Psa bump 14 years after prostatectomy

Then we had the scan scheduled and at 0.302 and then canceled when it went down 0.277 because my Dr. said sometimes anything below 0.3 could be inaccurate. (I'm paraphrasing.) Of course I was more convinced then that it was benign tissue and may have talked myself out of it some. I now am scheduled for it in 2 weeks.

Yes, correction made. Thanks!

Benign tissue typically bounces around at very low levels. From my untrained eyes with psa levels at .5 and rising steadily does not appear to be benign. You should further investigate.

So now I am officially freaking out. I just received my psa result 6 months after my last test which came back at .07 up from .06. Sounds like bcr to me. Not sure what I should do now other than stress.

Dalota - Another passing test that says you are ok, way to go! You really need to stop fretting over hundredths when tenths are your decision points, 0.10, 0.20, 0.50.

There is probably no doctor that would tell you have a problem and if there was, I would probably not trust that doctor. There is probably no insurance company that would accept much at this time with your track record either.

I understand PSA test anxiety like most everyone here but you have to keep it in perspective and only worry about it for a few days. If you get some significant change or finally reach a decision point, you can then be more proactive about next steps.

Just chill as they say…

Dalota,

I just wanted to let you know that going from 0.06 to 0.07 after 6 months is literally nothing to worry about. They are, for all practical purposes the same number.

You did not get conflicting advice from Halbert and Mumbo. Halbert was just pointing out that if something was brewing you would eventually need an MO and not a urologist. Mumbo gave you a sense of how any prostate cancer specialist would evaluate your situation.

None of us can take away your fear but if you want to guard against an actual big uptick, you may want to check once every 3 months.

Since I'm being discussed....the point I was attempting to make is simple: Sometimes getting in to an MO can take a while, and a general consensus in here over the years is to have one lined up early, so that if/when it happens, you're not scrambling, you're ready.

No, you don't NEED one yet--but having one in the wings isn't a bad idea.

Reminds me of an old wine advertisement ”We will sell no wine before its time”. It’s not that time yet.

There is nothing more frustrating than waiting when you want to know the answer now but that is the way it is with PCa where rarely anything happens quickly. The only thing that happens relatively quickly is we get our PSA results reported faster than years ago, for better or worse.

Hi Dalota. Sometimes it takes quite a few data points to determine whether you are just fluctuating or a fluctuating but gradually increasing. Remember: there is uncertainty in the right-most digit of any lab test. If you were to draw your blood today and repeat the PSA test you had 20 times on your same, I doubt that all 20 would come back with the same digit. You might see that while most were, say, 0.06, one or two might be 0.05 or 0.07. That's the nature of testing. Also, our PSA probably varies from day to day or week to week; I believe early testing when PSA was discovered showed that our PSA fluctuates.

Men who might need to start SRT between 0.1 and 0.2 are likely those who are within a few years from the surgery or have some high-risk factors (high Gleason score, adverse path findings such as seminal vesicle invasion and/or positive margins, etc.).

There is less urgency when a man is a good number of years out from surgery and the PSA is climbing slowly. I suggest that if you continue to worry, you switch to the Labcorp ultrasensitive PSA test, which has three digits after the decimal point: it lets you worry in greater detail In other words, you'll probably realize that your fluctuations are smaller than you think.

IMO you have plenty of time to monitor your PSA. Should you reach a confirmed 0.1, you can talk to your uro about a consult with an R.O. Can you provide you salient history (especially the pathology results after your RP: Gleason score pT staging, and any adverse findings like positive surgical margins), preferably in a signature file that gets added to all your posts, so you don't have to keep typing it and other Forum members wanting to answer your questions have this information. Thanks!

My post "Initial Consult with R.O." might help you.

Djin

Is it true that SRT is only curative about 50% and when it’s closer in to surgery. That would be very disheartening.

And Mumbo - I like your style so I will ask you - should I retest every 3, 4 or 6 months and when do you think I should consult with an RO. When my PSA hits what number?

Thanks Halbert. The details are in the signature in my last post and will be here also

So every 6 or more frequent?

Thanks Mumbo. The article certainly suggests that MFS is a lot higher than the 50% that JNF states in his post to Native. He then goes on to say that it’s even more effective when it’s in close proximity to surgery. I believe he has potentially misinterpreted study results from patients that waited too long to seek treatment when PSA rises beyond the optimal treatment range versus patients that have delayed PSA progression post 10 or more years from surgery. In fact, I have read a study from Hopkins that suggests that delayed PSA progression of more than 10 years may not metastasize at all so patients should weigh the risks of over treatment.