Rising PSA years after radical prostatectomy

Hi Michael,
Agreed. Sharing experience and information is so important. It sounds as though you are being treated by a facility considered to be in the 'center of excellence' catagory. Also so important.
My husband has found support groups through the center and they meet through ANCAN fairly often. Excellent shared experience from individuals with the same thing you are experiencing. Both informative and comforting.
It is quite the journey. Staying on top of it and realizing they come up with new ongoing treatments and information all the time is encouraging as well.
Dee

I know that while we still have a prostate, a urinary tract infection (among other things) can cause a rise in psa.

My question is, can a UTI spike psa *after* a radical prostatectomy? I'd think, "probably not", but I can see that it might.

Anyone out there know *definitively *?

8 yrs post Robotic Prostatectomy , clean margins

Hi, PSA rising slowly last few yrs. Highest .20 down to .14 during 2022. Now .24 four months after .14. Going for a repeat as M.D ruling out error. I've been in the hands of my Urologist for these 8 yrs. Researching for a Medical Oncologist. Any suggestions if PSA is accurate? My medical center has an affiliation with MSK in N.Y. Thanks fir any suggestions

Hi @bettwils16, this is a question that several have asked and had answered in the Prostate Cancer group. For that reason I moved your message to this existing discussion:
- Rising PSA years after radical prostatectomy https://connect.mayoclinic.org/discussion/rising-psa-2years-after-radical-prostatectomy/

I did this so you can read the previous posts and connect with others to ask questions.

PSA tests can have fluctuations, so I’m encouraged that your urologist is sending you to be retested to see if the .24 is an anomaly.

You mention that you are looking for a new medical oncologist. Might Mayo Clinic be an option for you?

Absolutely. Where do we even start? Some of the comments say it's hard to get an appointment or they have to wait quite a while. Thank you for contacting us.

I can help you get started with requesting an appointment at Mayo Clinic. Click this link for all the information you’ll need, including FAQs http://mayocl.in/1mtmR63

The first step in to fill out the online form (or call if your prefer) to schedule a discussion with the coordinator. Let me know if you have any questions.

My radiation oncologist is Dr. Choo. Wonderful team. 507.284.9428. Mayo Rochester

Thank you!

As with others, I am not a trained and certified medical person so just my experience.

As you can see from my attached clinical history, I have surgery, SRET and then triplet therapy.

Since switching from the standard PSA which measures to a single decimal point to the ultrasensitive PSA which measures to two decimal places, my PSA has been variable, a high as .36 and as low as .06.

I and my medical team decided not to act on any one reading. If the reading is up from the previous one we schedule a lab and consult two months from that, if it's down, four months. They have no explanation for the variability, that's the art versus science in medicine, I'm ok with "we don't know why...!"

What we do know is we have decision criteria for what we do.

We would need consecutive readings, 34 that showed continuous rise.
We would image when it gets above .5 and continues to rise. Somewhere between .5 and 1.0

Informed by the continuous rise which would indicate doubling and velocity and results from imaging, and any other clinical data, we would make a treatment decision.

You may not be at that point and can continue to actively monitor with labs and consults. Work with your medical team to have decision criteria that would inform any decision to treat and with what.

Here's links to some articles which may be pertinent to your decison making.
https://www.urotoday.com/video-lectures/apccc-2022/video/mediaitem/2646-who-needs-early-salvage-radiotherapy-and-who-needs-adjuvant-radiotherapy-in-2022-kosj-yamoah.html
https://www.urotoday.com/center-of-excellence/imaging-center/video-lectures/video/mediaitem/2566-higher-rates-of-metastatic-disease-on-psma-pet-for-biochemical-recurrence-risk-groups-journal-club-christopher-wallis-zachary-klaassen.html
https://www.urotoday.com/conference-highlights/eau-2021/eau-2021-prostate-cancer/130825-eau-2021-gaps-in-the-evidence-adjuvant-versus-early-salvage-radiotherapy.html
https://www.urotoday.com/conference-highlights/asco-2022/asco-2022-prostate-cancer/137633-asco-2022-salvage-treatment-for-biochemical-recurrence-after-radical-prostatectomy.html
https://www.urotoday.com/conference-highlights/apccc-2022/136843-apccc-2022-who-needs-systemic-treatment-with-salvage-rt.html
https://www.urotoday.com/conference-highlights/apccc-2022/136842-apccc-2022-biochemical-recurrence-after-definitive-radiotherapy-of-the-prostate-what-are-the-local-treatment-options.html
Kevin

Looking for some others experience with this scenario...

Had RP, Gleasons 4+3 (8 of 12 cores)
PSA went down to .039 over the next 6 months, then at 9 was .091

Referred right off to the Radiation Oncologist

My team told me that the ultrasensitive test is not worth retesting as the trend was more important than the actual number at this point. (assuming I understood them correctly, I also have hearing issues)

Have any of you had the experience of such a reading being an anomaly? Maybe poorly calibrated equip or something?

Do most Dr's suggest another test just to be sure? (mine did not)

I'm just curious at this point, I'm 27 radiation treatments as of today.