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Post RALP PSA - how concerned should I be?

Posted by foreright @foreright, Feb 7 7:19am

Hi all, I just got my fourth PSA results after my RALP last February. Taken three months apart (last one two months), my results were 0.04, 0.05, 0.09 and 0.09. Same Quest lab each time, and same time of day. So naturally my doc and I raised an eyebrow over the jump to 0.09, but having the same result two months later seems promising, even if it is still doubled from baseline. Still under 0.1 is good too, but damn close. My Gleason was 3+4, pre op PSA 4.1, age 55, Decipher 0.9 (ugh) but 4k and Polaris scores were low intermediate. Post op pathology was clear margins, no seminal invasion and clear lymph nodes (6 tested). Thoughts?

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survivor5280 | @survivor5280 | Feb 7 8:26am

I don't know what that means but I'm nearly identical with your data points so I'm curious as to what might be going on in case I run into this in a years time (just completed prostatectomy, age 54, Gleason 3+4, Decipher .7, path clear margins and no seminal invasion and clean lymph nodes).

I'm enjoying the fact that I'm not worse off but know, based a lot on what I've read here, that I might be in for a second bout with this demon in 1-3 years.

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Jerry | @jerryegge | Feb 7 8:45am

My situation is somewhat similar. However, cancer was found in one of eight lymph nodes. I’ve been having my PSA checked every three months for the past three years. It’s at .13. The good news is it hasn’t changed, and I’ve avoided radiation and ADT shots. I feel great and happy for each new day.
My suggestion for you, relax your doing well!

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heavyphil | @heavyphil | Feb 8 9:01am

All you can do is keep testing and see where it goes. It took me 5 yrs to need more treatment, others more than that.
Don’t stress! What will be will be.

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icorps | @icorps | Feb 9 2:36am

I'd let your Doc make the call on any need for future treatment
You're still at a low PSA and the Doc will know when it's time to think about so called salvage radiation therapy. There's lots being published on that lately where they say it's better to initiate it sooner than later. Good luck!

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sbassmeister | @sbassmeister | Feb 10 3:08pm

My post RARP was less than .05 for quite a while. Then it moved to .08 three months later to .12, then to .18. My urologist said once the PSA went over .20 they could find the cancer with a PET Scan. My next PSA was at .25 and ultimately the tumor was found in the bed area where the prostate had been. I had an MRI in November, 2024 to help pinpoint the location and started on Bicalutimide on December 1st and my first Lupron shot on Dec. 6th. I have a CAT Scan on February 20th for final radiation parameters. I will then start 8 weeks of radiation, five days a week at the Buffett Cancer Center in Omaha. My original score was 4+3. After the pathology of my prostate I was graded Stage 3 as the cancer had broken through the prostate capsule. The urologist had removed some local lymph nodes but didn't get all the elusive little cells!

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