HealingWell
Search Close Search
☰

Failed Operation?

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 7/8/2014 5:59 PM (GMT -5)
I had a radical prostatectomy with the Da Vinci robot in early February of this year. So far I have taken three PSA tests at 4, 8, and 12 weeks which scored: 0.1 > 0.1 > 0.2. From what I have seen on this site, this is not encouraging and is far wide of the zero "cure" that I was seeking with the operation. My prostate was extremely large, about 120 g which is about three times normal size. (The record at the hospital was 200 g.)

My doctor says that some "benign tissue" may have been left behind due to the difficulty in removal of such a large prostate and he wants to see if my PSA will stabilize. I will take another PSA test in September, but I am not hopeful that the PSA will go down. If it goes up, I am fairly certain that I will be facing SRT early in the fall.

I do not regret the surgery. In fact, the doctors would not recommend radiation for initial treatment due to the size of the gland. Now, I hope, the radiation may stomp the bandit for good.

Has anyone else out there experienced the "giant prostate" phenomenon and its complications?
Posted 7/8/2014 7:15 PM (GMT -5)
Hi Yank, - I need some clarification. In your Post and Signature you indicate that your post-surgery PSA tests have been 0.1, 0.1 and 0.2 but since you you use the "greater than" icon (>) as a separator, , it is a little confusing. Are you sure that these are actual readings or may they perhaps have a "less than" icon (<) in front of the numeric designation?

Since you are apparently using the Standard PSA assay which only provides results to the tenth of a nanogram, the presence of the < designation would indicate that it is the lowest reading reading possible with the assay employed, and is considered "undetectable". In verbal conversation this can often be addressed numerically, without acknowledging the "less than" symbol that is so important in such results if it is present.

Do you have printed copies of your PSA results? If you do not, I would suggest you obtain them now and in the future to avoid such potential confusion in communication.
This is particularly important at the levels you cite, since there is at least one PSA assay whose reliability threshold is 0.2 ng/ml. The size of your prostate should be accurately identified in the post-surgical Pathology Report, which you should also obtain, if you have not already.

If these readings do not have the < icon preceding the numbers, they are actual readings and could, potentially, indicate possible treatment failure and I would suggest that a subsequent monitoring PSA in September should help clarify whether there is an upward trend or stabilization present. Close monitoring is highly recommended. Good luck! - John@newPCa.org (aka) az4peaks
Posted 7/8/2014 8:21 PM (GMT -5)
Yank, I feel like a runner-up. My uro had my prostate ranked at 197 grams. It was removed in January of 2010 by the Da Vinci method. I had no out-of-the-ordinary things to deal with after surgery and since its removal, my PSA has been reported as 0.00 at each check so I can't ask for anything better than that.
Posted 7/8/2014 8:51 PM (GMT -5)
I'm pretty sure those greater than (>) signs were used to indicate a time progression, with the first result at 0.1, then another 0.1, and the third at 0.2.
Posted 7/8/2014 10:25 PM (GMT -5)
Sorry, sorry, gentlemen, for the confusion. "dmlvt" guessed correctly. In my post, if you replace the ">" with "=" this should be clear. The test results were indeed equal to 0.1, 0.1 then 0.2
Posted 7/8/2014 10:37 PM (GMT -5)
Inspector 13, congratulations on your cure. Sorry, though, you have to settle for second place in the weigh-in.

AZ4Peaks, thank you for the clarification on the differences between tests. I have some more study to do.
Posted 7/9/2014 7:56 AM (GMT -5)
Yank31

If you look at my signature you'll see a somewhat similar PSA trend as yours. I'm not sure why you're getting tests so often but it appears that you have progression. Another .2 or higher means more treatment is indicated per guidelines. As a Gl 8 you can't afford to wait IMHO.
Bob
Posted 7/9/2014 4:19 PM (GMT -5)
Bob, thanks for the input. Your history gives me some hints about what I should be reading about and researching. Good luck!
Posted 7/10/2014 7:07 AM (GMT -5)
Yank,
The rise in your PSA could be due to the benign prostate tissue that was left. You may want to talk to your URO about this possibility. I knew one guy who had benign tissue left and had a rise in PSA ... he was put on avodart.
Posted 7/10/2014 4:29 PM (GMT -5)
RCS - Your comment is helpful and much appreciated. Thank you.
Posted 7/10/2014 10:25 PM (GMT -5)

RCS said...
Yank,
The rise in your PSA could be due to the benign prostate tissue that was left. You may want to talk to your URO about this possibility. I knew one guy who had benign tissue left and had a rise in PSA ... he was put on avodart.

My issue with rising PSA in under a year is where is PC likely to appear?
Lymphovascular invasion & perineural invasion in my case surely points to a particular site or sites that it would progress to?
Posted 7/10/2014 10:31 PM (GMT -5)
My signature didn't appear for some reason so...hopefully it will this time!
Posted 7/10/2014 10:40 PM (GMT -5)
Aussie,

You ask where might your PCa occur? Based on what you put in your signature, have you considered the prostate bed ... and possibly SRT? What does your URO think?
Posted 7/11/2014 1:16 AM (GMT -5)
I've heard "prostate bed" mentioned quite a lot on here but where exactly is it? I rather hoped with clear margins everything was clear!

My concern is more to do with PNI & LVI and where PC cells venture from there!
Posted 7/11/2014 3:20 AM (GMT -5)
Hi Aussie,

Your elevating PSA trend is quite similar as mine...10.5mos @ 0.06 from undetectable post surgery. 

I asked the URO/surgeon for SRT opinion, his comment was 29 LN were dissected, radiation may not be effective in my case.  He suggested to opt for HT when the PSA hit @ 0.2. Anyway I m consulting Radiologist/oncologist in 2 weeks time to hear from him.

Posted 7/11/2014 6:23 AM (GMT -5)
YK, I think you are wise to take the initiative at this stage. I'd be interested to hear how you go!
I have an appt with Uro on 8 August and will see how my PSA stands then...expecting .10 by then at the rate it's increasing!
✚ New Topic ✚ Reply