Re: Positive PSA after RALP

[Guest guest]

There is still the problem similar to mine. Perineal surgery, reports of all contained within the gland. Still had rising PSA post surgery, went through IMRT, and still have rising (slightly) PSA. Was it left over tissue that had cancer or had it actually moved away from the prostate bed somehow prior to surgery? I don't think we'll ever realy know.

Subject: Positive PSA after RALPTo: "'The Prostate Problems Mailing List'" , ProstateCancerSupport Date: Friday, January 22, 2010, 6:31 PM

I have had more than one e-mail, and some discussion on the Yana forum about positive PSA results after surgery – particularly RALP (Robotic Assisted Laparoscopic Surgery). Some of these seem to be linked to what appears to be becoming a common practice of testing within four to six weeks of the procedure, as opposed to what used to be a ‘standard’ of 3 months. But others are seeing a rise in PSA some time after the procedure and that is very worrying for them.

My standard response to men who raise these issues is to tell the ones in the first group to have more tests done at a further interval of about six weeks – and to suggest they read Arnod Krongrad’s piece The Major’s PSA at http://www.laprp. com/article. php?aid=278 & type=4 & r=4 & page=2 : to the second, whose concern often is related to very small changes in ultra-sensitive test, I suggest they read the piece I wrote at http://www.yananow. net/UltraPSA. htm

But, having been through that process, there remain some men who still have unresolved problems and who have been told that the positive PSA may come from some prostate gland tissue that was not removed in the surgery – which I would have thought was a bit dodgy, given the multi-focal nature of PCa. Today I have had a second mail from a man who has been told that it is very difficult with the laparoscopic procedure to ensure that the entire gland is removed in sme cases because of th size and situation of the gland.

Anyone have any input in this?

All the best

Terry Herbert

I have no medical qualifications but I was diagnosed in ‘96: and have learned a bit since then.

My sites are at www.yananow. net and www.prostatecancerw atchfulwaiting. co.za

Dr “Snuffy†Myers : "As a physician, I am painfully aware that most of the decisions we make with regard to prostate cancer are made with inadequate data"

[Guest guest]

I had Laparoscopic Surgery this past July at Memorial Sloan Kettering in NY.

Surgeon was Dr Guillonneau. I started with a Gleason 8. stayed the same after

surgery. Margins were clear. Six weeks after surgery PSA was .07. six weeks

later PSA was .08. six weeks following that, PSA was now .1.

Was started on Casodex and Lupron shots and will have Radiation starting March.

one week after starting Casodex, PSA was down to <.05, and has been there ever

since.

Doctor tells me that these PSA numbers are quite low and what they could mean is

that MICROSCOPIC HEALTHY PROSTATE CELLS that ESCAPED during surgery is what's

producing it.

>

> I have had more than one e-mail, and some discussion on the Yana forum about

> positive PSA results after surgery - particularly RALP (Robotic Assisted

> Laparoscopic Surgery). Some of these seem to be linked to what appears to be

> becoming a common practice of testing within four to six weeks of the

> procedure, as opposed to what used to be a 'standard' of 3 months. But

> others are seeing a rise in PSA some time after the procedure and that is

> very worrying for them.

>

>

>

> My standard response to men who raise these issues is to tell the ones in

> the first group to have more tests done at a further interval of about six

> weeks - and to suggest they read Arnod Krongrad's piece The Major's PSA at

> http://www.laprp.com/article.php?aid=278

> <http://www.laprp.com/article.php?aid=278 & type=4 & r=4 & page=2>

> & type=4 & r=4 & page=2 : to the second, whose concern often is related to very

> small changes in ultra-sensitive test, I suggest they read the piece I wrote

> at http://www.yananow.net/UltraPSA.htm

>

>

>

> But, having been through that process, there remain some men who still have

> unresolved problems and who have been told that the positive PSA may come

> from some prostate gland tissue that was not removed in the surgery - which

> I would have thought was a bit dodgy, given the multi-focal nature of PCa.

> Today I have had a second mail from a man who has been told that it is very

> difficult with the laparoscopic procedure to ensure that the entire gland is

> removed in sme cases because of th size and situation of the gland.

>

>

>

> Anyone have any input in this?

>

>

>

> All the best

>

>

>

> Terry Herbert

>

> I have no medical qualifications but I was diagnosed in '96: and have

> learned a bit since then.

>

> My sites are at www.yananow.net <http://www.yananow.net/> and

> <http://www.prostatecancerwatchfulwaiting.co.za/>

> www.prostatecancerwatchfulwaiting.co.za

>

> Dr " Snuffy " Myers : " As a physician, I am painfully aware that most

> of the decisions we make with regard to prostate cancer are made with

> inadequate data "

>