I am 55 and had a Radical Prostatectomy in 2005 after 6 months of hormones, my psa has been fluctuating up and down from 0.04 to .22 and is now back to 0.04.
The biopsy of my prostate showed positive margins in 2 areas and I was wondering if I should be considered for further treatment like radiation or just keep watching my psa over time until it rises again. Would there be any definate benifits to treating earlier while my psa is 0.04. Would hormones be benificial at this time? any advice woulbe be great
Thank you for your question. Unfortunately, there is a paucity in the literature related to your particular situation, that is an elevated PSA after primary treatment. There are, however, several factors to consider; these include Gleason grading, extent of tumor or tumor bulkiness; presence of extracapsular extension; PSA prior surgery. These should guide you, your urologist and medical oncologist towards an understanding of your particular tumor's aggressiveness. Your options would be to radiate the prostate bed or wait and watch your PSA and then radiate.
Have you been getting your PSA tests from the same lab? What was the explanation given to you about the fluctuation?
Ash K. Tewari, MD
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