to be positive and be proactive . Let us know how you are doing and what is helping ! God Bless. James on Vancouver Island

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1 reply
ron58 | @ron58 | Nov 21 4:01pm
In reply to @vancouverislandhiker "Ron , with the advances in PC, things change yearly it seems now... keep positive ...." + (show)
@vancouverislandhiker

Ron , with the advances in PC, things change yearly it seems now... keep positive . With PC we all get some good news with bad it seems. This is a set back , but one can overcome this . You have man many years left , you have to be positive and be proactive . Let us know how you are doing and what is helping ! God Bless. James on Vancouver Island

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Thanks James. I am certainly living a good life having recently been in your part of the world in Banff & Vancouver as well as South France & Germany so hoping I keep well enough during treatment to see other parts of this beautiful world. Onwards & upwards

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