Wife Asking for Advice

Sephie · Regular Joined: 24 Apr 2008 Posts: 31

My husband had LRP in March 2008...PSA tests taken every 3 months since then have been 0.0. Last week, he had his 17 month test and check-up with urologist. PSA came back at 0.1 - huh!? Urologist said there are 3 things that could be causing this:

First, the test itself, though he felt this was unlikely but not impossible.

Second, we are seeing the beginnings of a trend.

Third, benign prostate tissue still exists especially around the urethra which is generating low levels of PSA.

Another PSA test will be taken in 4 weeks. Urologist, when he met with my husband on Friday, said that he would not be surprised if benign tissue is causing this. If the PSA stays at 0.1 or goes back down, no problem - we'll go back to 3 month PSA tests.

Apparently, this is not uncommon and by no means signals a recurrence. Since husband's PSA hit zero shortly after surgery and has stayed there for almost 1.5 years, doctor is hopeful that this is just a "blip" (he called it background noise).

Of course we will be vigilent and stay on top of this.

Husband's stats were: pre-op PSA 6.4, age 57, Gleason 3+4, clinical stage T1c. LRP performed March 2008. Surgical path report confirmed G 3+4 but upgraded to T3a due to minute capsular penetration. No evidence of disease in SV or bladder neck; clean margins. PSA reached zero 7 weeks post-op.

Your thoughts and words of wisdom would be welcome.

Hope you're all doing well.

Sephie (a/k/a Worried Wife)

Hawk · Senior User Joined: 22 Nov 2006 Posts: 406

Sephie,

I have just come down this road although I was close to 48 months when I hit .1 I immediately found a hospital lab that runs a sensitive PSA test carried out to two decimal places and got a test showing that my PSA was really .06 so likely the other test was set to round up or round off.

Because I found a sensitive test I watched my PSA go:

.06
.09
.10
.15

at 3 month intervals. With a one decimal test it would have looked like it was not climbing. This enabled me to get to Salvage Radiation (SRT) very early by the time I hit .16 and gave me time to do lots of research in the mean time. In my case it has certainly bought me time and may have even given a durable remission or cure. I am back to .06 with a decent chance I will drop more to undetectable levels (below .05)

I would recommend checking other hospitals or clinics associated with other hospital labs for a sensitive test. Your doctors PSA order is good at any lab. The quicker you get the new test the better since you do not have to factor both a lab change and a period of time into one PSA test. Static PSA from benign tissue or climbing PSA from a recurrence, you will have the answer quicker with a sensitive test. A recurrence caught very early is often curable especially with his stats.

Keep us posted.
_________________
History: PSA's 6.7 neg. biopsy - PSA 16.6 neg. biopsy - PSA's 8.2, 8.1, 8.7 - Biopsy. 4+4 Gleason 8. Lap RP Apr 2004, age 52 All neg margins, nodes, and structures. (T2a). Post RP PSA: every 6 mo. <.1 until Feb, 08 (46 mos) PSA .1 - I then got sensitive tests (all in 2008) showing:
Feb .06, May .09, Jun .10, Aug .10, Nov .15 -SRT

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