Viewer Question:
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
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