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Post prostatectomy: What do rising PSA levels mean?
Prostate Cancer | Last Active: Oct 6, 2023 | Replies (172)Comment receiving replies
Kevin, thanks so much for the detailed summary. Looks like you had a great post RP pathology report. Curious, was as there any indication of cancer making it out of the prostate, to the prostate bed or lymph nodes? With the micro-metastatic disease, have you found any data that shows when there are indications to be concerned with post radical prostatectomy? Are pathologists able to see micro-metastatic cells during the post-surgery pathology? I am assuming this is not possible but can't find anything online. I am 56 and had a RP in November 2022 (Gleason 4/3). Pathology was similar to yours - Negative margins, no cancer found in the 7 lymph nodes that were taken, etc... I will have my first post-op PSA check in early March and wanted to educate myself on micro-metastatic disease so that I can include this topic in my list of questions to ask my doctor.
Have a great week,
Jim
Replies to "Kevin, thanks so much for the detailed summary. Looks like you had a great post RP..."
Here's an article which may be of use when talking with your medical teams about micro-metastatic disease- https://www.ajmc.com/view/novel-assay-detects-and-characterizes-even-microscopic-prostate-cancers
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Unfortunately, even with the newer imaging, locating micro-metastatic PCa can be daunting.
A rising PSA is one piece of the clinical data. You can image though obviously at lower PSAs, the probability of locating sites of PCa is less. Generally, bellow .5 around 30%., then . 5-1.0, roughly 60%, of course, the probability rises as your PSA climbs above 1.
For myself and my medical team, we agree to image between .5-1.0 for two reasons:
Greater probability of the imaging locating the recurrence.
Waiting to image then doesn't impact the progression of my PCa in terms of risk of spread that wound change the treatment decision.
There are factors in play, the cost depending on your insurance, deductibles and co-pays and your financial situation.
Sadly, approval by your insurance company if the first one comes back negative, will they or won't they...?