Connect
← Return to Post Prostatectomy 6 years. PSA <.01 until now. Anyone else?
Discussion
Post Prostatectomy 6 years. PSA <.01 until now. Anyone else?
Prostate Cancer | Last Active: 44 minutes ago | Replies (81)Comment receiving replies
@diverjer Not really a stupid question at all.
Pathology after my RARP showed I had a positive margin, and Prolaris Score indicated at 53% chance of a BCR in ten years. Gleason was 3+4.
At eight years after my surgery, my urologist detected a small nodule in my prostate fossa during a routine DRE, but my PSA was still undetectable (<0.1). So no further action at the time. Two years later, my PSA rose to 0.11. A PSMA PET scan was performed and the nodule lit up with a SUVmax of 13.3. A pelvic MRI further indicated that the nodule was a cancersous lesion. At that point, I was diagnosed with a local recurrence and treated with radiation therapy.
If not for the DRE, I suspect that the PET scan would not have been performed, and I would be on active surveillance at most. Instead, the palpable nodule set things in motion and I got a jump start on treating the relapse.
In my case, a DRE gave the first indication of a local relapse, two years before PSA did.
Replies to "@diverjer Not really a stupid question at all. Pathology after my RARP showed I had a..."
@melvinw I just looked at an article on Google regarding DRE UCSF. They said again, it is extrememly rare for any DRE to be positive if PSA is below .1 That is why I have never had one post prostatectomy. They just believe it is too rare for it to be necessary. They have never required any in person follow up whatsoever (in 6 years). Just follow the uPSA and do the occasional Zoom call. I wonder if MAYO does routine follow ups with DRE? Maybe Coleen would know.
@melvinw
Thanks, I had to look up fossa, which just seems to be the empty space prostate was at. Then another surprise was they did anything with PSA of just .11. I thought they ignored anything less than .2 PSA. I guess it was the combination of the two (PSA and DRE) that made them check further. Sounds like a good idea and glad they found yours earlier than just waiting on a PSA to get to .2.
Connect
@melvinw What is interesting is; all the data I have read and including a written email from UCSF states "With a negative PSA there is absolutely no chance of prostate cancer being active". Yours' is the third I have seen lately indicating a DRE can show active cancer. This (to me) is amazing news. Why is the medical community (especially the UC syetem) not more proactive in this?