psa test

my husband surgery in dec of 2009 after surgery his psa was 0.0 now 9 months later it is 0.08 he has been losing weight these last couple of months a total of 12 pounds his urologist wants wait 3 months and do another psa should we be worried or should ask for more test if so what kind of test

[Ash Tewari, MD, M.Ch.]

Thank you for your question. The definition of biochemical recurrence after radical prostatectomy (robotic or open prostate cancer surgery) is a one time PSA test of anywhere between 0.2 ng/mL to 0.4 ng/mL. An elevated PSA after surgery could be a number of things 1) residual prostate tissue left in the body after surgery 2) an indication of advanced disease 3) lab variation or contamination. An important variable in understanding a PSA rise after surgery is the final surgical pathology including the extent of the tumor and Gleason grading.

Weight loss can be an ambiguous symptom that may or may not be related to the prostate cancer. I require my patients to walk 5 miles a day for 6 weeks prior to surgery as well as another 5 miles a day after surgery. This helps in preventing blood clots or DVTs. An increased amount of walking could be the cause of this weight loss.

Imaging studies may be necessary if a repeat PSA is also significantly elevated.

Thank you for your question. Best of luck.

Sincerely,

Ashutosh (Ash) K. Tewari, MD
www.cornellroboticprostate.org

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