CancerCompass message board discussion started by doctork on 11/28/2007 http://www.cancercompass.com/message-board/message/all,18422,0.htm Sun, 07 Sep 2008 00:00:00 GMT Sun, 07 Sep 2008 00:00:00 GMT http://backend.userland.com/rss RSS.NET: http://www.rssdotnet.com/ all i have read says after removal psa should be 0 if no prostate remains... some say up to .05 but 6 weeks post op my psa is 0.5 ... is this too high ??? doctork Wed, 28 Nov 2007 00:00:00 GMT it will all depend... my father had his removed and a few months later it started rising and slowly over the years it had continued to go up and was on hormone therapy,.  now after 6 years it is in his bones... that is an extreme and does nto always happen (when they remove it they can never guarnantee that it is all gone.. be cause my dad spread to the parts)  then my friends father same... removed and had the radiation seed therapy and is fine after years.. so, is yours normal for now i think it is .  but you have to watch it every few months for a while. sophia Smpal Thu, 29 Nov 2007 00:00:00 GMT It can depend on the lab.  Repeat the test to see if there are three new highs. Johnw100 Thu, 29 Nov 2007 00:00:00 GMT my concern is if there is still cancer in there now would it not be better to under go radiation before it has a chance to spread???? why wait???? why not be as aggressive as possible now so we can possibly prevent problems in the future... if we do it and there was no reason to so what??? doctork Thu, 29 Nov 2007 00:00:00 GMT Your PSA should be <0.01 (ultrasensitive) six weeks after RP. 0.5 would indicate that there is residual PC somewhere. I concur with another person here in suggesting that you request another test to confirm that it isn't a lab error. I'd suggest that you request an ultrasensitive PSA test. As to your question regarding RT, the question really should be where the cancer is located. If it's in the "local" area then you could undergo RT (I'd suggest Tomotherapy which is the most advanced system in the market). If it's distant then RT won't result in "cure". Ideally you'll want to eliminate the possibility that it is either: a) in your bones or b) in your lymph nodes before determining to pursue RT. There are some sensitive tests available for both invovlement of bones as well as the lymph system. Regarding lymph involvement I'd suggest Combidex. Unfortunately that test has not been approved by our FDA so you'd have to go to the Netherlands for it. Once again, the primary question you should be asking is whether there are residual cells (anything above <0.01 would confirm this) and if there are residual cells locating where they are. If you find that the next PSA is above 0.01 then my best advice would be to seek a true expert in prostate cancer. There are a handful of those around the US. Best wishes to you. Orionskye Thu, 29 Nov 2007 00:00:00 GMT  On 11/29/2007 Orionskye wrote:Your PSA should be <0.01 (ultrasensitive) six weeks after RP. 0.5 would indicate that there is residual PC somewhere. I concur with another person here in suggesting that you request another test to confirm that it isn't a lab error. I'd suggest that you request an ultrasensitive PSA test. As to your question regarding RT, the question really should be where the cancer is located. If it's in the "local" area then you could undergo RT (I'd suggest Tomotherapy which is the most advanced system in the market). If it's distant then RT won't result in "cure". Ideally you'll want to eliminate the possibility that it is either: a) in your bones or b) in your lymph nodes before determining to pursue RT. There are some sensitive tests available for both invovlement of bones as well as the lymph system. Regarding lymph involvement I'd suggest Combidex. Unfortunately that test has not been approved by our FDA so you'd have to go to the Netherlands for it. Once again, the primary question you should be asking is whether there are residual cells (anything above <0.01 would confirm this) and if there are residual cells locating where they are. If you find that the next PSA is above 0.01 then my best advice would be to seek a true expert in prostate cancer. There are a handful of those around the US. Best wishes to you.  needhelp Thu, 29 Nov 2007 00:00:00 GMT  On 11/29/2007 needhelp wrote: On 11/29/2007 Orionskye wrote:Your PSA should be <0.01 (ultrasensitive) six weeks after RP. 0.5 would indicate that there is residual PC somewhere. I concur with another person here in suggesting that you request another test to confirm that it isn't a lab error. I'd suggest that you request an ultrasensitive PSA test. As to your question regarding RT, the question really should be where the cancer is located. If it's in the "local" area then you could undergo RT (I'd suggest Tomotherapy which is the most advanced system in the market). If it's distant then RT won't result in "cure". Ideally you'll want to eliminate the possibility that it is either: a) in your bones or b) in your lymph nodes before determining to pursue RT. There are some sensitive tests available for both invovlement of bones as well as the lymph system. Regarding lymph involvement I'd suggest Combidex. Unfortunately that test has not been approved by our FDA so you'd have to go to the Netherlands for it. Once again, the primary question you should be asking is whether there are residual cells (anything above <0.01 would confirm this) and if there are residual cells locating where they are. If you find that the next PSA is above 0.01 then my best advice would be to seek a true expert in prostate cancer. There are a handful of those around the US. Best wishes to you.   needhelp Thu, 29 Nov 2007 00:00:00 GMT I have never heard of the "ultrsensitive PSA test"  Is this widely available?  Any references would be appreciated. needhelp Thu, 29 Nov 2007 00:00:00 GMT Any doctor who knows anything about prostate cancer will know about the ultrasensitive PSA test. Are you being treated by an oncologist or just a urologist? You should have (at least) one of each on your team. I'd strongly suggest that you seek the help of a real expert in prostate cancer. I've suggested Stephen Strum MD (Oregon), Mark Scholz MD (Los Angeles), Charles "Snuffy" Myers (Virginia), Eric Small MD (San Francisco) and Derek Raghavan (MD Anderson Houston). These doctors are tops in their field and it will take you some time to get an appointment with them. With all respect to others here, I wouldn't wait to take action. At 0.5 your PSA is too high and I would assume that you have residual cancer until proven otherwise. On the other hand you definitely need to determine whether RT would be helpful before pursuing it. This is where the experts come into the picture. They will cost you some $$$ but if you can swing it they are well worth the cost. My pure guess as to what they would do is get you on ADT fairly quickly (for maximimum cancer cell kill), put you through a battery of tests to determine if there has been spread to bone or lymph, and given the results of those tests determine whether RT would be beneficial. If it would not then ADT, chemo or one of the investigational therapies would probably be pursued. By the way, in the meantime I'd suggest that you buy Stephen Strum's book, possibly Snuffy Myers book, cut way back on fatty foods, get lots of deep dark green veggies, whole grains and check into the supplements that have been shown to be effective against prostate cancer. My best to you. I think you might have a good shot at licking this if you act deliberately and aggressively. Orionskye Thu, 29 Nov 2007 00:00:00 GMT Slight Correction to my message above. Derek Raghavan is at Cleveland Clinic. The expert at MD Anderson Houston is Chris Logothetis. Hope this is all helpful. Orionskye Fri, 30 Nov 2007 00:00:00 GMT Slight Correction to my message above. Derek Raghavan is at Cleveland Clinic. The expert at MD Anderson Houston is Chris Logothetis. Hope this is all helpful. Orionskye Fri, 30 Nov 2007 00:00:00 GMT My husband had a davinci robotic radical prostatectomy Sept. 2006. Stage T2c,gleason 3+4+7. His pathology was all negative,with negative margins. 3 months after surgery his PSA was .4 and now is up to .8. Radiation Oncologist says PSA cels are microscopic,and may not show up anywhere (bone scan,etc.),would prefer not to radiate prostate bed if the cancer cells are not there. Also,he said my husband would become incontinent again,(still has minimal "dripping".) We are clueless about what to do next since his oncologist says this is a rare case. Help! megsmum Tue, 18 Dec 2007 00:00:00 GMT