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Prostate Cancer

Elevated PSA

03/18/2011

Question:

3 and 1/2 years ago I was examined by Urology for an elevated PSA and BPH, PSA was @ 6.7. Subsequent levels fluctuated and biopsy revealed adenocarcinoma, Gleason 7[3+4] bilateral lobes. Initial laparoscopic surgery attempt was converted to a radical prostatectomy, pathology revealed a Gleason 5[2,3] adenocarcinoma, dissection also revealed follicular lymphoma grade 1. Regular PSA screening had been over looked for the past year and 1/2, PSA taken 4 months ago was @ 2.6, one month ago @ 1.46. My health care provider through medicare are draging their feet wile I`m sweating bullets, they said they wanted a second opinion, this was two months ago. I`ve had a bone scan that was negative, my Oncologist ordered Radiation therapy, still no authorization. I must admit, I`m scared, any suggestion`s or recommendations would be very welcome, I don`t know where I stand or where I`m going, [please help]

Answer:

A detectable psa after a prostatectomy does indicate likely residual disease. I would agree with your oncologist you should be seen by a radiation oncologist for consideration for adjuvant radiation.

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Response by:

Lee E Ponsky, MD Lee E Ponsky, MD
Associate Professor of Urology
School of Medicine
Case Western Reserve University