PSA not undetectable!

Posted by psychometric @psychometric, 4 days ago

Welp, made it less than a year after my RARP last June at age 50. God is good, my continence and mood are holding steady, and I'm looking forward to hot flashes and brittle bones. Okay, that last one is a complete lie but I'm still meeting the Meatloaf standard (2 out of 3 ain't bad).

4/13/26 Labcorp ultrasensitive PSA = 0.029
1/23/26 Labcorp (non-ultra) PSA < 0.1
11/25/25 Labcorp (non-ultra) PSA < 0.1
9/22/25 Labcorp (non-ultra) PSA < 0.1

Initial PSA: 6.68
Pathologic Gleason Score: 3 + 4
Grade Group: 2
Biopsy Gleason Score: 3 + 4
Pathologic Stage: pT3bN0M0R0
Positive Margins: No
Cribriform Histology: Yes
Intraductal Histology: No
Number of Lymph Nodes Removed: 15
Number of Positive Lymph Nodes: 0
Unfavorable histology: Present (Less than 10%)
Large cribriform pattern 4: Present
Intraductal carcinoma: Atypical intraductal proliferation, suspicious
Risk Group: High

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Jeff Marchi | @jeffmarc | 4 days ago

It’s good to see how well your PSA is holding up. You do have some aggressive issues, even though you have a 3+4. The large cribriform is a real problem as you know I’m sure. You might want to get a second opinion on your biopsy of the prostate. The intraductal Issue can be really problematic and it isn’t really definitively there, But you might want to get an opinion from a different specialist like Dr. Epstein.. It might be a good idea to find out.

Maybe your PSA won’t go up but with those two issues the Risk Group high Shows that they really do consider the 3+4 Not as important as significant other problems.

bearcat998 | @bearcat998 | 3 days ago

.029 is < .1 So the only change is the type of test. Or am I missing something?

surftohealth88 | @surftohealth88 | 3 days ago

In reply to @bearcat998 ".029 is < .1 So the only change is the type of test. Or am I..." + (show)

@bearcat998

You are not missing anything and you are making a good point.
Since no uPSA was ever done, there is a possibility that PSA was always 0.029 (from the beginning) and in that case this result would not be alarming.

climateguy | @climateguy | 3 days ago

A lot of the reason for the risk group being "high" is that cancer was found outside the prostate. T3a is confined to the prostate, T3b some of it is outside.

Jeff Marchi | @jeffmarc | 3 days ago

I missed that T3b With all the numbers after it. T3b means the vesicles are impacted by this. @climateguy made an important point. Another issue that can lead to reoccurrence.

You never know, though. The surgeon may have removed everything and you could go for years without a problem.

climateguy | @climateguy | 3 days ago

In reply to @jeffmarc "I missed that T3b With all the numbers after it. T3b means the vesicles are impacted..." + (show)

@jeffmarc No positive margins, nothing found in lymph nodes that were removed as a precaution. It sounds pretty good.

psychometric | @psychometric | 1 day ago

I'm going to request monthly tests for a bit to establish a baseline with the ultrasensitive test. Maybe it will hold steady but I would feel a lot more confident if it had been undetectable (< 0.006).

surftohealth88 | @surftohealth88 | 1 day ago

In reply to @psychometric "I'm going to request monthly tests for a bit to establish a baseline with the ultrasensitive..." + (show)

@psychometric
We did monthly uPSA tests (we ordered them ourselves at WalkinLab) and we are glad we did. Now we have proof of steady increase from 0.014 to 0.05 this month. I really hope it is not the case for you 🍀, and it is great chance that it is not. It could be that your PSA value was like that from the beginning and if it is not moving up than it could be that some benign tissue was left behind in prostate bed and is still producing some PSA.