Community Forum

Chris, you need to be referred to an Oncologist rather than a Urologist. They are likely to request a PET CT scan to determine to site of your PSA generation to look to see if it can be specifically targeted. You have been unlucky, but your tumour was locally advanced (T3) at the time of surgery, wh...

Chris I can see how the change in numbers is unsettling for you. The fact that your PSA has both apparently fallen and risen following surgery highlights the fact that the PSA test is not very accurate at the lowest limit of detection. This is why the definition of biochemical recurrence (failure) i...

Roland It is certainly possible that your low testosterone is contributing towards your erectile dysfunction (ED) and now that you are more than 1 year following surgery it would be reasonable to start testosterone replacement therapy. This is usually in the form of a gel or a patch applied to the s...

Carlos A biopsy is only a sample and, as you point out, can be inaccurate if it fails to represent the whole organ. This is called sampling error. The larger the prostate, the greater the possibility of sampling error (think needle and haystack). Sampling error can be reduced in a number of ways: ta...

Carlos This is an excellent question and the short answer is that it depends on the surgeon. Excellent results have been published in the medical literature for open, laparoscopic and robotic surgery, but so have very poor results and, by definition, most surgeons will achieve average results using ...

Chris Unfortunately, up-staging and up-grading of prostate cancer, as was seen in your case, is not rare and occurs in 5-30% of men, depending on which surgical series from the published literature you read. The advantage of surgery over radiotherapy as the initial treatment is that armed with knowl...

Hi and I'm sorry to read about your father's problem. I assume that you meant 6 month (rather than 6 week) check as November 2015 was 6 months ago and that he's had some form of imaging that shows nodal recurrence, such as a CT, MRI or PET CT scan, which followed an elevated PSA level. Depending on ...

Peter The 3 scenarios that commonly cause men to abandon active surveillance and seek definitive treatment are:- PSA progression. Gleason progression. Wanting to end uncertainty. If I understand your post correctly, your PSA in 2012 was 5.7 and is still 5.7 in 2016 but has fluctuated significantly b...

Hi. I think that many of the answers to your questions are covered in http://www.theprostateclinic.org/community/viewtopic.php?f=5&t=803 . Total PSA is elevated by age, prostate size, prostate injury (such as biopsy), urinary infection, bladder outlet obstruction and ejaculation, as well as canc...

PSA is an imperfect tumour marker but it is still an excellent tool for identifying men in whom more interest needs to be taken to either exclude or confirm the presence of prostate cancer. We know this because the largest screening study for prostate cancer (the European Randomised Screening study ...