I went through a robotics prostatectomy about 1 ½ years ago. Recently my PSA score climbed from .001 to .009. Does that mean my prostate cancer is coming back? --I.R.
Rabbi-Ed's Answer:Only the prostate or prostate cells that might have escaped from your prostate after surgery can produce prostate-specific antigen (PSA). But that does not sound like your main issue. Rather you appear to be worried that the prostate cancer you once had has recurred.
I understand why you are concerned, as your extremely low PSA score has gone up .008 of 1 percent. But please note that his occurred at an extremely low level. In fact your PSA remains under one hundredth of one percent. What you’re seeing is a normal fluctuation at a barely traceable level, which proves your prostate cancer has not returned.
By comparison, I can tell you that I had a similar concern after my own recent PSA lab report some 3 1/2 after my April 2007 da Vinci robotic prostatectomy. My PSA score was <.1 ng/ml, meaning less than one-tenth of one percent of the antigen or protein enzyme in a milliliter of blood in a person's bloodstream.
You can be sure I was relieved that my doc simply said that less than .1 is terrific and is absolutely no cause for concern. He added that variations that are .1 ng/ml or lower are barely discernible in a pathology lab and are of no consequence. That's even truer of you, since with your PSA score going from .001 to .009, your PSA is less than 1/100th of mine!
If your post-op PSA result was >0.2 ng/ml (.2 or greater), urologists would consider that as elevated and worthy of attention. However, please note that after a full course of radiation a PSA of .02 is typical.
To sum up, you have less than a trace of a trace of PSA. So, don’t worry. Be happy! --Rabbi Ed