DRE after prostate removal

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wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 1/24/2008 2:46 PM (GMT -6)   
I thought one of the benefits of having the old walnut removed is never having to drop my paints again for a DRE.

Everybody else get the finger with their PSA test or is just my doctor?
12/06/07 DaVinci and LRP


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 1/24/2008 3:09 PM (GMT -6)   
Nope, not on my one time post-surgical visit so far.  

James C. 
 
Help support the forums so they can support you:  http://www.healingwell.com/donate 
 
Age 60 
4/19/07   PSA 7.6, referred to Urologist, recheck 6.7 06/05/07
7/11/07   Biopsy- 16 core samples, size of gland around 76 cc. Staging pT2c
7/17/07   Path report:  3 of 16 PCa, 5% involved, left lobe , GS 3/3:6. 
9/24/07   Retropubic Radical Prostatectomy performed 
9/26/07   Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
10/15/07  ED- begin 25mg Viagra nightly, Fully continent
11/15/07  ED-continue 25mg Viagra, no response, begin Vacurect pump-
11/15/07  1st PSA-0.01
12/17/07  ED- 3 mts.-continue Viagra and pump-no change-no response
01/01/08  First use of Caverject 2.5mcg, successful, erections at last
01/14/08  Caverject abandoned due to pain and aching, Bimix ordered


Ripandburn
Regular Member


Date Joined Aug 2007
Total Posts : 125
   Posted 1/24/2008 3:24 PM (GMT -6)   
I've had 2 now, and no DRE. I can't imagine what he is checking. There's nothing left. Just one hand on your shoulder....right?
52 years old
T1c 3+3=6
DaVinci July 16, 2007
largest cancer .2mm
Bladder Sling installed during prostate removal
nerve sparing with both nerve bundles intact
all cancer contained within prostate nothing near margins
PSA after 6 weeks <0.1 - undetectable
PSA after 4 month .07 - undetectable
11 weeks post-op - no more pads


beachbum50
Regular Member


Date Joined Sep 2007
Total Posts : 293
   Posted 1/24/2008 3:32 PM (GMT -6)   
tongue  My Doc told me one advantage of having the prostate removed was I would NEVER have another finger wave (DRE) again!
Beachbum
 
PSA 10 June 2007
Biopsy July 2, 16 of 16 samples positive
T2C
3+3=6
Di Venci 10/09/07, four hours on table, 3 in recovery
Total time in Hospital: 29 hours
Record for Dr. Lance, 65% of prostate had cancer, but NO spread, clean margins
Clean nodes,
First PSA at 5 weeks, UNDETECTABLE!
Catheter out at seven days, dry from hour one!
The Lord has truly Blessed me.


Tamu
Veteran Member


Date Joined Oct 2006
Total Posts : 626
   Posted 1/24/2008 3:40 PM (GMT -6)   
My urologist has never mentioned it in the three post op appointments that I have had. I am not sure what he is feeling. Perhaps he just wants to charge for it.

Tamu
Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06, 6/25/07, 1/8/08
No more pads as of 1/13/07
Began injections in April '07
 


wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 1/24/2008 3:55 PM (GMT -6)   
Ripandburn I will pay more attention next time for sure.
12/06/07 DaVinci and LRP


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 1/24/2008 4:27 PM (GMT -6)   
Actually, I have heard of several docs who still do the DRE. Apparently they are checking for any growths, scar tissues that may be of concern and anything that may seem out of whack. One friend I know...his doc invited several students in to feel what a DRE felt like after the prostate was removed. The doc asked my friend's permission, but he said it was a bit odd to be the show and tell exhibit!
47 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6      (Biopsy 3/07 just suspicious)
10/07 PSA 5.06   (Biopsy 11/07  1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC  www.roboticoncology.com
Saved both nerve bundles.
Path Report:  Stage 2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
 
 


JCL
Regular Member


Date Joined Jul 2007
Total Posts : 242
   Posted 1/24/2008 5:46 PM (GMT -6)   
I've had three post surgery visits and no DRE.
Diagnosed: March 25, 2007. Age 49
Biopsy: Gleason 6. Five of twelve samples positive with <5% each. No perineural invasion seen.
Surgery: May 21, 2007
Post-op Pathology: Upgraded to Gleason 7 (3+4), negative margins, negative capsular penetration, negative seminal vesicles, lymph nodes left intact, multifocal perinural invasion, 15% of prosate involving cancer in both lobes. T2c
Continence: Out of pads at five weeks. Seven months post-op I'm fully continent.
Erections: Yes! With the assistance of Cialis.
Post Surgery PSA: Three tests, all <0.1
Family history: Great-great grandfather died from PC. My Father had his prostate removed at age 67 in 1997 and has had an undetectable PSA ever since. I was diagnosed at a much earlier age and had a more agressive cancer than my father. Go figure.


Pete trips again!
Veteran Member


Date Joined Nov 2006
Total Posts : 1899
   Posted 1/24/2008 6:31 PM (GMT -6)   

Yes,

My post op Uro did it every time. Then I got a new Uro about a year after and he did it to! That Doc didn't work out and I was shopping for a Doc who wouldn't call me names for asking for testosterone replacement theropy which wasn't easy to find. I was called crazy, insane, stupid, and a couple of bleep bleep bleeps!! but every one gave me the cold croocked finger of fate! I don't think it was my good looks that made them dig deeper, maybe it was just punishment for wanting to throw gas on the fire! Anyway I finally found the Uro who would give me the gas (TRT) and have been with him since 12/06 and sure enough, I drop them and bend over every appointment! I guess I'm just lucky like that!

Your friend,

Pete  


54 years old, Surgury, Radical Prostatectomy 8/20/03, PSA 6.6, Gleason 3 + 3 = 6, Adenocarcinoma extent (moderate) Stage & Margin:T2NOMX, No Metastases, Organ Confined, bone scan: Neg. Testosterone Theropy since 12/06. I am's what I am and that's all that I am!!! 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 1/24/2008 7:21 PM (GMT -6)   
Hey Pete,

One advantage of being ugly is no more DREs. My TRT friendly uro just reads my PSA report and writes another T script. He's a keeper...

Jim
Age 73. Diagnosed 11/03/06. PSA 7.05. Stage T2C Gleason 3+3.
RRP 12/7/06. Nerves and nodes okay.
Catheter out on 12/13/06.  Dry on 12/14/06.
Pathological stage: T2C N0 MX. Gleason 3+4.
PSAs from  1/3/07 - 1/17/08 0.00. 
Next PSA test on 7/17/08
 
 
"Patience is essential, attitude is everything."
 


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/24/2008 7:48 PM (GMT -6)   
Personally,
I see no reason for the DRE unless there is a PSA rise. So no, I would not understand a DRE when there is no prostate. But that stated, if the PSA rises, it could be in the prostate bed where the accumulation is (like 90% of the time) and I could understand a physical inspection. As it was, I was pT3b after surgery with a pre-op PSA of nearly 20 and cancer all over the place. My DRE's were negative. Must not have aimed their fingers well?

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
Visit my journey at:
 
STAY POSITIVE!


AndrewJ
Regular Member


Date Joined Jul 2007
Total Posts : 25
   Posted 1/25/2008 12:54 AM (GMT -6)   
I'm in Germany and it looks like they do some things differently here. I rarely had a DRE (even during the diagnosis period - maybe twice) - it was always an ultrasound using a nasty-looking probe - something like a light-sabre out of Star Wars. I came to hate that thing, but even I was interested to see the real-time images on the screen. Like others here, I thought one advantage of RP would be no more big probe where the sun don't shine. First visit post-op: no mention. 2nd visit: out came the big stick. He said he wanted to check the cavity where the prostate had been. Using this thing, my Urologist found traces of tissue and seminal vesicles, which he was concerned about (and followed up with the surgeon - another story for another post). "Bottom" line is that he wants to do this each time now to check that the tissue traces don't start growing again. When I rolled my eyes, he said I didn't have to if I didn't want to. I said anything that keeps that disease away is OK with me.
45 years old, Australian living in Germany
PSA: started around 3.5 in 2005, 6.1 at time of surgery
Biopsy: nothing found in 2006, 3 May 2007 3 of 24 cores positive, Gleason 3+3 or 3+4 depending on pathologist
RPE in Munich, Germany on 22 June 2007
Post surgery pathology: organ confined but less than 1mm from margins, Gleason 3+3, pT2c, Lymph nodes removed and clear
First post-surgery PSA 31 July 2007: 0.01 Confirmed in September and again in December.
Fully continent immediately after removal of catheter on Day 8.
No potency issues & looking at discontinuing small doses of Levitra "as required". (Still holding onto it as my security blanket.)
This man knows he has been VERY lucky.


PianoMan
Regular Member


Date Joined Feb 2007
Total Posts : 365
   Posted 1/25/2008 2:10 AM (GMT -6)   
I've heard about these post-op DREs too and wondered why the docs would want to do them. I think Paul1959 may have the answer to this riddle -- some docs want to check for any weird growths, scar tissue, etc.
So far, I'm having my post-op follow-up through my family doctor via PSA tests every six months.
Coincidentally, the other day I asked my doc what she thought of DREs for post-op guys with undetecable PSA levels and she looked at me as if to say, "YOU'RE KIDDING, RIGHT?"
I said thanks, because after what we fellows go through in our diagnoses and treatments, the last thing we want is another probe of any kind stuck up our "gazoos."
We shared a laugh when I told her if I had as many things sticking out of me today as I had stuck into me a year ago, I'd look like a friggin' porcupine.
Best to y'all..
Tom


D.O.B - 8/9/52

PSA: First ever was 9.8 in late Oct. ‘06, two weeks later, 10.1

DRE: Negative

Biopsy results 11/22/06.  Both lobes involved.  Six out of eight cores positive - from 100 percent to 90, to 60, to 50, two 20s and two zeros.

Gleason 3+3 = 6

Da Vinci Robotic RP surgery, City of Hope, Jan 12, 2007

Post surgery pathology – Organ confined, Gleason still 6, margins clear.  Volume of tumor much less than biopsy suggested.  12 percent overall.

First post-surgery PSA -- Undetectable, 2/20/07

Second post-surgery PSA -- Undetectable, 9/11/07

Post Edited (PianoMan) : 1/25/2008 8:12:44 PM (GMT-7)


smilingoldcoot
Regular Member


Date Joined Jan 2008
Total Posts : 338
   Posted 1/25/2008 10:36 AM (GMT -6)   
I am not there yet but my wife and I thank ya'll for the laughs. yeah
Richard & Debbie
The Shores of Toledo Bend Lake Louisiana
PSA 11/08 was 4.9 PSA 12/08 was 7.7
Biospy 1/10/08 positive for high grade Cancer but no Nodes noted
Gleason score 9, Stage T1C
Bone scan negative with additional exrays ribs and pelvic
Referred to M.D. Anderson, Houston, TX
Turn Stumbling Blocks into Steping Stones


Gene214
Regular Member


Date Joined Mar 2007
Total Posts : 422
   Posted 1/25/2008 12:05 PM (GMT -6)   

I went in two weeks ago for my regular 6-month check up with mly regular doctor.  I was surprised when he said, "bend over" as he put on his gloves.  I prostested, "But I no longer have a prostate!"  "I know!" said the offended doc. "Then why do you want to do that?"  He replied with somewhat of a smart attitude, "I am feeling for other things... like anything unusual."  So I bent over and endured it one more time, just like a good little boy.  But I still get flushed when I think of his attitude.

Gene


Age: 63
07/05 - Biopsy: Suspicious looking cells. 
12/27/06 - Biopsy
1/24/07 - Dignosed cancer: Gleasn Grade: 3+3=6
02-14-07 Radical Open Nerve-sparing surgery
Pathology Stage of cancer: T2c
4-18-07: First Post-Op psa = 0.011
05/31/07: Cystoscope reveals "Stricture"
06/12/07: Procedure to remove stone & dilate uretha at stricture: Successful procedure.
8/16/07: Start bleeding again in urine.  Get to see a new urologist same day.
8/20/07: Go back to dr. for cystoscope.  "No sign of stricture"!  Wonderful news! Still leaking.
8/31/07: Back to new urologist for regular check up & received 2nd post-op Psa.  It was 0.05
8/31/07:  First Bio Feedback session.
9/19/07: Finished 4 Bio Feedback sessions.  No imporovement with leaking. 
9/26/07 - Started injections 
10/27-07 - Began using clamp at uro's encouragement.
1/6/08 - Still incontinent & impotent... and still "down."   
 
 
 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2361
   Posted 1/25/2008 12:17 PM (GMT -6)   

I heard a true story about a guy who showed up at a free community prostate cancer screening that included a PSA and a DRE. At the check-in he was told that he would have his blood drawn first, followed by a prostate exam by a physician.

He replied, "I thought they were going to do a computer check of my prostate?"  The woman at the check-in looked puzzled and said, "I'm not sure what you mean."  The man said, "Well, it said on the notice that we would get a blood test for PSA and a "digital" rectal exam.  The woman laughed and said, "In this case, digital doesn't mean by computer, but means a finger."

Blame it all on the computer age in which we live...Tim



Age 59 PSA 2.6 PSA velocity quadrupled in 1 yr 
1 of 12 biopsy cores positive Open RP 6/21/06  Gleason 5
Cancer confined to prostate  Post-op PSA's non-detectable


War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 1/25/2008 12:31 PM (GMT -6)   

I have found out that the DRE is a secret handshake that most doctors use. I have had it almost every time by my radiation oncologist. If my dentist ever trys it, I'm gonna blow a fuse.

War Eagle to all.

Walt


Age: 54
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005 (Eligard every 6 months)
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007 Bone mets
Casodex 4/2007
Zometa infusions 4/2007
PSA 4.8 8/2007
PSA 6.34 12/2007
Radiation (15 treatments) started on bone mets 12/2007
PSA 6.72 1/2008
 
 
"I will persist without exception - I will find a way where there is no way"


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 1/25/2008 12:45 PM (GMT -6)   
LOL,
Walt, when I had my first one the doctor joked, "there it is, oops, no that's your tonsils." So I think your dentist comment rings in here. If my dentist ever tries it, he will become his own patient.

Tony
Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
 
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
 
My Life is supported very well by family and friends like you all.
 
Visit my journey at:
 
STAY POSITIVE!


kdnole
Regular Member


Date Joined Jun 2007
Total Posts : 152
   Posted 1/25/2008 1:11 PM (GMT -6)   
I had a DRE 3 months post surgery but that was it so far. He was just checking for anything unusal - scar tissue, etc.

Age 44
PSA 4.8
Gleason 3+3=6
T2
Biopsy - 3 of 12 (2@20% / 1@80%
Da Vinci 7/31/07 @ Duke
2.5 hr. surgery, released from Duke with in 14 hrs.
Saved both nerve bundles. 
Foley out 8/10/08
Positive Pathology Report 
Near left side nerve bundle
New Gleason 7
Oncology visit in the near future for radiation
Back to work 3 weeks following surgery - Sales
 
9/13/07 - 1 Post PSA Undetectable less than 0.1 
 
9/17/07 - Pad Free! 
 
10/11/07 - ED, Trimix injection .2cc Tooo much but it worked. Now on .05cc, 3 times a week
No luck with viagra or pump. 
 
11/19/07 - 5 mth. PSA 0.1 (Ouch)
12/14/07 - 1st Appt. with Medical Oncologist - Radiation here I                 come. (This sucks)  


Paul1959
Veteran Member


Date Joined Nov 2007
Total Posts : 598
   Posted 1/25/2008 1:27 PM (GMT -6)   
I agree with Walt. For months everytime I met a doctor he wanted to stick his finger up my whazoo. Well, after meeting over a dozen physicians, iit became such second nature that I accidentally mooned my boss when I entered his office.....sigh.
47 at Diagnosis.
Father died of Pca 4/07 at 86.
1/06 PSA 3.15
1/07 PSA 4.6      (Biopsy 3/07 just suspicious)
10/07 PSA 5.06   (Biopsy 11/07  1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC  www.roboticoncology.com
Saved both nerve bundles.
Path Report:  Stage 2cNxMx
-Gleason (3+3)6
-totally contained to prostate,
-10% involvement in L & R Mid lobes
 
 


Pete trips again!
Veteran Member


Date Joined Nov 2006
Total Posts : 1899
   Posted 1/26/2008 8:35 AM (GMT -6)   

Ain't it great the way we can joke about a subject that the rest of societies male population is teriffied even to talk about? Like Paul said, after what we've been through, the DRE is almost like shaking hands w/ your Doc when you see him! Y'all crack me up! Keep the funnies coming, they are good for the soul!!!

Your friend,

Pete

PS>>> Jim, if UGLY was protection from DRE's I'd still have my prostate! 


54 years old, Surgury, Radical Prostatectomy 8/20/03, PSA 6.6, Gleason 3 + 3 = 6, Adenocarcinoma extent (moderate) Stage & Margin:T2NOMX, No Metastases, Organ Confined, bone scan: Neg. Testosterone Theropy since 12/06. I am's what I am and that's all that I am!!! 


CaPCa
Regular Member


Date Joined Aug 2007
Total Posts : 118
   Posted 1/26/2008 12:31 PM (GMT -6)   
A couple of years ago prior to my surgery, I happened to have my physical scheduled on Halloween. Everyone in the doctor's office was dressed in costume, including my doc. As a result, I my DRE was done by Elvis.

Age:44
Father diagnosed and cured at age 52.
08/21/07: Diagnosed with T1c cancer
1 of 12 biopsy cores positive; 10% tissue
Gleason score: 3+3=6
PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)
10/19/07: da Vinci prostatectomy by Dr. Vipul Patel at OSUMC.
              Difficult surgery due to prostate inflammation.
              Both nerve bundles spared.
              Spongy erections began within 24hrs of surgery!
10/24/07: Catheter out; down to 1 Serenity pad/day next day.
              Final pathology: neg margins, no capsular penetration,
              Gleason 3+3=6, 5% tumor involvement, multi-focal.
11/04/07  First usable erection with Cialis
11/22/07  Thanksgiving - Bye-bye, pads
01/17/08  First post-surgery PSA result: < 0.008 ng/ml
 


HIFU
Regular Member


Date Joined Feb 2007
Total Posts : 27
   Posted 1/26/2008 2:15 PM (GMT -6)   

Had Hifu March "07, and seen my Uro 4 times.

3 with DRE

0 DRE last time 


Age 75
January 2007 PSA 14.2
February 07 Gleason 3+4=7
March 2, 07 TUR-P+HIFU Munich Germany by Prof Chaussy and Team
April 30, 07 PSA Undetectable 0.05


wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 1/26/2008 3:33 PM (GMT -6)   
First week in feb is my first psa test date. I will post if I have a DRE, if I fell two hands or if I find myself . . . enjoying it.
12/06/07 DaVinci and LRP


War-eagle
Regular Member


Date Joined Sep 2007
Total Posts : 219
   Posted 1/26/2008 7:20 PM (GMT -6)   

I have set here today laughing over the Elvis DRE. CaPCA, don't tell me your doc said' "thank you..thank you very much"?

Every time I think about another DRE one image keeps coming to mind and I laugh till I have tears. Anyone remember the movie Cannonball Run with Burt Reynolds? Remember the doctor that rode in the ambulance? If I were to walk into a doctors office and see him there, I think I would run from the room screaming. 

Sweet dreams to all.

Walt


Age: 54
PSA 43 7/2005
Biopsy 12/14 Gleason 7 & 9
Divinci 9/2005 - spread to bladder
HT - 10/2005 (Eligard every 6 months)
RT - 10/2005 (38 treatments)
PSA 0.12 to 1.9 2/2007
Bone Scan and CT 4/2007 Bone mets
Casodex 4/2007
Zometa infusions 4/2007
PSA 4.8 8/2007
PSA 6.34 12/2007
Radiation (15 treatments) started on bone mets 12/2007
PSA 6.72 1/2008
 
 
"I will persist without exception - I will find a way where there is no way"

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