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Posted 3/26/2019 8:23 PM (GMT -5)
PSA Recurrence when is it considered Recurrence and what is the standard treatment.
Tony W
Posted 3/26/2019 9:56 PM (GMT -5)
The answer would depend on what you have done previously. RP? Radiation? Both? Perhaps you could create a signature with details like I have.
Posted 3/26/2019 10:40 PM (GMT -5)
Please tell us more about your treatment, as well as your PSA history post treatment.
Posted 3/28/2019 2:56 PM (GMT -5)
Thanks Guys I'm confused I'm now 9 years since my RP I went to my Urologist
for my yearly check up I have been on yearly checkups for 6 now.
My PSA reading from the hospital lab was 0.05 I was expecting it to be 0.03 as it
was the previous year and 3 weeks before I asked a different lab to do PSA test
while getting results for cholesterol and liver it was 0.03 .
So my concern and question is my Urologist was concerned about the 0.05 reading
and now wants to put me back on 6 monthly check ups again I'm confused and
worried after 9 years since my RP I'm now back to 6 monthly check ups I would
thought 0.05 was OK.
He did say in the 9 years my PSA is up and down at one stage 0.07 but in 9 years
but's usually 0.03 to 0.04 to 0.05 do you guys think the Urologist is over reacting or have I a problem ?
Tony W
Posted 3/28/2019 3:22 PM (GMT -5)
Tony,

If they want another check in a few months, that's not a bad idea. Is the fluctuation a normal "noise", or is it the beginnings of a trend. It's unlikely to be the trend, but it doesn't hurt to find out.

Were you ever "non-detectable" (meaning you had a "<") in front of your PSA number? If not, then you have some residual prostate tissue in there somewhere putting out a bit of PSA--which isn't a bad thing, but it can suggest trouble where there isn't any.
Posted 3/28/2019 3:29 PM (GMT -5)
Thanks Halbert no never "<") always since my RP 9 Years ago been 0.03 or 0.04
Tony W
Posted 3/28/2019 3:42 PM (GMT -5)
Your URO is being cautious. Likely you have nothing to worry about, but an extra check or two would be in order.

Until you got a number of consistent readings over .05 (and closer to .1), it's nothing.

At these low levels of PSA, a little change can seem like a lot. The difference between .03 and .05 isn't much and could be due to a number of reasons - including lab error. Repeat the test sometime and if it's still over .05, you've got something that needs to be looked at.

but most likely, you've just got a URO being careful.
Andrew
Posted 3/28/2019 4:18 PM (GMT -5)
All good points; one has to remain vigilant. A change in test method (or even the test instrument) can also change the result.
Posted 3/28/2019 4:29 PM (GMT -5)
Thank you all for the reply's it's just so annoying and frustrating after 9 years I'm
back to 6 monthly tests there is just NO rest from this awful disease.
Tony W
Posted 3/30/2019 6:17 AM (GMT -5)
Hi Tony, my dad has a very similar medical history on this crappy PCa train... he also had his prostate out in Melbourne in 2010... I’m wondering if it is the same urologist. Dads psa went up and down like yours over the 9 years which led to annual psa checks to 6 months.
Posted 3/30/2019 2:57 PM (GMT -5)
Kmac my initial Urologist that performed my RP was Dr Peter Liodakis from Norther Urologists
but now I'm attending the Olivia Newton John Wellness Centre.
Can I ask how is you Dad doing ?
Tony W
Posted 3/30/2019 3:50 PM (GMT -5)
It would be a good idea to ask other people getting the test in the same place. Some labs report the raw number without reporting or informing about the equipment accuracy. In other words, they never report a <. Many equipments are calibrated to be accurate at values useful for diagnosis, not for postsurgery follow-up. Of course, doctors are aware of this and advice taking into consideration other results from the rest of their patients, usually reported by the same lab. On the other hand, some people show consistently rising or fluctuating patterns obtained with real ultrasensitive tests. But many comments here assume that this is the general case for results reported with two decimal digits and this is not always true, sometimes the numbers reflect equipment changes.
Posted 3/31/2019 10:53 PM (GMT -5)
I applaud your uro for doing his job!. I know it's a pain but it's better to be cautious. but of course that's your call.
Posted 4/1/2019 1:40 PM (GMT -5)
After mine recurred, I had scans done both CT and bone.
No mets, so they put me back on Lupron.
With mets, I'm betting it would have been additional radiation, but who knows?
Might have been Xtandi or ......
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