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PSA Level After Removal

AFTER HAVING MY PROSTATE REMOVED 11 YEARS AGO MY PSA IS NOW 3.5. Should I BE CONCERNED?

  1. A number years ago I was working with guy who had his prostate removed and was declared in remission. We happened to meet due to the fact I was interviewing new folks who had expressed some interest in serving on the board of a men's health organization

    During the interview I mentioned my run in with prostate cancer, the fact I had the surgery several years prior and that I was facing a slow 5 year rising PSA from 0.01 to 0.13

    He indicated he had been in a similar but with a more advanced situation.

    Following surgery he did not continue to follow-up with his urologist but chose instead to see his general practitioner. Every year he went in for an annual physical and each year his MD told him he was in the normal range for a man of his age.

    All went went well with until one year when the GP said his PSA was getting a bit high at 2.7 and that he might want to get it checked.

    This was the first time he had heard the number and was shocked. He told the MD his prostate had been removed years earlier and his number should have been in the 0.02 range not over 2.0. Apparently the GP had been using the standard test for years vs using the recommended hyper sensitive post-prostatectomy PSA test.

    He want on to say he was immediately referred to a radiation oncologist and urologist who jointly put him on androgen deprivation therapy Lupron to stop the spread of the cancer and then he underwent 40 treatments of external beam radiation.

    Given you appear to be in a similar situation it might be prudent to be meeting with a urologist for a follow up sooner than later for an professional evaluation.

    Best of luck and please ...let us know what you discover as you continue your journey.

    ... Dennis(prostatecancer.net team)

    1. Hi jfp159. Your concern is certainly understandable. Roughly 30% of men do have a recurrence and, just like with an initial diagnosis, it is important to catch it early. Has your doctor had anything to say about the increase? The short answer is that, after 11 years, I'm not sure what else could cause this rise. This document on the topic from the American Cancer Society states "Your PSA should fall to a very low or even undetectable level within a couple of months after radical prostatectomy:" https://www.cancer.org/cancer/prostate-cancer/treating/psa-levels-after-treatment.html. In addition, I want to direct you to this article from our contributor Len on PSA and recurrence after prostatectomy: https://prostatecancer.net/living/psa-undetectable/. Don't hesitate to get forceful in asking your doctor about next steps and know that you are always entitled to a second opinion. Please feel free to keep us posted on how you are doing. Best, Richard (ProstateCancer.net Team)

      1. aside from the difference in the ‘normal range’ what is the real difference between the PSA Standard and PSA Third Generation Tests?

      2. Hi . The primary difference with the "third generation PSA" is its sensitivity. It is "capable of measuring PSA levels down to 0.01 ng/mL and lower." This article goes into further detail on this and other variations on the PSA test: https://prostatecancerinfolink.net/diagnosis/psa-testing/different-psa-tests/. Best, Richard (ProstateCancer.net Team)

    2. Mine is now 0

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