1St Psa After Robotic Surgery

My husband just had his first PSA test after robotic surgery to remove his prostrate on November 6, 2007.  His PSA was higher now than before his surgery!  Going into surgery his PSA was 12 and this last test was 18.  The surgeon reported that he was "agressive" in taking more tissue, nerves, and lymp nodes on the right side (only side with cancer).  According to path reports the margins were clear and the lymp nodes were also clear.  Our family doctor was speechless for a moment and said to recheck it in 2 weeks after suggesting that our local hospital has been known to mess up blood work. 

I'm worried sick and wonder where do we go from here?   Any suggestions or has anyone else had this happen where the PSA is so high after surgery?

Thanks for any and all advice!

Lynne

First of all I am not a doctor nor am I in the medical profession.  I do have prostate cancer and have read extensively about various treatments.  I would think that having a PSA test this soon after the surgery you might have a high reading.  After all it has only been a little over two months.  My doctor told me that perhaps we would have one done on me 3 months after my Brachytherapy on Nov 29, 2007.  Even then it may still be high.  It could be different for me though.  Anything tramatic could cause a high reading.  I have even heard that it is best not to have sex or even drink coffee or alcohol before having the test because that could effect the reading.  Hope this is the case with your husband. Best of luck!

Pre surgery PSA should be flushed from the system within 6 weeks after surgery, which usually results in very low numbers by then.

Lab errors / one-off unexplained  elevated  readings do happen, and there are  reasons why surgery is not always successful as a cure. 

Without knowing your full details, it sounds as if there was no indication of  potential problems of this kind  with your original diagnosis or surgical reports which makes a PSA this high  very unusual.

To use the analogy by Dr Myers in his book, prostate cancer treatment can be like golf and we need to play it as it lies: obviously you need the early repeat test to more accurately gauge what you're dealing with.

I had my prostate removed in Oct 2003. PSA before surgery was 14. No sign of cancer external to the prostate upon explanation of lymph nodes, vessels, tissue in that area at time of surgery. First PSA test after 8 weeks was PSA down to 0.0.  Unlike radiation, surgery SHOULD cut PSA to almost zero, under PSA of 0.1   I strongly suspect the lab made a mistake. Have a repeat high sensitivity PSA test done at a major cancer hospital, NOT at a conventional blood analysis storefront....   Good luck . 

I had Davinci surgery in April of 07, pre-surgery psa 4.57.  I had first post operative psa test in early June with a reading of .62, I had a second a couple of weeks later reading .59.  I had a positive margin, a seminal vesicle involved plus a gleason score of 4+5=9.  My doctors immediately put me on hormone therapy and then as soon as continency allowed scheduled me for IMRT therapy.  I was told that any psa reading post surgery over .2 was indicative of cancer cells still being present.....If I were you I would first get a recheck of the psa and if the readings are still the same ask the Docs about ADT (hormone therapy) and also Radiation therapy.....I'm no Doc but if the psa is correct you need further treatment.  FYI.....my psa level is now .05 which is as low as my labs equipment will check....they called that undectable.  Good luck in your journey with pca.   jwb.