PSA detectable 18 mos after prostatectomy

Been there, done that...

a .14 sounds like an USPSA test.

With USPSA, measuring to two decimals, there is not, at least that I have found, a commonly agreed upon definition of BCR.

With the standard tests, to single decimal, the generally agreed upon definition of BCR is two or more consecutive increases where PSA it .2, then .3, spaced several months apart. As others have said, use the same lab and generally try and follow the same routine prior to the draw.

Going back to my high school math, if your husband's PSA was a single decimal one, rounding off would be to .1 (< .5, round down,,,)and likely you two would be saying to your medical team, "see you in...!"

As others have said, what you and your medical team look for are trends. A single data point with PSA shouldn't constitute clinical data sufficient for a treatment decision. Discuss with your medical team about when to have another PSA test, one, two, three months...whatever you decide, you'll have another decision when that comes:

If it increases again, what do you do? The urge will be to act and do something. But, then the question of imaging comes in, do you into image then or wait until it increases say to .5-1.0 where imaging such as Plarufy (not C11 Choline or Aximun!) statistically has a better chance of locating any recurrence. If you decide that, you may have more clinical data to make an informed decision on any treatment, likely doublet or triplet therapy.

Take some time to do your homework, read the NCCN guidelines, do a literature search on doublet or triplet therapy. That will inform you and may guide your discussion with your medical team.

This may also be the time to bring a radiologist and oncologist onboard if you have not already done so. If so, they should have a focus on treating prostate cancer!

I've attached my clinical history. As you can see, 15 months after a very successful surgery my urologist hesitated after looking at his screen and my PSA results. You can also see that when my urologist switch to USPSA test, it went from undetectable to .36, then went down, later it went up, then back down. Finally in late 2022 and early 2023, it went up and up...That's when we decided to treat again, not the previous two ups and downs.

You don't give his pathology report, GS, ECE, SVN % of prostate involvement, Margins...so the forum doesn't know his risk category. Certainly if he has BCR at 18 months, that is a high risk factor.

It's frightening, I know. I think the good news is the revolution in treatment and management of advanced prostate cancer, and more is in the research pipeline. That means a dizzying array of treatment choices though!

Kevin

GS 3+4=7 (lesst han 5% grade 4)
T2
ECE neg
SV neg
Margins neg

Thanx, that's a "good" pathology report.

Like mine, only my GS was 4+4...

the 3+4 puts him in the zone of Grade Groups 2, intermediate risk.

If he does have a BCR based on additional PSA testing, the less than three years to BCR, that may move into the the high risk group.

Kevin

Thanx, that's a "good" pathology report.

Like mine, only my GS was 4+4...

the 3+4 puts him in the zone of Grade Groups 2, intermediate risk.

If he does have a BCR based on additional PSA testing, the less than three years to BCR, that may move into the the high risk group.

Kevin

Isn’t BCR defined as >.20? So he’s not there yet?
Median time to BCR ranges from 20 to 38 months (15, 19). Although BCR occurs more often in first 3 years from RP, longer follow-ups are required whereas a considerable number of patients may recur even after 15 years (20, 21).

Biochemical recurrence after radical prostatectomy - NCBI

Is it possible for psa to stabilize or go down?

Been there, done that...

a .14 sounds like an USPSA test.

With USPSA, measuring to two decimals, there is not, at least that I have found, a commonly agreed upon definition of BCR.

With the standard tests, to single decimal, the generally agreed upon definition of BCR is two or more consecutive increases where PSA it .2, then .3, spaced several months apart. As others have said, use the same lab and generally try and follow the same routine prior to the draw.

Going back to my high school math, if your husband's PSA was a single decimal one, rounding off would be to .1 (< .5, round down,,,)and likely you two would be saying to your medical team, "see you in...!"

As others have said, what you and your medical team look for are trends. A single data point with PSA shouldn't constitute clinical data sufficient for a treatment decision. Discuss with your medical team about when to have another PSA test, one, two, three months...whatever you decide, you'll have another decision when that comes:

If it increases again, what do you do? The urge will be to act and do something. But, then the question of imaging comes in, do you into image then or wait until it increases say to .5-1.0 where imaging such as Plarufy (not C11 Choline or Aximun!) statistically has a better chance of locating any recurrence. If you decide that, you may have more clinical data to make an informed decision on any treatment, likely doublet or triplet therapy.

Take some time to do your homework, read the NCCN guidelines, do a literature search on doublet or triplet therapy. That will inform you and may guide your discussion with your medical team.

This may also be the time to bring a radiologist and oncologist onboard if you have not already done so. If so, they should have a focus on treating prostate cancer!

I've attached my clinical history. As you can see, 15 months after a very successful surgery my urologist hesitated after looking at his screen and my PSA results. You can also see that when my urologist switch to USPSA test, it went from undetectable to .36, then went down, later it went up, then back down. Finally in late 2022 and early 2023, it went up and up...That's when we decided to treat again, not the previous two ups and downs.

You don't give his pathology report, GS, ECE, SVN % of prostate involvement, Margins...so the forum doesn't know his risk category. Certainly if he has BCR at 18 months, that is a high risk factor.

It's frightening, I know. I think the good news is the revolution in treatment and management of advanced prostate cancer, and more is in the research pipeline. That means a dizzying array of treatment choices though!

Kevin

Hello Group:

I had Robotic Prostate Surgery Aug. 2, 2022. Had 5 PSA tests since surgery. Here are the levels 0.06; 0.11; 0.12; 0.13; 0.13. Met with Radiation Oncologist last week after last PSA test and he recommended that I have another PSA test in April. He said he follows the American Guidlines that which indicates radiation from 0.18 to 0.23. Has anyone experienced rising PSA post surgery and if so, what were the next steps?