PSA Persists After RP

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27 Comments

Comment by ronald neff on October 28, 2009 at 5:48pm

oct. 26 psa went from 1.5 to 0.07 see urologist fri. what will be next wait and see if it lowers another 90 days or have treatment

Comment by ronald neff on August 16, 2009 at 9:23am

combine gleason score7 ,with isolated foci of 8
extent of invasion [tmn}73bnxmx
lymph examined n/a
margin 1 mm from ottermost bladder neck inked margin posiitive margin, 1 mm from posterior black inked margin ,positive seminial vexicle sorttissue margins blue ink
extraprostatic extension :yes
seminal vesicle invasion: yes
8o % involved on the right
60% involved on left
there is also pobable lymphovascular invasion section
8 out of 12 cores cancer
psa was 17.6 da vince removal of prostate 4 weeks post psa 1.2 7 weeks latter 2.3 then 36 treatmeant of radiation now waite for next psa see doc july 31 on friday and monday before do psa . worried that ill have to do hormone im tired most of the time and hard to keep mind on my job, four weeks after radiation went from 2.3 to 1.5 .. wait till oct. 30 for another psa test

Comment by E. Michael D. ("Mike") Scott on August 9, 2009 at 7:18pm

Ron: When you take someone's prostate out -- and assuming that you remove all the prostate tissue -- the PSA drops to undetectable within a matter of days because there is no PSA being made and whatever is present in the bloodstream is rapidly metabolized and cannot be replaced.

In contrast, when one is treated with any form of radiation (including HIFU), it takes time for the cells in the prostate to die, and sometimes they are not all killed off. Therefore some PSA often continues to be produced, and the PSA levekl rarely falls to a completely undetectable level. This also explains why biochemical failure following radiatioin therapy is defined using the Phoenix criteria of the nadir PSA + 2 ng/ml as opposed to the criterion used for surgery (which is simply a PSA level > 0.2 ng/ml).

Comment by Ron on August 9, 2009 at 12:28pm

Mike Scott, you said "Your doctor's comment would seem to me to be more accurate with reference to forms of treatment like EBRT, brachytherapy, cryotherapy, and HIFU."

Yes, I had HIFU, why do you think the PSA is usually high after HIFU, and then settles downward? I've seen that in other men.

Comment by Stuart Holland on July 25, 2009 at 11:07am

Have fun on your trip abd think positive. Keep me posted.

Comment by Jerry W on July 25, 2009 at 10:15am

Stuart:

I like your results and am hoping for same. Its been 4 weeks since Lupron injection and side effects have been minimal. With Viagra, still capable. Do have some mood swings (wife says we have 2 of her in the house now! ha!), some insomnia and some fatigue. But I've maintained my exercise program and I think that has helped minimize side effects. I'm still going on my planned week long backpacking trip to Colorado with 19-year old daughter and father-in-law. Can't let this interrupt my fun!

Comment by Stuart Holland on July 24, 2009 at 9:06pm

Most likely the target will be the prostate bed. They hit me with IMRT when my
psa started rising a year after surgery. It has been 5 years in August and has
remained at 0.003.

Comment by turner on July 24, 2009 at 8:49pm

Iam a bit nervous as to what my dr has to say about my 3 month post-op psa of .10 :( I am not looking forward to injections or radiation just yet. Viagra is bringing things back to life(somewhat) &continence just now getting much better. However, i wouldnt want to "freeze things at thier current state. I see him on the 30th and am hoping he will want another test in a month or so before starting radiation,etc. Besides, with a clean path report, wheres the target?

Comment by E. Michael D. ("Mike") Scott on June 17, 2009 at 3:56pm

Well I'm not sure that most surgeons would agree with that. It is perfectly normal for many men to have an effectively undetectable PSA within 3 months after surgery.

Your doctor's comment would seem to me to be more accurate with reference to forms of treatment like EBRT, brachytherapy, cryotherapy, and HIFU.

Comment by Ron on June 17, 2009 at 11:33am

Now I hear from my doc that it actually takes 9 months for the PSA to settle down after any treatment. so any psa test before 9 months should be taken with a grain of salt.

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