How long after surgery for first PSA test

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KrisP
Regular Member


Date Joined Mar 2008
Total Posts : 162
   Posted 6/4/2008 8:11 AM (GMT -6)   
I've been reading quite a few posts on how long after surgery should we wait for the first PSA test. I found folks doing it from 6 weeks to about 3 months. Is there a specific length of time for the old PSA to work itself out of the body? I'm just starting my seventh week post surgery and my doctor told me to do it after 8 weeks or later.
 
Kris
Biopsy done 3/2008
Pre surgery: Gleason 6 (3+3), involving left lobe
DRE=15gm with indurated left base and mid prostate
Cores positive: left base medial, left base lateral, left mid medial and left mid lateral (4 of 12)
Clinical stage t2b.
Prostate Carcinorna 185
DaVinci Surgery on 4/21/2008 in Austin by Dr Randy Fagin.
Pathologist report upgraded to a Gleason 7 (3+4)
Clinical stage upgraded also to a T3a
Margins Clear


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 6/4/2008 8:47 AM (GMT -6)   
Hi Kris! Congrats on making it through surgery and best wishes for a lifetime of undetectable PSAs. This question comes up frequently and there are varying answers. If you go up to the "google" box located at the top of the screen and type "psa after surgery" or something similar, a list of threads relating to the topic will appear. There have been a lot of great discussions on here regarding PSA tests at 6 weeks vs. 3 months etc.
My father's surgeon recommended 12 weeks, but we did one a little earlier because of his pathology report. His 6 week PSA was .07 and his one that was done around 8-9 weeks was .05. We were obviously hoping for less than .01, but it could have been worse too. Good luck and I am sure you will get quite a few responses!
Father's Age 62 (now 63)
Original Gleason 3+4=7, Post-Op Gleason- 4+3=7,
DaVinci Surgery Aug 31, 2007
Focally Positive Right Margin, One positive node. T3a N1 M0.
Bone Scan/CT Negative (Sept. 10, 2007)
Oct. 17 PSA 0.07
Nov. 13 PSA 0.05
Casodex adm. Nov 07, Lupron beg. Dec 03, 2007 2 yrs
Radiation March 03-April 22, 2008- 8 weeks 5x a week
Praying for a cured dad. First PSA 3 months!


Co-Moderator Prostate Cancer Forum


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 6/4/2008 9:18 AM (GMT -6)   

Hi Kris,

I had mine at 6 weeks.  Did not provide number but stated undetectable.  I had a bad margin and got upgraded like you to Gleason 7.  They are anticipating me getting radiation at around the 3 month marker after I heal more but I am betting that if my 3 month PSA is significantly less undetectable than the 6 week undetectable they may reconsider. I will kick my heals and howl at the moon it that occurs.

I guess I am saying it depends on a lot of things such as your situation and your Doctor. No matter what the number or time they take it they cant do anything now for you need to heal more. You should have a 3 month re-examine with your Surgeon.

I was tempted to ask for the exact numbers i.e. .005 or .00005. or whatever but I guess I just want to get on with this, what ever I need to do I will do.  In the meantime I am going to livvvvvve and be free. tongue tongue

Frank

 


Diagnosed 01-08-08 @ 53 years old 
DRE normal - High PSA for 5 or more years
2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
Current PSA 6 - Bone and Ct scans negative
clinicalg Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008
University of Chicago,5 hour surgery , 3 hour recovery
Unexpected Cardiac issues appear and disappear?
Hospital stay 30 hours - Catheter out in 7 days  normaly expected leakage - Erectile funtion back on line 9 days 
Post Pathology T2C, Gleason 7, 10 % of both portions of prostate, Seminal vessels clear, fat tissue clear,Tumor on top of prostate distal from apex. 1 positve margin at urethra and bladder.
Six week PSA < 0.05 Ya Ba Da Ba Dooooooooooo.  Put a steak on the grill Wilma!!!!
Oncologist to discuss case with Urologist and Radiation Oncologist to consider radiation.
 


JCL
Regular Member


Date Joined Jul 2007
Total Posts : 242
   Posted 6/4/2008 10:20 AM (GMT -6)   
My first post-surgery PSA test was taken exactly five-weeks after surgery. Fortunately it was undetectable, but if it wasn't I was ready to request another test since most of what I had read stated the test should be done between two and three months.
Biopsy: Diagnosed March 25, 2007. PSA 3.0. Gleason 6. Five of twelve samples positive with <5% each. No perineural invasion seen.
Surgery: May 21, 2007, Florida Hospital, Orlando,FL
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/Erections Out of pads at five weeks. Fully continent and can achieve erections.
Post Surgery PSA: Four 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.


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 6/4/2008 10:22 AM (GMT -6)   
Hi KrisP,

Apparently it takes some time for all the residual PSA to wash out of a persons system. My doctor ordered my first test 3 month after the operation to make sure that any residual has left the body. Waiting for that first test result can be somewhat nerve wrecking and it doesn't get any easier with time, but patience is an absolute must with this disease.
Wishing you a full and speedy recovery.

Magaboo
Born Sept., 1936
PSA 7.9
Stage T1C
-ve DRE
Gleason's Score 3+4=7
2 of 8 positive
Open RP 28 Nov 06
Post op staging T3
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06
Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA test Mar., 08 =.04 
 
 


biker90
Veteran Member


Date Joined Nov 2006
Total Posts : 1464
   Posted 6/4/2008 10:45 AM (GMT -6)   
My first PSA was 3 weeks after surgery. It was .04. The next was 3 months later and then every 3 months for the first year. Now it is every 6 months.

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.
50 mg Viagra + 1000 mg L-Arginine + .03 cc Trimix = Excellent Results
PSAs from  1/3/07 - 1/17/08 0.00. 
Next PSA test on 7/17/08
"Patience is essential, attitude is everything."


Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 6/4/2008 11:37 AM (GMT -6)   
90 days is the manufacturer suggested retail amount unless the surgeon has any reservations tongue
 


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 6/4/2008 1:46 PM (GMT -6)   

my surgeon requested on 4 weeks after surgery.  i go in this friday for my first one.  he requested it before my pathology report came in.  after surgery, he said everything looked good.  i was upgraded to gleason 8 but margins were clear.  i have always heard 2 - 3 months after surgery.  

 


 
Age 48
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
surgery may 9, 2008 - houston, tx
pathology report -gleason 8
margins clear
waiting on first psa post surgery
continence ok during day - 1 pad
night time different story
kegel's twice a day 20 reps


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 6/4/2008 2:14 PM (GMT -6)   
I am part of a trial group experimenting with some sort of "Italian stitch" which is an extra stitch somewhere to supposedly help you regain continence faster. I have no idea whether I got the stitch or not (I cannot know for the trial). By the way I am dripping, I would bet money I don't have any special stitch.

Anyway, as a reward, they are doing a PSA at 6 weeks. But my doctor (the famous Jason Engel - he of the NY Times article) says, "I don't want to hear about it. I don't care what your 6 week numbers are. It is 3 months that counts." And then he usually says something like, "Everything else is crap." So there you go.
kcragman
Age: 52
March 2006: PSA 2.5
Dec 2007:   PSA taken for insurance application. I did not see the results until late Jan '08 - after I was rejected. Their lab said PSA 4.5. PSA again in Feb '08: 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were cancerous and the 6th did not look good.
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.
Post op: Gleason 9 (4+5). 15% of prostate involved. Negative margins. Lymph nodes and associated glands all appear to be cancer free.


KrisP
Regular Member


Date Joined Mar 2008
Total Posts : 162
   Posted 6/4/2008 3:03 PM (GMT -6)   
Thanks for all the response. Boy, I can't wait to get this first PSA done and over with. I havn't had a glass of wine since two weeks prior to surgery and I'm trying to hold up until my first PSA. Not sure if it will make a difference.

Kris
Biopsy done 3/2008
Pre surgery: Gleason 6 (3+3), involving left lobe
DRE=15gm with indurated left base and mid prostate
Cores positive: left base medial, left base lateral, left mid medial and left mid lateral (4 of 12)
Clinical stage t2b.
Prostate Carcinorna 185
DaVinci Surgery on 4/21/2008 in Austin by Dr Randy Fagin.
Pathologist report upgraded to a Gleason 7 (3+4)
Clinical stage upgraded also to a T3a
Margins Clear


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 6/4/2008 3:10 PM (GMT -6)   
good to hear the 3 month psa is the key.   i will let you know what mine is after a month and what the doctor says.  also, i am waiting on a glass of wine as well.  i have had 2 cups of coffee since surgery.  i drank them last saturday (i used to drink 3 or 4 cups a day).  i do miss my caffeine but am only drinking caffeine drinks on weekends.  also, stil have continence issues at night when i go to bed.  i don't have control but have control during the day.  i guess it takes time and patience (and kegel's).
 
also, some of you were gleason +7 post pathology.   did doctor recommend bone scans are waiting on psa results.
 
Age 48
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
surgery may 9, 2008 - houston, tx
pathology report -gleason 8
margins clear
waiting on first psa post surgery
continence ok during day - 1 pad
night time different story
kegel's twice a day 20 reps


Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 6/4/2008 3:51 PM (GMT -6)   
I had my first PSA at exactly 6 weeks post op, and came out zero. I had the occasional glass of wine before then, not even knowing that it might have an effect on PSA.

Kris, if your doc says 8 weeks or later, I suggest stick with that.
Age 63. Other than cancer, in good health; BMI 20
Pre-op: No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores
7 March 2008, RRP, non nerve sparing
Two nights in hospital; catheter and staples out after 7 days
Continent, no pads needed from the get-go
Post Op: Stage pT2 M- N-; clear margins and lymph nodes; Gleason 4+4=8; prostate weight: 37gm
6-week PSA: 0 


KrisP
Regular Member


Date Joined Mar 2008
Total Posts : 162
   Posted 6/4/2008 5:48 PM (GMT -6)   
rob2,
I didn't know that caffieine affects PSA. I've been drinking four cups of coffee daily. Someone please let me know if this is true. Not sure how I will survive without my coffee, but if I have to stop, I will.
 
Thanks
Kris.


Biopsy done 3/2008
Pre surgery: Gleason 6 (3+3), involving left lobe
DRE=15gm with indurated left base and mid prostate
Cores positive: left base medial, left base lateral, left mid medial and left mid lateral (4 of 12)
Clinical stage t2b.
Prostate Carcinorna 185
DaVinci Surgery on 4/21/2008 in Austin by Dr Randy Fagin.
Pathologist report upgraded to a Gleason 7 (3+4)
Clinical stage upgraded also to a T3a
Margins Clear

Post Edited (KrisP) : 6/4/2008 5:53:55 PM (GMT-6)


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 6/4/2008 6:05 PM (GMT -6)   
Holy crap! Wine affects PSA!? Where did that come from? I usually have one beer a day, or a couple of glasses of wine. As a matter of fact, my doctor told me to go home and have a beer after I had my catheter out.
kcragman
Age: 52
March 2006: PSA 2.5
Dec 2007:   PSA taken for insurance application. I did not see the results until late Jan '08 - after I was rejected. Their lab said PSA 4.5. PSA again in Feb '08: 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were cancerous and the 6th did not look good.
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.
Post op: Gleason 9 (4+5). 15% of prostate involved. Negative margins. Lymph nodes and associated glands all appear to be cancer free.


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 6/4/2008 7:30 PM (GMT -6)   

i've been avoiding caffeine because they told me it made you go to the bathroom more.  i don't think it affects psa.  i am just cautious during the week since this is my first week back in the office.   i will be back on coffee next week since i have pretty good control during the day. again its night time that i have a problem with.  

 

 


 
Age 48
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
surgery may 9, 2008 - houston, tx
pathology report -gleason 8
margins clear
waiting on first psa post surgery
continence ok during day - 1 pad
night time different story
kegel's twice a day 20 reps


Lungman
Regular Member


Date Joined Jan 2008
Total Posts : 276
   Posted 6/6/2008 5:18 AM (GMT -6)   
My first PSA was at 3 months, then at 6 months. Just had my 9 month PSA done this week. I can't imagine a caffeine/PSA connection, I drink quite a bit of coffee/soda, has had no effect on my testing, and the MD didn't mention it. I will check into it though.

Randy
46 you when diagnosed, now 47
Pre-Op PSA 9.9
1 of 12 cores positive, Gleason 3+3
DaVinci on 9/5/2007
Post-Op Gleason 3+6, Negative Nodes and Margins
Less than 1% of prostate involved with CA
3 Month PSA 0.01, 6 Month PSA 0.01
Incontinence resolved 9/15/2007, one day after cath removal
ED showing significant improvement.
Cialis 5 mg every night.
Success with BiMix


creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 6/6/2008 4:59 PM (GMT -6)   
Hi Kris,

Busy lately, so sorry we have not been in touch with you. Glad to hear you are well and we keep you close in our prayers. CJ had a PSA 7 weeks post op, then about 4 months later, then 6 months later. We panicked a little, and kept requesting them as we read about protocols here. He is now on 6 monthly for the next year after seeing the Specialist.

Like others, he cut down on coffee early on to prevent urgency, as coffee does seem to have that effect on him anyway, but CJ did not cut it out completely prior to the first PSA, and also had the occassional beer without any affect to his PSA too. From what I remember, he swapped to green tea and reduced his intake of coffee by about 50%, for about the first 3-4 months, but now is back to consuming quite a bit of coffee without affecting his PSA or continence.

It is really hard waiting for that first PSA. We were also told about the possibility of residual PSA left as Magaboo mentioned, so our surgeon was more interested in the 3 month mark and told us this beforehand. However we were lucky to be clear from 7 weeks, fluctuating only slightly due to the ultrsensitive test used, but undetectable .
Wishing the very same path for you Kris. Cheers and all the best to you and your family, Lana & CJ
Creed_three (Lana & CJ)
 
Husband CJ aged 50 yrs (49 years at diagnosis and surgery)
PSA (2002) 2.1.  PSA (2006) 3.5.  1 x (5%) core of 12 positive at biopsy. 11 cores negative. Open Radical Prostatectomy with nerve sparing, on 17th April 2007 (Sydney, Australia).
Gleeson 3 + 4 = 7.   
Fortunate to have three (3) "undetectable" PSAs since surgery 1 yr ago.  June 2007: PSA 0.01; Oct 2007:PSA 0.02; April 2008:PSA 0.02.
 


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 6/7/2008 3:24 AM (GMT -6)   
Hi Kris.  My doc had me do one 6 weeks post op.  Then we will do one every 90 days for two years and every 6 months for two years and annually thereafter. 
 
Regarding coffee, my doc said if I cut out caffiene as much as possible and particularly coffee, it would help with the waterworks.  Don't think it has any effect on PSA.  David
Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me

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