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PSA six weeks after radical prostatectomy

Posted by dwb1 @dwb1, Feb 29 8:40am

My PSA was 7.75 and MRI showed prostate lesion with extension into left nerve bundle, no other areas affected. I decided to have radical prostatectomy. Gleason score was 4+3=7 with minor tertiary gleason pattern 5. Pathology came back clear of additional spread to surrounding tissue. At my six week follow up my PSA was 9.9 and my urologist stated he had never witnessed in over a thousand cases a PSA being higher six weeks after surgery and ordered another test. One week later it was 10.3. He and the oncologist said they had never seen this before. I am now being scheduled for a PSMA Pet scan. Has anyone experienced a similar outcome or seen a similar case?

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dwb1 | @dwb1 | Mar 16 9:21am
In reply to @hammer101 "dwb1, not sure where you had your initial radical prostatectomy, but would highly recommend using the..." + (show)
@hammer101

dwb1, not sure where you had your initial radical prostatectomy, but would highly recommend using the best possible center of excellence for your second opinion. I was treated at Mayo-Rochester -- Sorry, I don't have any experience with virtual services at this location.

Best of luck with your follow-up treatment!!

Jim

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Thanks Jim. I'm in southwest virginia and not real close to any of the high rated facilities. The virtual route seems to make sense. Both Cleveland and Cedars are top rated and they obtain your records, evaluate them and deliver a written report usually within two weeks. You'd probably be months getting the same results in person.

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dwb1 | @dwb1 | Mar 16 9:30am
In reply to @ozelli "Did you have any symptoms prior to diagnosis such as urinary flow issues, pelvic pain, bloody..." + (show)
@ozelli

Did you have any symptoms prior to diagnosis such as urinary flow issues, pelvic pain, bloody urine, etc. or was it totally out of left field? It does seem to be a very, very unusual result.
Wishing you the best.

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No symptoms at all. My PSA was elevated at my yearly physical and that's what started it all.

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perrychristopher | @perrychristopher | Mar 16 10:58am
In reply to @dwb1 "Had my psma pet scan yesterday. It shows spread to two areas that seem atypical for..." + (show)
@dwb1

Had my psma pet scan yesterday. It shows spread to two areas that seem atypical for prostate cancer.
1. Uptake in multiple retroperitoneal lymph nodes.
2. Nonspecific uptake in hilar mediastinal lymph nodes, metastatic disease cannot be entirely excluded.
I have my follow up with urologist next Wed. These results lead me to a couple questions.
1. Has anyone here received similar results?
2. I want a second opinion. Has anyone used a virtual service like offered by Cleveland Clinic or Cedar Sinai?

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I have not used a virtual service, but this seems like a good idea. You have a lot of data they can review. Also, their second opinion may be useful to an Oncologist you choose for treatment. I'm sure you have a list of questions for your Urologist next week but if you're like me sometimes after getting home and digesting the consult I have further questions. A virtual meeting with a second party would be a good place to ask these new questions in addition to your Urologist. Good luck and I pray your future treatments will be successful.

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dwb1 | @dwb1 | Mar 16 2:16pm
In reply to @perrychristopher "I have not used a virtual service, but this seems like a good idea. You have..." + (show)
@perrychristopher

I have not used a virtual service, but this seems like a good idea. You have a lot of data they can review. Also, their second opinion may be useful to an Oncologist you choose for treatment. I'm sure you have a list of questions for your Urologist next week but if you're like me sometimes after getting home and digesting the consult I have further questions. A virtual meeting with a second party would be a good place to ask these new questions in addition to your Urologist. Good luck and I pray your future treatments will be successful.

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Thanks Perry, good feedback

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