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Monitoring PSA post surgery with Gleason 9

Prostate Cancer | Last Active: Apr 12 1:10pm | Replies (18)

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@johndavis60

Thanks @jeffmarc
I guess I’m just concerned about how my doctors will monitor me because it seems to me like I had something undetected going on for maybe years while my psa was around 1, but maybe this thing just developed within 1 year? I don’t know, but I hope psa tests will be accurate for me since I understand that not all aggressive cancer cells express psa. Thanks!

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Replies to "Thanks @jeffmarc I guess I’m just concerned about how my doctors will monitor me because it..."

By aggressive, you may mean small cell or neuroendocrine prostate cancer. It cannot be seen on a PSMA scan. Not only is it hard to see it is hard to treat. The few people I’ve known that have had it aren’t still around.

It is unusual to see neuroendocrine cancer. A very small percentage of prostate cancer patient get it. It is more common if you are on one of the ARSI or ADT drugs for 4+ years, But even in that case after four years there is only a 5% chance of having that happen.

It is possible that some of your cancer cells produce PSA and other don’t.