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    PSA of 40.00 after Surgery?
    Anon_151893 posted:
    Almost two years ago I had my prostate removed via robotic surgery due to elevated PSA, at the time 3.34 and a gleason count of eight. I was 59 then. My two PSA tests thereafter in March 2011 and August 2011 were 0.1 and 0.2 respectively. I had no more tests until last week with a result of 40.00 not 4.00. My doctor did the test again this week and this time it was 45.00. Can one of Web MD's Urologists please explain to me how this is possible after the prostate has been removed. I currently have no insurance and have to wait for a city hospital appointment on 10/31 to see a urolgolist. In the meantime I'm worried and confused. I thought my problem was over having opted for the surgery rather than radiation or seeding.
    Basir U Tareen, MD responded:
    With a Gleason 8 prostate cancer there is certainly a chance of PSA recurrence after surgery. Just because the prostate is removed, doesn't mean that it hadn't already spread (microscopically -- ie, no way to tell on CT/x-ray/etc.) to either the local area where the prostate was located or to the lymph nodes/bone.

    The fact that the PSA never went to 0 after surgery suggests that it was always present even after surgery.

    At this point you need to get some imaging studies -- bone scan and CT or MRI. If there is obvious metastatic disease than likely homone therapy is the next step. If there is no evidence of visible disease on imaging studies than you need to consult with your urologist and possibly a radiation oncologist as to whether radiation therapy may be worth considering.

    best of luck,
    Dr. Tareen
    cbonjo replied to Basir U Tareen, MD's response:
    Thank you Dr.Tareen.You are right on the money. I did have abone, pelvic and lung scan and the pelvic scan revealed a lympnode of 3cm. I had one hormone shot in November and the PSA at 12/31 was 0.4.I also read about the side effects of these shots. Is there any chance of radiation or any other treatment that my doctormay not be aware of and if I continue these shots what are my chances of survival and for how long.

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