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Increased PSA years after RADICAL PROSTATECTOMY for malignancy.

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Dear Dr, In 1977 my PSA was 33. I had radical prostatectomy done as the the tumor was malignant. Followed by Radiotherapy and Hormone Replacement Therapy. All these years after my treatment my PSA was below 1. My recent test results show my PSA to be 44!! What does this mean and what would be the next course of treatment? If the prostate is removed why should my PSA be at 44? I must add there was no 'sparring' done during the radical prostatectomy. Your advice would be of great value for me. I have ordered another PSA test to confirm today's results. Thank you.

Category: Oncologist

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Category: Hematologist
 32 Doctors Online

Thank you for your query at
Kindly send me your repeat value to confirm your status. One such isolated value can be a false positive. So kindly get it done again and send the values. Have you done any PSA test in last couple of years ??
As evident from your history, you had a quite a good disease-free survival after surgery, RT and hormones . present status can be late metastases which can be one possibility, which could be due to testosterone from testicles.
I would suggest you to do a complete metastatic survey work up if your second value is elevated.
Kindly revert back after your test to guide you.
However, I see a good prognosis considering your long disease-free period.
Feel free to discuss further,

Patient replied :

Dr Prasad Eswaran , Oncologist
You asked if I had any "done any PSA test in last couple of years ??" Yes, every six months and all the values were below 1 - in the decimals. Thank you for your reply. It gives me great encouragement to think positively about the future. Thank you again, warm regards, Jeh.
PS. How long can I consult you like this?

I am glad I could help you.
Dr. Prasad Eswaran
Note from In House Physician:
We allow 5 free follow up questions. So please feel free to discuss again.

Patient replied :

Dear Dr. Eswaran,
A repeat of my PSA (test) showed the same result - 44. I underwent a pelvic and abdomen MRI and the scans showed absolutely nothing in the slighest. My doctor has put me on an antibiotic for the next 21 days. One tablet daily. Following this I go in for another PSA test in the fourth week. His line of treatment if the PSA shows no reduction is to start me once again on Hormone Therapy for the next 2 years. One shot every six months. Afrer seeing my MRI he feels doing a Bone Scan would not help. What is your opinion? I look forward to your reply. Thank you very much, in advance. Jehangir Chinoy.

That might be probably because the physician thinks it could be due to
infection ??. Are there any signs of infection now ?

More than MRI, probably a nuclear scan can be of some help. Please consult with your oncologist regarding
feasibility and availability.

If not, a whole body PET CT can help sometimes, though the uptake in
PET CT can be doubtful certain times.

Kind regards
Dr.E.Prasad, M.B.B.S., D.M.R.T., M.D., D.M (Onco)

Dr. Prasad Eswaran
Category: Hematologist
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

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