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Rising PSA years after radical prostatectomy
I am 60 years and I had radical prostatectomy on 23rd Nov 2018. I was told out of the 15 lymph nodes taken only one was affected less than a millimetre. It was Gleason score 7B with PSA around 13 at time of surgery but 11 at time of diagnosis in June 2018.
The PSA been fluctuating between 0.09 and 0.18 since surgery on 23rd November 2018
I have no incontinence as well as Erectile dysfunction. I take hypertension medication – Norvask Amlodipine 5mg daily and Cetirizine 5mg for allergy. Below are some of the test results. I have many of these test results – a few below
Jan 2019: 0.11
April 2019: 0.11
June 2019: 0.09
August 2019: 0.12
December 2019: 0.12
April 2020: 0.12
August 2020: 0.11
October 2020: 0.17
December 2020: 0.15
February 2021: 0.18
I am worried the cancer may be returning or might have spread. I met my doctor today and expressed my concerns. He has agreed to refer me to the hospital where I had the surgery. Any suggestions based on this brief history?
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I think that is may be time to get a new doctor or a new medical plan. You should be able to visit with your doctor face to face and not just text. At the least a video conference that allows you to have a decision. Also, a full body pet scan is a test to see what is going on and where and help to properly determine the best treatment. I think that something is definitely going on in your cancer department and addressing a new small problem before it gets big is best. Best of Luck.
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1 Reactiontypo should be PET
So sorry but what is PED?
<p>Rising PSA years after radical prostatectomy</p><p>Radical Prostatectomy surgery was in July 2020. PSA test results were less than .01 through Feb 2022. Then, Jan 2023 .04, Mar 2023 .05 and Aug 2023 .08</p><p>My Dr said (text message only) my two choices are radiation at the prostate area or wait until I am at .2 and then do a PED</p><p>I thought his response was way too cryptic and I am now searching for more information on my own.</p><p>I am healthy 63 year old male</p>
Hi,
There is so much variability in the world of PSA numbers. Then we try to analyze a lab result to the nearest hundredth. Results can vary from lab to lab, the time of day of the test, what you did yesterday or even the day before. Results from your normal labs do a regular test, not a sensitive one. Therefore their PSA test only reports down to 0. If your level is below that, then it’s reported as undetectable.
Sincere my surgery in Jan. 2022, I’ve been tested every three months with a variety of reports. At 74, I’ve decided to cling loosely to my death, for there-in you find life. Best wishes with you PSA management and health.
I had a CT scan with contrast before the surgery and it found no apparent metatheses. I can't have a MRI because I have a large rod in one leg.
Have you had a scan? MRI? PSMA PET/CT?
I am 81yo and had a radial prostatectomy in September 2018. I have always had low PSA so when mine went from .9 to 2.1 over a 1 year period I wasn't alarmed. During a physical the doctor did a rectal exam and didn't like the feel of my prostate so he ordered a biopsy. It came back with Gleason score 10 and after much deliberation I decided on removal over radiation. They also removed 15 lymph nodes and one tested positive. I have since had about 6-7 PSA blood tests and all show less than .1 which they call undetectable which is the smallest that my hospital lab gives. My point is that PSA has a wide range of variability. I have a friend that has tested PSA in the teens and they are just "watching" him not concerned about cancer.
PSMA Pet scan would probably be something they would want to do
Ejaculation and bike riding will increase one's PSA reading. It is recommended that you avoid both prior to your PSA test. Google and you will find out how many days before to avoid those two activities. Make sure the PSA test is done at the same lab. I would not consider any imaging test yet but would recommend that you have another PSA test, either in 3 months or currently if that will give you peace of mind.