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PSA = 0.02 on second post-op test

Posted by anosmic1 @anosmic1, 3 days ago

Since my surgery in November showed me to be Gleason 9 (4+5) with some bladder neck invasion, I have assumed recurrence would happen at some point. I'm 67 and diagnosed 11 months ago. I was undetectable in February but 0.02 in testing this week. I know a PSA of 0.02 doesn't necessarily mean cancer is back but it's not the reassuring sign I was hoping for. Now I have to wait until Wednesday to hear what the doctor has to say. Damn.

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Jerry | @jerryegge | 13 hours ago

Hello, I’m not sure why the period was not included. It’s 0 period 19 Thanks for your support.

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Jerry | @jerryegge | 12 hours ago
In reply to @jeffmarc "Did you Have a prostatectomy? If so, it is recommended that you get treatment when you..." + (show)
@jeffmarc

Did you Have a prostatectomy? If so, it is recommended that you get treatment when you hit .2 and at this point, you may be where you should get treatment now. Check out this information about what happens if you don’t get treatment soon enough.

From Ascopubs about what PSA to do salvage radiation.
≤0.2 ng/mL:
Starting at this level maximizes disease control and long-term survival. Patients treated at PSA < 0.2 ng/mL achieve higher rates of undetectable post-SRT PSA (56-70%) and improved 5-year progression-free survival (62.7-75%).
Delaying SRT beyond PSA ≥0.25 ng/mL increases mortality risk by ~50%.
0.2–0.5 ng/mL:
Still effective, particularly for patients with low-risk features (e.g., Gleason ≤7, slow PSA doubling time). The Journal of Clinical Oncology recommends SRT before PSA exceeds 0.25 ng/mL to preserve curative potential.
0.5–1.0 ng/mL:
Salvage radiation remains beneficial but may require combining with androgen deprivation therapy (ADT) for higher-risk cases.

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Yes, I had a prostatectomy. My Gleason was a 3+4 =7
Cancer was also found in one lymph node.

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1 reply
jeff Marchi | @jeffmarc | 12 hours ago
In reply to @jerryegge "Yes, I had a prostatectomy. My Gleason was a 3+4 =7 Cancer was also found in..." + (show)
@jerryegge

Yes, I had a prostatectomy. My Gleason was a 3+4 =7
Cancer was also found in one lymph node.

Jump to this post

A Gleason 3+4 Is a nice number to start with, But the fact that it had already spread to one lymph node could means that it is in the bloodstream.

Don’t freak out, You still have a very mild case. You could have salvage radiation and it might resolve the problem.

You could see if your doctor would let you get a PSMA PET scan even though your PSA is quite low. Maybe you can find somewhere else that has spread that is not in the area that you would have salvage radiation. Doctor at PCRI conferences say that salvage radiation doesn’t hit the right spot in about 2/3 of the cases and That zapping it with SBRT is a preferred method.

What kind of doctor are you working with? You are now beyond the expertise of a urologist, You should be working with a radiation oncologist to start with and also a Genito Urinary Oncologist To try to guide your treatment. You could wait one more PSA test to see if your PSA continues to rise. If it does, as you can see from the other information I provided, you don’t want to wait too long And allow your PSA to get too high before treatment.

I had a prostatectomy 15 years ago and 3 1/2 years later it came back. I had salvage radiation and two years later it came back, Went on Lupron at that point. I was 4+3 with BRCA2 And I’m still around.

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Jerry | @jerryegge | 2 minutes ago

Thanks for your input. It was really helpful! I’m seeing a local family doctor. I’m also sending my lab results to the Mayo Clinic. They are monitoring this. 😊

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