hi brandon - as a young member of the club you didn't want to join, that
must have been quite a shock for everything you're gone through.

assuming the lab didn't do something on the psa to give a higher reading
and that it is correct, then you have read enough to know that there are
some prostate cancers giving off psa.  it's still very early in the ball
game to say what they will suggest.  if you have been reading the posts
here, you will have noticed quite a few very good suggestions.

you didn't give your psa at the time of your RP, your staging or your
gleason.  

but you still have a lot of miles on the body there,  just have to do a
little maintenance.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional

Dr. Walsh's book addresses this, starting on page 302.  It is much to
complex to summarize here.  But obviously repeating the test is wise, since
how fast the PSA is rising is a factor.

Another factor is your pre-op Gleason score.  Dr. Walsh writes that with
Gleason 7 or lower, radiation to the prostate bed is likely to be
beneficial, whereas with Gleason 8 or higher radiation may not be the way to
go.

Hope this is a false alarm for you.

jimhoney

Hopefully, this is just a false alarm.... a fluke in the test results.
Do you know if it was a different lab that did this test than the one that
did your other four??  Sometimes the type of test can make a slight
difference.

I'd suggest having the test re-done by the same people who did your other
four... to see what results come back.

Take care,
MikeH

You have a very good reason for concern, but not necessarily one for fear.
First, your PSAs were likely reported to you as less than 0.1, not .01, but
I could be wrong.  Less than 0.1 is considered (for the moment)
undetectable.  If I am correct, you went up 8 hundredths of a point.  It is
possible that your next one will be back where it belongs.

If not, and I guess the chances are 50/50, then you will likely be offered
external beam radiation treatment (EBRT) of the prostate bed for recurrent
prostate cancer.  In other words, you will go to a center 40-35 consecutive
weekdays while a particle beam accelerator shoots particles through your
body.  It will take no time at all each day, no pain, and minor temporary
side effects.

Don't get too concerned yet, just watch it more closely for a while.  The next
step if it stays up or increases more is a bone scan.  If no mets are found,
radiation to the prostate bed will probably be tried.  If it keeps going up
after that, hormones and/or chemothrapy are next.  My chemotherapy seems to be
doing very well.

Hi Brandon...When the nurse called with my last PSA test result, she
read it wrong.  Although I knew she probably read it wrong and that I
was probably OK, it was more than enough to raise my blood pressure a
few points.  We understand where you're at.

You might want to post some more data like your pre-op PSA, TNM
staging, GS and biopsy results, also your post-op pathology results.
This information could help us respond to your question more clearly.
In any case, the following scenarios are among the possibilities that
could play out:
1. The lab made an error: A 20-fold error is unlikely, but not
impossible.
2. Standardization issues: Since two labs are involved, test
standardization issues come into play.  Again, a 20-fold
standardization error is unlikely, but not impossible.
3. PSA recurrence without disease progression: A small percentage
(around 2.3%) of men have a PSA increase at some point after surgery,
but the PSA remains stable thereafter and there is no clinical
progression of the disease (Urology 61: 380-385, 2003).
4. The PCa has recurred: Again, without your stats it's difficult to
say, even with your stats it won't be open and shut, so take the
following as pure speculation.  PCa at age 41 and with cancer in all
quadrants might be signs of aggressive disease.  If so, it may have
escaped from the prosate prior to surgery.  There are many treatment
options for post-surgical recurrence.  You might want to read Pounds
paper on post-surgical recurrence longevity (JAMA, Vol 281, No. 17
1591-1597, 1999).  He makes clear that, even if you do nothing, you
still would have a significant amount of time in front of you.  Of
course, doing "something" will add to this.

Your plan for a retest makes sense.  If the PSA remains elevated, then
you've caught it early and have time to plan and react.  Keep tracking
the PSA and determine a doubling time, that will be a key.  A good
oncologist who specializes in PCa would be able to work with you and
help you chart a course.  If you post your location and ask for
recommendations for a good onc on this or other newsgroups, you'll get
helpful responses.

At this time we don't know what caused the PSA reading to be high.
I'm pulling for the error scenario...Best wishes and good health, Ron

 Concern is indeed in order, thus the repeat test. Cross your fingers,
we've had folks that have had screwy test results before, that were in
error.