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PSA is .4 ng/ mL 3 years after prostectomy
I had a prostectomy in Feb of 2021. PSA tests have been undetectable < .07 ng/mL) as recently as 7 months ago. Is a test result of .4 ng/mL high and cause for concern ? I have another test scheduled in 2 weeks which will be 30 days after the test result of .4 mg/mL. What would be a high result on that test? If it comes back at only .4 what would that indicate?
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You are correct, the .4 slipped my mind. Time to test and then treat
Sorry you are dealing with this. It is something all of us post-surgery know that we may have to confront.
I’d just like more clarification around this “has been sub 0.07 since surgery”. Are you saying you received values written with a less than sign, for example “< 0.07”, on your PSA test reports? Or, did you receive values with no less than sign that were actual number but were smaller than 0.07, like 0.05 or 0.06 or 0.02 etc?
This is a somewhat important distinction. Additionally, I am not aware of any uPSA test thresholds being < 0.07 (although they may exist). Thanks for the clarification.
Here is what my previous test results were from UC Health which is our main health care system in Denver and all along the Front Range in Colorado.
PSA TOTAL
Collected on March 9, 2024 9:19 AM
Lab tests - Blood (Blood)
Results
PSA Total
View trends
Normal range: below < =4.00 ng/mL
Value
< 0.07
Method: Ortho Vitros Chemiluminescent Immunoassay
Please let me know your thought and suggestions. I very much appreciate your concern and reply.
Thanks for clarifying. Well, the first step is going to be getting a retest, obviously. I’ve seen people on other boards have this happen and then it was a nothing burger because the test was gooned up. Hopefully that’s your case. You had such a dramatic jump that it makes me wonder.
If you have another 0.4, I’d think you would be headed to a PSMA PET scan. At a 0.4 reading, there’s a good chance that’ll light up where the problem is. From there, one would suspect salvage radiation is in your future and a good chance that’s successful knocking it back. Good luck. Hopefully the new test shows nothing.
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I was going to post a response but @manutebol said exactly what I was going to say. My PSA reached .297 3 1/2 years after RP and I had a PSMA-PET scan in January 2022 which detected some cancer where my seminal vesicle had been. That led to Salvage Radiation along with 6 months of ADT. My PSA post SRT has remained at < .008 for 2 1/2 years.
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I'm in the same boat .one lymph node..slowly raise in psa.36 ro said biopsy next week anyone have the same situation with a biopsy
Personally, I would skip the Urologist and get something setup with a Radiation Oncologist immediately. As posted elsewhere, I had my meeting yesterday since my RP in 2016 went from undetectable to .34 to .7. Even without full scans back yet they are recommending Orgovyx and 7.5 weeks of radiation. Anything greater than .2 is considered a Biochemical Recurrence and PSA is being produced somewhere in your body. A Urologist will just refer you out to a RO most likely anyway. Save yourself the time and cost of another visit.
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2 ReactionsJerdeb- this profile is similar to mine . yoru 3+4 Gleason is solid . No 5 Gleason which is very good ! I like also no invasions or extensions and Lymph are all negative . IF it were me , I would push for a PSMA PET scan, and a few more PSA's for data points and velocity checks while waiting . Also , start researching who the best RO in your area is . I would want a consult with him asap. Dont let your URO pick him , as around and see who is considered the "best". Funny/odd how "merit" is always front and centre with Dr's yet DEI is ok for other jobs ? I know , as I am a pilot and we are getting some very strange hires as 1st officers -wow! . But I digress. I think once you consult with a radiation oncologist and have another appointment with your urologist, things will come in into picture. Let us know what he says about the PSMAPET scan. I would be pushing for that. Overall, your PSA number is fairly low, but you would get a good image on the scanner. What part of the country do you live in? I gather you live in the USA? Things are a little bit different here in Canada however, the care is quality. Each hospital here is kind of different. Some are on the ball and some are mixed up and understaffed. It depends who the managers are in the hospital. So take the recommendation of your urologist, but start your research on who the best RO in your area . Keep us in the loop . Your pathology isn't that bad actually , very similar to mine . I am 3+4 as well. About a year after the operation, my PSA never zeroed out so at 0.14 I consulted with a radiation oncologist Inn Victoria. He said the PSA is rising slightly over the last year, so there may be some healthy or cancerous cells left behind probably close to the bladder in the pelvic region. He said I could wait a year and a half and have external beam radiation at that time and he hypothesize that my PSA would be around 0.4 at that point. He said we could attack it early with 22 sessions and no ADT right now and that alternative would probably be more fruitful. Two years ago I did the 22 sessions. Now my PSA has been falling off. Last PSA was 0.041 . quit a bit down from 0.14 in reality . I will continue my prayers for you and provide you my best advice, not being a doctor, but having experienced what you may go through. Ask a lot of questions of your urologist. Prepare your notes and folder ahead of time. Dont worry too much .... keep active ! James on Vancouver Island.
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