I am a year into my journey and it has had its ups and downs. I am now in a situation where after just a year my PSA has begun to rise. I know it is only a small reading but it has gone up from being undetectable for at 6; months to 0.04 and now the year point 0.07. As I said small readings but a definite increase. My nurse told me that the surgeon will not instigate any investigations until the reading is 0.1. I understand this is because any cancer which gives such low readings will ne difficult to find. My problem is that I feel the surgeon has made some errors in the treatment plan.
it was identified on the initial biopsy that there was Perineural invasion. My consultant said this was not an issue and would not effect the outcome. However I have read that Perineural invasion would be considered as a negative when considering nerve sparing surgery. I had nerve sparing surgery and in less than a year I am showing negative signs.
On the biopsy from the removed prostate there was positive margins, which from my research suggests the need for closer monitoring, this has not been implemented as I went from one undetectable at 3 months straight to 6 monthly testing. The 0.04 reading was a blood test my GP asked for along with my yearly hypertension check. I have read that in some authorities positive margins are treated, why not in my case as I had 2 danger signals, perineural invasion followed by positive margins.
what should I ask the surgeon when I speak to him.
sorry if I come across as neurotic but it hasn’t been an easy ride.Al985
Hello Al985
Yes, it looks like you have had a very bad time with your surgery - there's no mention of PIN in your journey notes - although from my understanding with surgery they are blind until they open you up. They do have the MRI scan to go off but again - when you agree to surgery there are no guarantees.
Your PSA is rising but it's only 0.07 - the guidelines are further treatment once your PSA is above 0.1 - and this would be Radiotherapy and possibly Hormone Therapy.
A Second Opinion now would only suggest you need further treatment once once your PSA reaches 0.1 - if you are unhappy with your treatment to date you need to go back to the treating hospital - your first line of complaint is to the NHS Service Provider.
I am sorry - but I am being honest with my advice, but I hope it helps.
Best wishes - Brian.
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