I am seeking some feedback from my results. I had a Radical prostate removal done [Oct 2011] and had a general PSA test done 6 weeks after surgery – the PSA was .17 On [January 2012] I had a ultra sensitive PSA test done at the same lab. the PSA result was .20 My doctor wants to wait 3 months and do another PSA. I think he plans on doing both the ultra sensitive and the general psa tests. With these numbers, should I be thinking that all the cancer cells were not gotten? Please share your thoughts, I am anxious. - someone wrote
My reply: I am not sure where you had it done, but I just wanted to make sure I read it right since the formatting was off. It was “0.17″ mid-November 2011 and then “0.20″ on Jan 18 (today), right?
I’m not a doctor, but those seem high. The gold standard according to my Dr. at Mayo in Florida is that it should be undetectable (“< 0.01″) on the ultra-sensitive test 3 months after surgery. And it should be going down if it is still elevated at 6 weeks since they half-life is around 3-4 days.
Have you thought about getting a second opinion? When I was going through it a year ago, I ran everything by a friend who is an oncologist where I am and he told me to definitely get the ultra-sensitive test and it should be “undetectable” too. He said if it was detectable (e.g. over 0.01) to come see him or someone else because he’d want to think about something else. Fortunately my is still < 0.01, but if (let’s hope not) it ever is, I’m calling him right away.
I think in theory there could be other explanations, but I’d want to know ASAP because suppose there was something in the prostate bed (e.g. where the prostate sat) they could treat it with radiation ASAP. Did you get the pathology report? e.g. where the margins clear? confined to the prostate etc? Gleason score? Stage? There are lots of variables – how aggressive it was etc. If it were me, I would find an oncologist (my friend is a radiation oncologist) who has dealt with it before and I’d want them to find out why it was still detectable.
I understand why you’d be anxious, I get anxious just waiting for a PSA result. I talked to a different Dr at Mayo who is in a different department who is in his 60s and went through the surgery. He says it has been 5-6 years, but he still gets very anxious while waiting for the PSA results, so it is normal.
All the best…no doctor should discourage you from seeking a second opinion.