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After radical prostatectomy

DeanClueless
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Hi have alot of questions, more come along the longer I think about things, but the main ones are.

How is monitoring my PSA levels of any use if my Prostate has been removed (as the P in the PSA is gone)?

My diagnosis is they didn't get the clear margin that they wanted and some of the cancer was 5 (more aggressive I think he said).

So in light of above is frequent PSA testing the only option to monitor for cancer?

And if there wasn't a good clear margin can the cancer spread to nearby area that doesn't produce an increase in PSA?

 

Sorry if it's a bit jumbled hope it makes sense.

 

Thanks

  • Hello there and thanks for the post

    I am sorry to hear you have undergone treatment for prostate cancer and appreciate you having some questions.

    When the prostate is removed it is expected that the psa should be virtually undetectable or at a very low level. Checking the psa after treatment is measure of how successful a treatment has been, as well as a way to monitor if the cancer is returning. This is because prostate cancer cells release psa, therefore if there is any activity of growth of these cells in the body this should cause the psa to rise wherever it may be. 

    Regular psa testing is the usual way that patients with prostate cancer are monitored. At follow up appointments the doctor will assess any symptoms or side effects a patient may be experiencing as well as looking at the psa result. It is also important that patients tell their doctor about any concerns or changes to your body in between appointments.

    Unfortunately cancer can come back after treatment. If a clear margin wasn't obtained during surgery, as well as the cancer cells being graded as more aggressive, your risk of it coming back may be higher. Sometimes microscopic cancer cells remain in the body after treatment and because they are so tiny they are unable to be picked up on scans. Overtime these can then start to grow and form another tumour.

    When a cancer re occurs it can either be a local recurrence, meaning the cancer has returned to the original or nearby site of where the prostate gland used to be. Sometimes microscopic cancer cells travel around the body through the blood stream or lymphatic system and start to grow in a different place, such as the bones and when this happens they are called metastases.

    I hope this helps, do get back if needed or call us on 0808 800 4040 if you prefer. We're here weekdays 9-5.

    Take care

    Naomi

  • Offline in reply to CRUK Nurse Naomi

    Hi. Thanks very much for your answer that had helped clear up alot.

    A follow up question, you talk about microscopic partials potential forming a tumour, 

    Would this produce a rise in PSA as it is originally from prostate Cancer cells, even if it developes elsewhere in the body?

  • in reply to DeanClueless

    Hello and thank you for getting back to us.

    Yes, cells that are originally from the prostate that have travelled can produce PSA wherever they are in the body. But the team would also check in with you and how you are feeling in case you have any new symptoms.

    We have information on our website about how prostate cancer patients are followed up, you can see it here 

    and here is a link to living with prostate cancer from the charity Prostate UK.

    Take care and hope you have all the information you need.

    Sarah.

     

  • Offline in reply to CRUK Nurse Sarah

    Thanks for all your answers.

    Sorry but another question. As they know where the cancer currently is (was) and are not confident that they got it all is it not better to have some localized treatment IE radiotherapy in that one area  rather than playing hunt the needle in 2 or 3 years time when it could be anywhere?

  • in reply to DeanClueless

    Hello and thank you for getting back to us.

    I would urge you to talk through this with your specialist so that you fully understand the decisions that have been made about your treatment. 

    They will know how to answer this question so it is as specific to your own situation as possible, whereas we can only speak about treatment generally. 

    Take care, and I hope you get the information you need.

    Sarah.

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