How is post-surgery PSA monitoring done?

Question

Hello doctor,

Recent prostatectomy pathology revealed positive surgical margins and extracapsular extension, with the Gleason score upgraded from 3+4=7 in the biopsy to 4+4=8. Post-surgery PSA is 0.1 ng/mL. My urologist recommends adjuvant radiation therapy. How urgent is this additional treatment, and could it impact my continence recovery? Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your post-surgery findings suggest a higher risk of residual or recurrent prostate cancer (which occurs when cancer returns after initial treatment). Although your PSA (prostate-specific antigen) level of 0.1 ng/mL (nanograms per milliliter) is low, it is still detectable, indicating the possibility of microscopic disease remaining. This is why your urologist has recommended adjuvant radiation therapy (ART) to target any remaining cancer cells and reduce the risk of recurrence.

ART is typically started within four to six months after surgery when high-risk features, such as positive surgical margins and extracapsular extension, are present. Delaying this treatment could increase the likelihood of cancer progression and recurrence.

Radiation therapy can cause some irritation and scarring in the bladder and urethra, potentially impacting continence. However, if you have already regained significant continence after surgery, the risks of radiation therapy affecting it are generally lower. Additionally, pelvic floor exercises can be helpful in further improving continence and strengthening the muscles involved in urinary control.

It is important to discuss any concerns with your urologist regarding the timing and potential side effects of the recommended treatment. The goal is to effectively manage the cancer while minimizing the impact on your quality of life, including continence.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.