first PSA after RP

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kreplerfp
Regular Member


Date Joined Oct 2008
Total Posts : 56
   Posted 11/10/2008 4:00 PM (GMT -7)   
 
 My first follow up appointment to discuss my first PSA after RP. is 8 weeks after surgery. (Surgery Sept 18 first appoint Nov 12) Two friends first appointments are 4 months after their robotic surgery. What is the usual follow up appointment time after RP for your first PSA reading. Are the follow up appointments long for robotic bover RP?
 
Fred
Diagnosed Feb 08
 
PSA 6.3
gleason 3+3
T2C
first biopsy 1 of 10 needles positive
surgery Sept 18 08
bone scan negative
evidence of sinus histiocytosis?
involvement of the margins identified at right and left apex and right anterior surface
also perineural invasion
no extraprostatic extention
no seminal vesicle invasion
tumor cells aggressive features of moderate to severe pleomorphism
possible radiation depending on first  PSA  Nov 12
kept left side bundle of nerves but lost some of the right side bundle


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 2268
   Posted 11/10/2008 4:07 PM (GMT -7)   
Fred--It varies from a few weeks to several months after surgery for your first PSA.  Some of this depends on the urologist and some depends on each individual case.  
 
I had my first follow-up PSA at three months.  Hope all goes well for you and that you have a non-detectable PSA...Tim  
PSA quadrupled in 1 yr (0.6 to 2.5)  
DRE neg  1 of 12 biopsies pos (< 5%) 
Open surgery June 06 at age 57
Organ confined to one small area Gleason 5   
PSA's undetectable  < 0.1  


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 11/10/2008 4:10 PM (GMT -7)   
My doc did it at 8 weeks, so that seems ok by my experience. It really doesn't matter when after the first 3 or 4 weeks, as the residual PSA leaves fairly quickly. My psa was at 7.6, but had dropped to .8 8 days after surgery, during a routine exam with my GP.
James C.
Co-Moderator- Prostate Cancer Forum
Age 61
4/19/07 PSA 7.6, referred to Urologist, recheck 6.7
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 (open) Retropubic Radical Prostatectomy performed
9/26/07 Post-op Path Report: GS 3+3=6 Staging pT2c, 110gms, margins clear
Present- 1 year: ED- Viagra, pump continues, no response- Trimix .10ml x 2 weekly continues
Post Surgery PSA's: 3 mts-.04, 6 mts.-.04, 9 mts.-.04, 1 Year-.02.


kreplerfp
Regular Member


Date Joined Oct 2008
Total Posts : 56
   Posted 11/10/2008 5:07 PM (GMT -7)   

 

 Thanks for the response. I have to say though I am concerned because of the involvement of the margins and the perineurel invasion.

 Its been a trying year. Besides the PC, I had glaucoma and my pressures were so high I had to have 200 lasers  into my eyes to save my sight ,and I spend three trips too the emergency for 2 different kidney stones before my surgery. So needless to say I am hoping for a non-dectable PSA on Wed. :-)

Fred


Diagnosed Feb 08
 
PSA 6.3
gleason 3+3
T2C
first biopsy 1 of 10 needles positive
surgery Sept 18 08
bone scan negative
evidence of sinus histiocytosis?
involvement of the margins identified at right and left apex and right anterior surface
also perineural invasion
no extraprostatic extention
no seminal vesicle invasion
tumor cells aggressive features of moderate to severe pleomorphism
possible radiation depending on first  PSA  Nov 12
kept left side bundle of nerves but lost some of the right side bundle


KrisP
Regular Member


Date Joined Mar 2008
Total Posts : 162
   Posted 11/10/2008 5:11 PM (GMT -7)   
Hi kreplerfp
I had my first PSA check up 8 weeks after surgery and the doctor told me to do the next 6 months after that. I couldn't wait so I had the second one done 4 months after the first.
Age: 54
Occupation: Mechanical Engineer
Home: Dallas/Fort Worth Area
Biopsy: 3/5/2008; Pre surgery: Gleason 6 (3+3), involving left lobe
Clinical stage: t2b. 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
First post surgery PSA = < 0.04 (Undetectable)
Second PSA (10/27/08) = < 0.1 Undetectable


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/11/2008 7:26 AM (GMT -7)   
Interesting thread....I had my first three weeks after the cath was removed and will have my next one the first week of January at the three month mark. Was told I would have it every three months for the first year, then every six months for the next two after that...then only once a year after that...unless there is a PSA rise along the way. I think it just based on the doctors protocol and what he feels is best for you.
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA Oct 08 <.05


Doting Daughter
Veteran Member


Date Joined Aug 2007
Total Posts : 1064
   Posted 11/11/2008 8:23 AM (GMT -7)   
My dad had his three months after, but there are a couple of different schools of thought. Hope this next year is an easier one.
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
July 2, 08 PSA <.02
Oct. 10, 08 PSA <.02
Praying for a cured dad.

Co-Moderator Prostate Cancer Forum


cave88
Regular Member


Date Joined Jul 2008
Total Posts : 76
   Posted 11/13/2008 3:35 PM (GMT -7)   
I just had my first post-op psa test three months and five days after surgery. The result was 0.11. The Dr said I should not be concerned since it was less then one. It could be the result of residual tissue. He just scheduled the next test in three months. I inquired as to how common this is and never really got an answer. Does anyone know how common this is? As always thanks for the feedback.
age:  44
1st psa Apr 08 3.06
2nd psa 6/16/8 4.02,  DRE showed nothing abnormal
biopsy 7/10/08 positive 5 of 12
Da Vinci 8/04/8 Parkview Memorial in FT Wayne IN 
gleason 3 + 3 = 6
prostate 27 g, 4 x 4 x 3.1 cm
Stage:  pT2cNXMX
margins:  apical margin involved
no extraprostatic extension of tumor
seminal vesicle involvement: absent
1st post-op psa  0.11
 
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 11/13/2008 4:09 PM (GMT -7)   
indiana-ice...you sure your doc said not to be concerned because it was less than 1.0. Standard is less than 0.1 when the prostate is removed. Your reading of .11 is above that standard. At the three months level I would have thought that the amount of PSA would be much lower than that. Also you did have a positive margin and that could account for the level. I would be concerned if it goes any higher on your next test.
Les
 
Age 58 at Diagnosis
Oct 2006 - PSA 2.6 - DRE Normal
May 2008 - PSA 4.6 - DRE Normal / TRUS normal-Gland 38 cc
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral (Perineural Invasion present at base)
Gleason (3+3) 6  Stage T1C
August 23 - Bone Scan - Hips, Spine and ribs marked uptake - X-Ray showed clear -Hooray
Sept 9 2nd DRE - questionable - TRUS...shadow in base - Gland now 41 cc
Robotic Surgery Sept 18, 2008
Pathology October 1,2008
Gleason 7 (4+3) Staged pT2c NO MX
Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
4 tumors in prostate - largest being 6 cm 
PSA Oct 08 <.05


cave88
Regular Member


Date Joined Jul 2008
Total Posts : 76
   Posted 11/13/2008 4:59 PM (GMT -7)   
My wife said she thought the Dr said not to worry if it was less than one. His nurse told me it was 0.11 but not to be concerned because it could be residual prostate tissue. I have been looking a lot at others journeys. I have not seen too many with a post-op psa of 0.11 Most seem to be much lower. I guess at this point I just wait. I was hoping for a smaller number. I am the type who kind of compares my situation to others. If my 1st psa results were similar to others I would not be too concerned. Since mine is higher I will have to work on the positive attitude thing. Thanks for the feedback Les
age:  44
1st psa Apr 08 3.06
2nd psa 6/16/8 4.02,  DRE showed nothing abnormal
biopsy 7/10/08 positive 5 of 12
Da Vinci 8/04/8 Parkview Memorial in FT Wayne IN 
gleason 3 + 3 = 6
prostate 27 g, 4 x 4 x 3.1 cm
Stage:  pT2cNXMX
margins:  apical margin involved
no extraprostatic extension of tumor
seminal vesicle involvement: absent
1st post-op psa  0.11
 
 


CaPCa
Regular Member


Date Joined Aug 2007
Total Posts : 118
   Posted 11/13/2008 8:54 PM (GMT -7)   
Ask your doctor for a copy of the written report from the lab - say it's for your records. My personal experience has been one where often doctors and nurses misquote the number. I have had this happen several times.

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
11/04/08  One year PSA: 0.01
              Still taking 10mg Cialis every other day - enjoying the results
              too much to stop yet.
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 11/13/2008 10:30 PM (GMT -7)   
I have to endorse what CaCPA has said. If there is a report issued (no matter what for) make sure you get a copy of it and maintain your own records and eyeball your own results just to make sure that somebody has quoted the numbers correctly. indiana-ice, so far as the 0.11 PSA is concerned, it is that close to 0.1 it doesn't matter. There are several things that could cause the small reading including nerve sparing surgery which could leave a small amount of prostate tissue attached and there are a couple of glands in there as well that can also produce minute amounts of PSA. The important thing is for you (as well as your doc of course) to watch it for any changes.
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

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