My First Post Surgery PSA Results

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Purgatory
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Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 11:08 AM (GMT -6)   
Well, the test came back.  My first post-surgery PSA results were .05  The dr was hoping for lower, but he said it was still good, and that in 3 months he hopes it will adjust downward a bit, not upward.  He said the lab person was mistaken telling me that they could test to .001.
 
I hope this qualifies me into the "zero club".  He set me up for another test in 3 months, which will be my six-month mark.  He did explain in detail how the half-life of psa works, and that being slightly less than 3 months out from surgery, the psa can still drop.
 
Right now, I am happy with this, and I hope it stays good for a long time.
 
David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 2/9/2009 11:25 AM (GMT -6)   
David, that's great results. Anything under .09 is a Zero, so welcome to the club. Your .05 is only .01 more than my .04 that I get every time so far. .04 is statistically as low as it can go with the lab I use. So that .01 difference for you is miniscule, in my opinion.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months


Purgatory
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Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 11:31 AM (GMT -6)   
Thank you, Brother James, I needed someone to tell me this. It's what I thought. My dr/surgeon is a deep thinker and he knows I am well read, so I think he was just thinking out all possibilities. I am happy with it, I really am.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


Doting Daughter
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Date Joined Aug 2007
Total Posts : 1064
   Posted 2/9/2009 11:49 AM (GMT -6)   
I'm with James C! Congrats on your entry into the Zero Club!! I think anything with a zero to the immediate right of the decimal point qualifies you! May your life be filled with zeroes and best wishes as your move forward cancer free! All the best!
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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 12:12 PM (GMT -6)   
Thank you so much, Doting, seems a long time coming, I hope this is a long long trend for me, I am looking forward to being among the living and less like a patient
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


AstroNerd
Regular Member


Date Joined Sep 2008
Total Posts : 56
   Posted 2/9/2009 1:21 PM (GMT -6)   
Congrats!
cheers & beers,
Chris


Diagnosed on 9.23.08, age 47
Gleason 6, T1a
da Vinci LRP performed 1.22.09 at Moffitt Cancer Center by Dr. Pow-Sang
Catheter out on 2.4.09!!!!
Pathology: Gleason 7 (3+4), T2c. Tumor 15%, fully contained, margins clear, lymph clear.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 2:18 PM (GMT -6)   
thanks astro and ohiostate
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


mirv
Regular Member


Date Joined Nov 2008
Total Posts : 30
   Posted 2/9/2009 2:34 PM (GMT -6)   
Hey David,
Great results! and Congratulations! Here's hoping all zeros all the time!
Mark
Age 52
Dx 11-07-08
PSA 3.1
fPSA 26%
1 of 12 cores with 5% adenocarcinoma
11 of 12 cores clear
Gleason grade 3+3=6
Robotic laproscopic surgery 2-4-09
Dr. Garret Matsunaga, Torrance Memorial Hosp.
Free hernia repair! 2 day stay.
Preliminary pathology: upgraded to 3+4=7
Awaiting full pathology report.


Godfather
Regular Member


Date Joined Jan 2009
Total Posts : 64
   Posted 2/9/2009 2:36 PM (GMT -6)   
David:

Thinking about you today - glad to see that the first number was a big fat zero. We have our first of two appointments with robotic guys on Wednesday. Already have my "open" guy in NYC at MSK.

Back to you... you have a good initial PSA score and lots of options still available. You did your research and made the right choices - that's all any of us can do.

Peace and health, brother.

Tony
Age at diagnosis 61  5'8" 260 lbs.
Resides in SW Florida
12/07 PSA 2.6  12/08 PSA 4.0
Biopsy 1/09 - 6 of 8 nodes positive 
Left - 2 of 4 positive, 2% involved, 4+3=7 Gleason
Right - 4 of 4 positive, 40% involved, 4+3=7 Gleason
Perineual invasion is present 
DRE small nodule on right - Prostate 22.6 cc's
 


JerseyG
Regular Member


Date Joined Feb 2009
Total Posts : 65
   Posted 2/9/2009 2:37 PM (GMT -6)   
Congradulations David. May you see zeros for the next 30+ years!

Age now 44 (43 when dx)
 
Pre-op PSA:  0.9
Biopsy: 3/12 cores pos  20% 30% 50%
Gleason 3+3=6
Robotic RP:   Aug 08 1 day hospital stay, cath out on 8th day.
Post Surgery Pathology Report: Gleason 6, pT2c, tumor 10% contained in prostate gland, all margins negative. Negative lymph nodes
Post Op PSA: Dec 08 <0.1


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 2:45 PM (GMT -6)   
Thanks Godfather and Jersey, that's all we can hope for each of us. My best to the two of you
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


Ripandburn
Regular Member


Date Joined Aug 2007
Total Posts : 125
   Posted 2/9/2009 3:33 PM (GMT -6)   
Fantastic!!!!!!!!!!!!! Keep those 0's coming.http://www.healingwell.com/community/posticons/icon5.gif
53 years - 5' 11" 205 lbs.
T1c 3+3=6
DaVinci July 16, 2007
Bladder Sling installed during prostate removal
nerve sparing with both nerve bundles intact
all cancer contained within prostate nothing near margins
11 weeks post-op - no more pads
all PSA's since removal < .1 - Undetectable


DoingFine
Regular Member


Date Joined Sep 2008
Total Posts : 46
   Posted 2/9/2009 3:33 PM (GMT -6)   
Congrats David

I was waiting to see this today.

Cheers,
Rich
Age at dx: 51 Age now: 52
Great health: Riding bike 200+ miles weekly; no symptoms
First PSA: 4.7 March 2008 Second PSA: 4.97 June 2008
Biopsy June 2008 Positive 5 of 12 cores T1c, Gleason 3+3, Bone scan: 7 July negative
RRP surgery 3 Sept 2008 at the Mayo Clinic: Rochester, MN, All clear
Catheter out 22 Sept 8:30 AM, catheter back in at 11:30, Catheter out 30 Sept (this time for good!)
Total continence, no erectile difficulties from day one (Cialis 10mg daily)
Back on bike 15 Oct. (42 days . . . with doc's approval)
Dec. 2 2008 psa Undetectable!


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 2/9/2009 3:55 PM (GMT -6)   
Great news David, you are now a technical zero. I would not be at all surprised to see your PSA decline slightly over the next 3 months. It is annoying that lab technicians do not know their own equipment though and complicate matters by giving out erroneous information about its capabilities. Congratulations and long may the zeros continue. yeah
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)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 4:37 PM (GMT -6)   
THanks Mark, Billy, Rich, and Rip, just thrilled to have made it to this threshold. I will see my doc again in May for the 6 month mark.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


sandstorm
Regular Member


Date Joined Dec 2008
Total Posts : 194
   Posted 2/9/2009 5:30 PM (GMT -6)   
Really good news David! Congratulations! Hope your next one is even lower.
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa, but stable
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c / post-op 3+4  7  stage t2c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Catheter removed 1-15-09
Pathology Report says it's gone!
First Post-op PSA due 2-17-09


gpg
Regular Member


Date Joined Jan 2009
Total Posts : 180
   Posted 2/9/2009 5:33 PM (GMT -6)   
David,

I am glad you are a zero but I am interested in why people go for the u/s test.

Are you requsting it, or is that what your Dr. is ordering?

Scott
Diagnosed @ 48yo 04/07
focal, low volume tumor gleason 6
RRP 07/30/07
Persistance of PSA
IMRT 11/07-01/08
Emerg, cysto obstructed bladder 01/08
Persistance of PSA
08/08 learned Dr. left significant amount of prostate
12/08 PCA3 negative
12/08 saturation biopsy 36 cores 24 having normal prostate tissue
12/08 referred whole to med malprac attorney


zufus
Veteran Member


Date Joined Dec 2008
Total Posts : 3149
   Posted 2/9/2009 6:03 PM (GMT -6)   
S-u-p-e-r ditto from the others above on this.
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 2/9/2009 6:05 PM (GMT -6)   
Way to go David...congrats on the Zero Club Membership....here is hoping that it will be a lifetime membership as well.
You are beating back cancer, so hold your head up with dignity
 
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 5 week Oct 2008 <.05
       3 month Jan 2009 .06


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 6:16 PM (GMT -6)   
Thanks zufas and les.....almost makes me wish i drank so i could celebrate!
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 6:17 PM (GMT -6)   
scot (gpg) what is the u/s test, lost me there.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 6:19 PM (GMT -6)   
p.s. scot - if you are talking about the psa test, from 2002-2008, all were done by whatever lab my GP used. For this one, and from now on, I am using the one that my urologist's practice uses. I didn't request anything extra, special or different. They drew blood last week, and today I was given the results.

thanks too, sandstorm
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 2/9/2009 6:35 PM (GMT -6)   
gpg,
There are two schools of thought. I have seen arguments supporting Ultrasensitve PSA testing as a much earlier indicator of possible relapse as is described here under "What is an Ultrasensitive PSA Assay":

www.prostate-cancer.org/education/preclin/McDermed_Using_PSA_Intelligently2.html

and arguments for not having the ultrasensitive test from the same source:

PSA Anxiety:

The Downside of Ultra- Sensitive Tests

You've had the radical prostatectomy, but deep down, you're terrified that it didn't work. So here you are, a grown man, living in fear of a simple blood test, scared to death that the PSA- an enzyme made only by prostate cells, but all of your prostate cells are supposed to be gone -- will come back. Six months ago, the number was 0.01. This time, it was 0.02.

You have PSA anxiety. You are not alone.

This is the bane of the hypersensitive PSA test: Sometimes, there is such a thing as too much information. Daniel W Chan, Ph.D., is professor of pathology, oncology, urology and radiology, and Director of Clinical Chemistry at Hopkins. He is also an internationally recognized authority on biochemical tumor markers such as PSA, and on immunoassay tests such as the PSA test. This is some of what he has to say on the subject of PSA anxiety:

The only thing that really matters, he says, is: ''At what PSA levels does the concentration indicate that the patient has had a recurrence of cancer?'' For Chan, and the scientists and physicians at Hopkins, the number to take seriously is 0.2 nanograms/milliliter. ''That's something we call biochemical recurrence. But even this doesn't mean that a man has symptoms yet. People need to understand that it might take months or even years before there is any clinical physical evidence.''

On a technical level, in the laboratory, Chan trusts the sensitivity of assays down to 0. 1, or slightly less than that. ''You cannot reliably detect such a small amount as 0.01,'' he explains. ''From day to day, the results could vary -- it could be 0.03, or maybe even 0.05'' -- and these ''analytical'' variations may not mean a thing. ''It's important that we don't assume anything or take action on a very low level of PSA. In routine practice, because of these analytical variations from day to day, if it's less than 0. 1, we assume it's the same as nondetectable, or zero.''


Now my head is spinning, turn
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)

Post Edited (BillyMac) : 2/9/2009 4:46:39 PM (GMT-7)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 2/9/2009 6:37 PM (GMT -6)   
Bill, thanks, I know you addressed that to Scott, but I needed to see that, the non sensitive testing argument was more along the lines of what my dr said today
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Right nerves saved, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9 .05
 
 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 2/9/2009 7:08 PM (GMT -6)   
David,
Reading your other posts on your ED (or rather lack thereof) that is probably an alternate explanation for your very slight ultrasensitive PSA reading. It is not uncommon for a very small amount of healthy benign prostate tissue to be attached to intact nerves when nerve sparing surgery is carried out.
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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