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Thread: PSA two years after RP now < 2

  1. #1
    Newbie New User
    Join Date
    Apr 2011

    Question PSA two years after RP now < 2

    Hello Forum Members,
    I had a Gleason 5 + 4 = 9 T2 tumor and a RP, no nerve saving, operation.
    All scans etc. were negative.

    My PSA 'progression` -0.001-0.002-0.003-0.005-0.006 and my recent test < 2
    my, perhaps, rather naive question is - should I be taking action and if not, how long should I wait until I do?

    Thank you for a reply!
    Best Wishes to you all
    from (a slightly worried but very healthy at present)

  2. #2
    Top User
    Join Date
    Jun 2010
    PSA 2.0 now?? If so, it's time for action...Time to talk with both a Medical Oncologist and a Radiation Oncologist..
    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5.

  3. #3
    Senior User
    Join Date
    Aug 2009
    You need to provide a lot more stats before any kind of credible response can be given. Age, PSA progression over what period of time. Your current reported set of PSA's make no sense as stated. That big of a jump over a short unknown period is not realistic.
    PSA at Dx 105 at age 68, 4/04. ADT, RRP, 5/04. 66 grms, GS 4+5=9, SVI, Staged pT3b N0 MX, 3D rad, 40 treatments, 8/04. PSA 1/05 <0.01. ADT (Lupron) till 7/07. PSA 0.03 12/08, 0.07 4/09, 0.13 8/09, 0.19 12/09, 0.30 4/10, 0.41 8/10, 0.47 12/10, 0.60 4/11, 0.64 8/11, 1.10 12/11, 1.03 1/12, 0.95 2/12, 0.92 4/12, 0.86 8/12, 0.757 11/12, 0.92 3/13, 0.93 7/13, 0.861 11/13. Will start ADT3 after PSA reaches 1.2.

  4. #4
    Senior User
    Join Date
    Oct 2009
    Hi Gunter, - I believe you have erred in the report of your most recent PSA result. The < icon before the numerical digits(s) that follow ALWAYS represent that any readings, if any, were below the established reliability of the assay material used (the number following).

    So in YOUR case the previous readings reported to the "thousandths" of a nanogram resulted from hyper- or Ultra-sensitive assays with reliability to .001 ng/ml. I SUSPECT that your most recent PSA report is from a STANDARD PSA test, with a reliability rating of 0.2 ng/ml, a reading in the 10th of a nanogram. IF this ASSUMPTION is true, all of your former readings AND the present result would all have been reported as LESS THAN 0.2 ng/ml (<0.2 ng/ml), IF the STANDARD PSA assay, had always been used.

    The other POSSIBILITY is that, IF THE SAME assay was used as previously, the reading could have been <0.002 which would be even less reason for any concern. You should verify which of these possibilities is the case or provide another REASONABLE explanation. - John@newPCa.org (aka) az4peaks
    Last edited by az4peaks; 04-25-2011 at 06:39 AM. Reason: clarification

  5. #5
    Senior User
    Join Date
    Sep 2010
    Cumming, Georgia
    In any event I believe you need a very good medical oncologist that specializes in prostate cancer as G9 is high risk. The urologist is basically done after the surgery. The med-onc is the long term advisor. If you are showing recurrance then salvage radiation and/or hormone based therapy will be next. An excellent med-onc that specializes in prostate cancer is needed.

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