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PSA level after prostatectomy

Posted , 7 users are following.

ayman78787
ayman78787

What is the expected PSA level after prostatectomy? What is expected when you measure it during your bi-yearly and yearly regular PSA checks?

I had my RP 2 months ago (March 24th) and my blood test yesterday shows PSA of 0.03.

Doctor is happy and wants another test in 6 weeks from now.

0 likes, 11 replies

11 Replies

  • patrick1952
    patrick1952 ayman78787

    Posted

    That's a good number. I had a rp in July 2015. First psa was .08

    Then .04 and has been .01 ever since. Even two months after rp the trauma to your pelvic area could cause the small elevation or its just the sensitivity of the machine that's measuring your psa. Some people believe the ONLY thing that can elevate psa is cancer or prostate gland that was left behind. That's not a 100% true. Infection or machine sensitivity can cause psa to rise...pat

  • steve82587
    steve82587 ayman78787

    Posted

    I am suprised they tested it that soon after rp,,,,, my first check up is 6 months after procedure.......
    • ayman78787
      ayman78787 steve82587

      Posted

      It seems it differs from one doctor to another. Plus, iny case it was a marginal cancer and not encapsulated, so a sooner PSA test seems to make sense I was told by my doc
  • mariner2021
    mariner2021 ayman78787

    Posted

    The only PSA reading that I have been able to get at 3 months post RP is < 0.1 Where are you able to get readings with an accuracy to two decimal places ? in UK ?

    My oncologist claimed that the labs in the Guildford area of Surrey won't work to 0.01 because of the inaccuracy of the results. However it occurs to me that even if the figure was inaccurate - two decimal places would provide much earlier warning of a rising PSA. 

     

    • ayman78787
      ayman78787 mariner2021

      Posted

      No, in Switzerland. This is the number O was told when I called in today for the results. You got me thinking. I will call again tomorrow to reconfirm
  • romneyj
    romneyj ayman78787

    Posted

    Mine too was extra capsular on one side and the surgeon said he had had to remove the neurovascular bundles and as much tissue as possible as it was more than marginal and had spread a little. However all the extra-capsular tissue was cancer-free at histology (almost certainly due to a 5 week course I had taken prior to surgery). My PSA at 6 weeks post op was <0.01 and at 3 months post op still <0.01. The reason for the 6 week one was that the surgeon said that that was the earliest time possible for PSA levels to have settled down and I was welcome to have one then if I wanted but he wanted the 3 month one before he saw me again as that was the time by which it would probably have settled to it's lowest level.

    I'd agree that unless the lab uses standards at 0.01 and 0.1 in its standard curve and gets consistant reslts in that area, it's unlikely to be very accurate. You'd need to see the inter-lab figures on a panal of sera to know. If it is inconsistant then fluctuating levels eg up to 0.05 then 0.07 before going down again would be needlessly worrying.

    My understanding is that there has to be some prostate tissue left behind in order to have an elevated level after 3 months. One of the problems with endoscopic surgery (eg Robotic) is that the insufflation gas used  (normally carbon dioxide) can have a greater or lesser effect on intraperitoneal seeding and port-site (entry site) recurrences - ie blowing tumour cells around. It is the seeding of cells that is considered often to be the cause of a low PSA.

    • ayman78787
      ayman78787 romneyj

      Posted

      Thanks Romney. I have to admit that I am a little confused as far as the technicality of the accuracy of the number.

      I am wondering if the number remains at 0.03 3 months post op, which would indicate remaining prostate cells, would this be worrying and warrants a radiation treatment, or would it be a surveillance only since it's very low?

      I had a RP but not the robot assisted one.

    • romneyj
      romneyj ayman78787

      Posted

      The PSA test is an ELISA test which is fundamentally variable in signal. In order to get over that the manufacturer supplies 'standards' to run with each assay. The standards will usually be at 6 concentrations of PSA. The question on accuracy at the bottom end is really whether the standards start at 1 and go to 5, 10, 50, 100, 500 which would give a reasonably accurate curve in the most commonly needed area for initial detection, or whether they run a low curve starting at 0.01, 0.1, 1, 10, 50, 100 which would give an accurate curve for post-operative readings but less accurate over the initial detection range!

      My guess is that the accuracy at 0.01 to 0.1 is poor and that unless it is so low as to be undetectable (<0.01) it could be anything between 0.01 and 0.1! Your 0.03 is a low low figure and not reppresentative of anything other than artefact.

      My RP was robotic by the way. But the disappearance of all external cancer cells and consequent lack of PSA altogether was, I'm sure, due to the medication I took smile

    • RichardKen
      RichardKen romneyj

      Posted

      Dear Romney

      Thanks for that interesting information. Cheers Richard

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