A friend has had his prstate completely removed after a biopsy, but his
PSA continues to be elevated. Does anybody have any information on why
this happens. Is it normal, significant or is the elevated PSA a
possible indicator of metastitization?

steve jordan

It is evidence that PCa cells had escaped the gland prior to the surgery,
which at best is only a local tx.

This means that the PCa is "systemic" which is *not* the same as
"metastasized." As such, it can be treated but is not curable.

For authoritative information, not just my amateur ****ysis, see the
Prostate Cancer Research Institute website:
http://prostate-cancer.org/index.html

Corky's friend should also buy and study _A Primer on Prostate Cancer_,
subtitled "The Empowered Patient's Guide," by Stephen B. Strum, MD, a
medical oncologist who specializes in PCa, and Donna Pogliano, a PCa
warrior. It is thorough and, unlike some of its competition, objective.

I most earnestly recommend that the patient consult a medical and a
radiation oncologist. A urologist is only a surgeon and is useless in this
situation.

Although the hour is late, there is still much that can be done -- *IF* the
patient educates himself. This is a war with a ruthless, merciless killer.
Study, learn, take charge!

Regards,

Steve J

"If you know the enemy and know yourself, you need not fear the result of a
hundred battles. If you know yourself but not the enemy, for every victory
gained you will also suffer a defeat. If you know neither the enemy nor
yourself, you will suc***b in every battle."
--Sun Tzu, "The Art of War"

leonard evens

It means that not all the prostate tissue was removed, and most likely
there is some cancer remaining in his body. If it is localized in the
prostate bed, it may be possible to treat it with radiation. On the
other hand, it may have spread to distant sites even before the surgery.
In that case, it can be controlled for an unknown period of time but
not cured.

The most common treatment for prostate cancer which has spread to
distant sites is the use of drugs which suppress production of male
hormones. There are some differences of opinion among prostate cancer
experts about when to start such treatment and how to administer it.
Dr. Peter Scardino of Sloan Kettering has written a book which presents
a balanced viewpoint, I feel, of all aspects of prostate cancer, and
that might be one place to begin for general background. In the end,
of course, your friend should rely on his physician for advice. If he
feels he is not getting good advice, he should seek additional medical
opinions and possibly switch to another physician. But it is probably a
mistake to decide on one's own, from information obtained on the web,
what the proper treatment is and then to shop around for a physician who
will provide it.

We live in a small town with (in my opinion) very inadequate health
care resources, so an unbiased second opinion here is hard to get.
I'll recommend that he goes to one of the research(universtiy) hopitals
in the area. That means a drive of at least 4 hours but it's better
than taking chances. Thanks for your help
Corky

bill houdek

My PSA has also risen during the 12 years since my surgery. The explanation
I was given was that it is always possible some micro-particles could remain
and they tend to grow and expand. These particles were so small they were
not detected in biopsy or didigital exam but do result in elevated PSA.
Since then, I am on Lupron Depot plus Casodex. As there was a spot on a rib
indicating Metastasis, am taking a monthly infusion of Zometa. My PSA
continues to creep upward and this is troublesome but being carefully
monitored.

Bill Houdek