As you can see by my signature, I was blessed with a very good post-RRP pathology: Gleason 6, 5% gland involvement, no capsular penetration and negative margins. My first post-op PSA was "<0.008" which is, of course, considered "undetectable". Statistically, I have something like a 1% chance of recurrence over the next ten years. Even with a great outcome and pathology, I still fight PSA anxiety and it is just part of my personality to worry about such things. I had originally requested from my urologist's nurse that I be given the "standard" PSA test, but alas, my request was either ignored or misunderstood and I received the ultra-sensitive variety. To be consistent, I have stuck with the ultra-sensitive test through the same office and from the same lab for the last three tests. The first two came back at "<0.008" and the last one was "0.01" which is still extremely low.
I am considering, in no small part due to a suggestion from my wife and counselor, that I try switching to the standard PSA test from now on. After all, that is what I had originally wanted. This would hopefully allow me to avoid seeing the background noise so common with these tests. I have read that the ultra-sensitive tests may give an earlier indication of a recurrence, however it seems that nobody would recommend adjuvant therapy unless the level were to reach 0.1 anyway. Therefore, it seems to me now that it has no real value in my case.
Has anyone else made a similar decision? I don't want to short-change myself and risk letting this disease get an upper hand, yet I know that emotionally I would benefit from not seeing the ultra-sensitive test noise. One thought I had was to switch to the standard test, yet test at 6-month intervals instead of the yearly intervals normally recommended at a year out from surgery. Your thoughts and advice would be appreciated.
Age:45 (44 when diagnosed)
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
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
03/17/08 Erection quality mostly back to pre-surgery levels with Cialis;
have not tried without meds yet.
04/23/08 Second post-surgery PSA result: < 0.008 ng/ml
07/30/08 Third PSA: 0.01 ng/ml