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Posted 10/4/2022 6:02 AM (GMT -5)
Almost 4 1/2 years since my RALP. I have monitored my PSA levels regularly since then and was always relieved to get less than 0.02 ng/ml. Last week I went for another and the result is a distressing 0.7 ng/ml.
What should my course of action be. Please assist me me with some advice.
Greetings from South Africa
Posted 10/4/2022 7:47 AM (GMT -5)
Hi Diver and welcome to the Forum.

Any unexpectedly high PSA increase should be retested to ensure there was no lab error. That said, your pT3b staging (seminal vesicle invasion) really warranted much closer PSA monitoring--IMO every three months. The ideal time for investigation and start of treatment was at around 0.2. If your PSA rise is confirmed, you should meet with a radiation oncologist to discuss imaging to locate the source(s) of any recurrence and a salvage radiation plan.

Was your Gleason 4+3 confirmed in the post-RP pathology report? Biopsy info in a signature is helpful, but what counts are the findings in the post-op pathology report.

Let's see what other Forum brothers have to say. Please keep us posted

Best of luck,

Djin
Posted 10/4/2022 9:13 AM (GMT -5)
Thanks for your reply Djin,
Yes, I have been doing regular PSA tests 3 - 4 times aa year and the results have always been between 0.02 and 0.03 ng/ml. thus my concern after the last test.
The Biopsy done on the gland post-op showed a combined Gleason pattern of (4 = 3) GG-3
Posted 10/4/2022 10:33 AM (GMT -5)
I would be surprised if your PSA went from 0.03 to 0.7 in just a few months. I am, however, suspicious about the sensitivity/accuracy of your last test if it reported just one decimal place (0.7) rather than two (0.70). As you probably know, there is uncertainty for the right-most digit in any lab test. I would repeat with an ultrasensitive test, whether two or three decimal places.

Are you sure you last result wasn't 0.70? I'm not familiar with a commercial PSA test that reports just one decimal.

Djin

Post Edited (DjinTonic) : 10/4/2022 8:37:43 AM (GMT-7)

Posted 10/4/2022 11:33 AM (GMT -5)
And, double check that it wasn't 0.07. 🙂
Posted 10/4/2022 12:38 PM (GMT -5)
You guys are correct. My apologies. The latest test result is 0.07
Posted 10/4/2022 1:46 PM (GMT -5)
Well Diver,
That's a good piece of information, which gives you some breathing room. Another three month PSA should confirm if you are recurring. There's a lot of opinions concerning when to start Salvage Radiation. As Dijin mentioned, a PSA of 0.2 has been the standard for a long time. Then there's the question of ADT during salvation radiation too.

I hope your latest PSA is just a fluctuation, but it would be best to be prepared by consulting a radiation oncologist. Also, retesting before 3 months might be better.

Good luck!
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