Prostate Cancer Survivors






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Re: 3 month PSA

Your situation is similar to mine, and I got very clear advice from my surgeon. (I'm not on the mentor list here.) I had a single small positive margin from surgery in July 07. And the pathology was definite that some cancer had escaped the capsule. My PSA at 5 weeks post op was 0.1, and the same at 9 weeks post op. I didn't have the extra sensitive PSA test results that you have.

A week after surgery when my surgeon and I discussed the pathology report he suggested that I consider adjuvant radiation, and discuss it with my urologist. After the PSA of 0.1 report he reiterated his suggestion, saying that 0.1 was fine, but not the 0.0 that we most wanted. He also said not to start radiation until my continence was fully restored. My local urologist suggested I start the radiation as soon as I felt ready, not to wait. The urologist seemed concerned about the extensive perineural invasion but my surgeon didn't seem bothered by that. Both surgeon and urologist are very experienced.

I cannot address the location of your positive margins, but likely you should understand the implications of the location, if there are any. Mine was different.

I started a 60Gy course of radiation 13 weeks after surgery, and it went smoothly, 30 sessions. I've had three PSA tests since then, all at 0.0. I feel great and I'm happy with the course I have taken.

I suppose that you would do well to get adjuvant radiation also, given your situation. I don't think it is urgent, given your very low PSA. I think you should read up on it more and be ready to talk turkey with your doc at your december appointment. There may be other reasons why radiation is not appropriate for you. But if you do radiation it is most valuable to do it while your PSA is still quite low. Don't wait for it to get up to 0.50 or higher.

In summary, I dont think the rise from 0.05 to 0.06 is of consequence. But with the positive margin as well as some sign of remaining PSA I do think you probably need additional treatment, and sooner is better. But there is of course a chance that you will find yourself disease free over time without any further treatment. And getting radiation like I did may be unnecessary. But I think the odds are against you on that bet, given the info you have supplied.

Feel free to correspond further if you'd like to.

Re: 3 month PSA

My Psa bounces between 0.04 and 0.09 and has since I had RP in November 2003

Re: Re: 3 month PSA

It's obvious from reading the comments to my post in this forum that I still have a lot to learn. I seem to have read more of the mentor stories than studying the actual disease. So, it's back to the books and late night cramming sessions!

One thing I have definately noticed is the wide variety of treatment options and yet no single treatment seems to offer the "magic potion".

Like everyone else, I'll continue on and hope for the best.

Thanks to all who responed.


Re: Re: Re: 3 month PSA


You could do worse than start with my guide, or even following all the links on the Yana site - especially the Resources page. If you want a hard copy of my booklet, drop me an e-mail giving me your snail mail address I'll get one off to you, hot off the press. Or you will be able to download a copy as soon as I get it on the site - but since it is 42 pages long, you might not want to print it yourself.

All the best