Increase in PSA 12 years after prostatectomy.

Posted by guitar1468 @guitar1468, 2 days ago

Prostatectomy was performed 15 years ago. 3 years ago PSA was .1 and last year it was .14. This year it is .44. My oncologist, which I respect, said we are in a monitoring phase. If my PSA has gone up more after my May 2026 PSA test, a scan may be warranted.
Is this a correct plan for post prostatectomy treatment?

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guitar1468 | @guitar1468 | 1 day ago

Very helpful! Sound advice! Thank you!!🙏

ozelli | @ozelli | 1 day ago

In reply to @guitar1468 "@ozelli prostate in mid 60s and now 78! Does that make a difference?" + (show)

@guitar1468
Of course it does, you are still young.
It is a long time for your PSA to be undetectable so that would hopefully indicate that it is not a particularly aggressive variant. Maybe that is your doc’s reasoning…..

oskarpr | @oskarpr | 16 hours ago

Questions:
How was your pathology report after surgery
Glenson score?
Do you had positive margins?
I have my surgery a year ago, curious to know what other experience long after surgery.
Good luck and Good health to you on your journey 🙏🏻

rlpostrp | @rlpostrp | 14 hours ago

Your most current .44 ng/ml PSA is approximately "300%" higher than previous PSA's. Granted, it is not even at "1.0 ng/ml", but I wonder why these urologists "wait"? Maybe at that level, a PET Scan won't show enough focal presence of where the cancer is growing.
As a separate thought, I am really pissed off that my urologist, and likely many of everyone else's, say: "Radical Prostatectomy is 100% curative for prostate cancer", when they know FOR A FACT that it isn't. If it was, then this blog would not exist. Excluding those writing here that they are just starting the process, we all have "post-RP sequelae." The unlucky 10-20% like me end up with "surgical margins" which means my urologist left cancerous tissue in my body, and chose to close me up instead of having a pathologist standing-by ready in the lab to do a frozen section of my prostate to tell my urologist to "keep cutting" while I was still under anesthesia on the table. A lot, like me, end up with Cribriform glands...a rather more ominous sign of patterned tissue pathology that does not bode well for our future. It goes on and on. If any of you reading this happen to be urologists, please STOP telling us that RP is 100% curative, or...add the caveat: "...if everything goes well."

surftohealth88 | @surftohealth88 | 9 hours ago

In reply to @rlpostrp "Your most current .44 ng/ml PSA is approximately "300%" higher than previous PSA's. Granted, it is..." + (show)

@rlpostrp

It is curative if it is caught early enough and surgery done correctly.
Those lucky people have better things to do than dwell here with us on this forum ;).

Biopsy and PSMA can not see everything - surgeons can only go by what is seen with those tests. Now- positive surgical margins are another story. They do not happen often and yes, in ideal world surgeons would have pathologist exam every slice but it is rarely done, unfortunately. *sigh

We did not have ideal scenario happening either, but my husband is still extremely happy that he took such aggressive cancer out (cribrifom and IDC).