Post prostatectomy: What do rising PSA levels mean?

Posted by hoard @hoard, Sep 10, 2019

New to group! Wish I had checked this out 2 years ago while supporting my husband! Now over e years post prostatectomy, wondering what might make psa go from all 0 to 2.6…

Interested in more discussions like this? Go to the Prostate Cancer group.

@colleenyoung

Treatment appears to be having the desired effect. :: Thumbs up ::

How are you feeling? How is radiation going?

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Feeling ok. Lower energy level but that’s mainly fm the adt. Radiation progressing nicely

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Had prostate removed 2 1/2 years ago. No cancer beyond prostate. Have had undetectable psa until now. 0.06. Should I have a second blood test? Concern?

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No reason to hit the panic button. You may want to consider having several more USPSA tests 90 days apart to determine if the change is a continuous upward trend or fluctuations. If those tests continue to rise then you may have other decisions to consider with your medical team. You will want to gather clinical data…

The first may be whether to image, when, at what PSA and with what? The PSMA scans recently approved by the FDA can detect at <.5 but as your PSA goes up, so does their detection rate.

If your PSA continues to rise then you can calculate PSDAT and PSAV.

You may want to discus Genomic testing with your medical team.

Informed by clinical data, you and your medical team can make a decision about treatment, whether to and if, when to initiate, with what, for how long, how to monitor response…

In my case, I was diagnosed in Jan 14, had RP in March 14, BCR in Dec 15, SRT in Mar 16 then in Jan 17 did 18 months of ADT, six cycles of taxotere and 25 IMPRT to the PLNs, finished treatment in May 18.

My PSA has fluctuated over the last three years. My medical team and I continue to monitor every 2-4 months and have decision points:

Need three or more tests 90 days apart with continuous rise and calculate PSADT and PSAV.

Image between .5-1.0

Then decide on treatment.

Here's my recent PSA tests:

2018

12 February 2018 Testosterone <7, PSA <.1 (Mayo)
27 April 2018 Testosterone <3, PSA <.1 (SMC)
1 August 2018 Testosterone <3 PSA <.1 (SMC)
30 October 2018 Testosterone 135 PSA <.1 (SMC)

2019

2 February 2019 Testosterone 481, UPSA .36 AHC
16 February 2019 USPSA (AHC) .3
2 April 2019 USPSA KCUC .06
7 June 2019 (USPSA KCUC).124
19 August (USPSA KCUC) .06

2020

3 January 2020 USPSA (KCUC) .07
5 May 2020 USPSA (KCUC) .07
4 August 2020 USPSA (KCUC) .09
5 November 2020 USPSA (KCUC) .16

2021

5 February 20221 USPSA (KCUC) .29
30 April 2021 USPSA (KCUC) .3
12 July 2021 USPA (KCUC) .17

Kevin

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Great information! Thanks

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Colleen young. How do I unsubscribe fm all blogs and highlights. Only want to follow Pc.

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@itterac

Colleen young. How do I unsubscribe fm all blogs and highlights. Only want to follow Pc.

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Interac, according to your settings, you receive an email when someone replies to one of your posts, @mentions you or likes one of your posts. See the section “Activity Involving me” in your profile settings https://connect.mayoclinic.org/member/00-16e793013113d007225419/settings/#ch-tab-navigation

Because you have participated in discussions outside of the Prostate Cancer group, you are receiving notifications in those discussions. To no longer receive those notifications, you can “mute” discussions that you’re no longer interested in. See how to mute a discussion thread in this article https://connect.mayoclinic.org/blog/about-connect/newsfeed-post/am-i-missing-out-where-did-all-the-emails-go/

If you need further assistance, please send me an email using this form: https://connect.mayoclinic.org/contact-a-community-moderator/

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Hi All, I'm new here. I have found reading this forum very informative. I was diagnosed in January 2021 with PSA of 28. Had not had it checked since 2014. Bit of a shock. Short version – had robotic radical prostatectomy in May 2021. T3bNO, Gleason 5/4, 18cc. Pre-surgical PSMA showed seminal vesicle invasion, but no spread anywhere else. Monthly post-surgical PSA results of 0.17,0.12,0.23, 0.24. Recent PSMA post shows undetectable including prostrate bed. Because of high grade pre-surgery, radiologist is recommending 6 months ADT and SRT. Here's my question, I have been fighting incontinence since surgery. I have reduced from 4 cups leakage per day to about 1/2 cup (200g). If measured in "pads", this is 4-5 soaking wet pads down to 3 pads changed for convenience (e.g. after workout, etc.). Any thoughts on postponing SRT to gain more continence. I find that there isn't much talk about continence at support groups and maybe I'm whining to much, but it really is a QoL consideration.

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@jjmack

Hi All, I'm new here. I have found reading this forum very informative. I was diagnosed in January 2021 with PSA of 28. Had not had it checked since 2014. Bit of a shock. Short version – had robotic radical prostatectomy in May 2021. T3bNO, Gleason 5/4, 18cc. Pre-surgical PSMA showed seminal vesicle invasion, but no spread anywhere else. Monthly post-surgical PSA results of 0.17,0.12,0.23, 0.24. Recent PSMA post shows undetectable including prostrate bed. Because of high grade pre-surgery, radiologist is recommending 6 months ADT and SRT. Here's my question, I have been fighting incontinence since surgery. I have reduced from 4 cups leakage per day to about 1/2 cup (200g). If measured in "pads", this is 4-5 soaking wet pads down to 3 pads changed for convenience (e.g. after workout, etc.). Any thoughts on postponing SRT to gain more continence. I find that there isn't much talk about continence at support groups and maybe I'm whining to much, but it really is a QoL consideration.

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Hello @jjmack and welcome to Mayo Clinic Connect. Thank you for joining the discussion and sharing your personal journey with incontinence so that others may as well. Members such as @scullrower and @ch665296f have both shared the same and may have some additional information they can pass to you.

Additionally, you'll find other men talking about this issue in this discussion:
– Does anyone still have leakage? https://connect.mayoclinic.org/discussion/does-anyone-still-have-leakage/

What have you been doing to see the improvements you have to date?

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@kujhawk1978

No reason to hit the panic button. You may want to consider having several more USPSA tests 90 days apart to determine if the change is a continuous upward trend or fluctuations. If those tests continue to rise then you may have other decisions to consider with your medical team. You will want to gather clinical data…

The first may be whether to image, when, at what PSA and with what? The PSMA scans recently approved by the FDA can detect at <.5 but as your PSA goes up, so does their detection rate.

If your PSA continues to rise then you can calculate PSDAT and PSAV.

You may want to discus Genomic testing with your medical team.

Informed by clinical data, you and your medical team can make a decision about treatment, whether to and if, when to initiate, with what, for how long, how to monitor response…

In my case, I was diagnosed in Jan 14, had RP in March 14, BCR in Dec 15, SRT in Mar 16 then in Jan 17 did 18 months of ADT, six cycles of taxotere and 25 IMPRT to the PLNs, finished treatment in May 18.

My PSA has fluctuated over the last three years. My medical team and I continue to monitor every 2-4 months and have decision points:

Need three or more tests 90 days apart with continuous rise and calculate PSADT and PSAV.

Image between .5-1.0

Then decide on treatment.

Here's my recent PSA tests:

2018

12 February 2018 Testosterone <7, PSA <.1 (Mayo)
27 April 2018 Testosterone <3, PSA <.1 (SMC)
1 August 2018 Testosterone <3 PSA <.1 (SMC)
30 October 2018 Testosterone 135 PSA <.1 (SMC)

2019

2 February 2019 Testosterone 481, UPSA .36 AHC
16 February 2019 USPSA (AHC) .3
2 April 2019 USPSA KCUC .06
7 June 2019 (USPSA KCUC).124
19 August (USPSA KCUC) .06

2020

3 January 2020 USPSA (KCUC) .07
5 May 2020 USPSA (KCUC) .07
4 August 2020 USPSA (KCUC) .09
5 November 2020 USPSA (KCUC) .16

2021

5 February 20221 USPSA (KCUC) .29
30 April 2021 USPSA (KCUC) .3
12 July 2021 USPA (KCUC) .17

Kevin

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The same thing happened to me after 9 years — went from undetectable to 0.1. Tested that way repeatedly over the course of 6 months, and then went back to undetectable. So I agree; don't hit the panic button. Just get retested for a while.

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Had robotic removal Mayo Jacksonville Nov 09. Gleason 3+4.
At 3 years psa .04. Gradually up and held about .25 from 5 to 9 years. Last year .45 and know.73. Now age 78. I am in west Tn so long way to Mayo.

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@jic811

Had robotic removal Mayo Jacksonville Nov 09. Gleason 3+4.
At 3 years psa .04. Gradually up and held about .25 from 5 to 9 years. Last year .45 and know.73. Now age 78. I am in west Tn so long way to Mayo.

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Hi @jic811, welcome. Has your local oncologist suggested that further diagnostic testing is necessary at this point?

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@colleenyoung

Hi @jic811, welcome. Has your local oncologist suggested that further diagnostic testing is necessary at this point?

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Thanks. Appt with oncologist at Vanderbilt tomorrow.

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