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Been wondering if any traces of left behind prostate tissue after prostatectomy could continue to survive to produce minute quantities of PSA. My PSA never went below .07 but has been holding around the .1 level - plus or minus - for about four years. I know there are no clear lines for a surgeon to follow when removing the prostate, especially in the area of connection with the bladder so if any prostate tissue is left behind (hopefully normal) would it continue to live as viable but non functioning tissue able to give off minute traces of PSA? I guess my hope is that a minute PSA reading does not necessarily mean cancer as long as it remains fairly stable and does not show a rising trend. My other concern is that if there is some minute surviving prostate tissue, could it also develop cancer even if it is normal for now? Probably thoughts more wisely not thought of and maybe no real answers but how does one put such things out of mind? Jon.
Thank you for your post. It is certainly possible that some small amount of prostatic tissue may have been left over after your surgery. However, there are other sources of PSA, such as the Cowper's Glands, that produce trace amounts of PSA. It is unlikely that there was any prostatic tissue left at the bladder neck, since the separation plane is fairly well-defined. If there was any prostatic tissue left over, it more likely may have been left at the apex of the prostate, where it connects to the base of the penis, since that transition is less clearly defined. If you still have concerns, you should absolutely discuss those with your doctor.
In addition, you should always use the same lab for all PSA tests, and they should always use the same tools and methods to measure your PSA. That way, you will be able to track the history of your PSA changes with greater accuracy. The rate at which your PSA is changing is more important than the actual amount, since there are always experimental inaccuracies in any measurement process. Also, some test methods begin to lose their ability to measure PSA accurately at the very low levels, so the measurements you are seeing may just be attributable to experimental noise.
Thanks Mark, I would guess that the PSA reading in my case is not coming from the cooper's gland as it was evidently excised along with everything else (No evidence of it being there any more). Doc. explained that because of the extent of cancer shown in the biopsy he went wide to get all possible cancer. The results are obvious but one does what has to be done for the best chance of success. Jon.