6 month post op PSA + DRE today

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coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 2/10/2009 6:59 PM (GMT -6)   
I had my six month post op follow-up examination today.  I expected the PSA but also got a DRE!  smhair
I told the urologist I thought a benefit of the prostatectomy was to never have another DRE.  Doctor said he would perform a DRE each six months.  Oh well.
Age 50
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/10/2009 7:51 PM (GMT -6)   
Cox, my dr suggested the possibility of a dre at my six month, I am hoping he wasnt being serious
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
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/10/2009 7:59 PM (GMT -6)   
I've gotten one each 3 months visit since surgery, plus my GP wants to take a feel every 6 months.... turn The Urologist tlad me he was checking for growth, or anything unusual that he can feel. He said to expect one the rest of my life, after having had PCa surgery. Oh, well tongue
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
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/10/2009 8:13 PM (GMT -6)   
James, sounds like another one of those "little" details that they don't tell you about, thrills.
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
 
 


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 2/10/2009 8:21 PM (GMT -6)   
James, The doctor said he was checking to see if the prostate "grew a tail". I guess it's better they didn't tell me about the DRE before. I would have been dreading the appointment.
Age 50
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 2/10/2009 8:24 PM (GMT -6)   
I am 9 months post op and have had 5 PSA tests starting at the 1 month mark but never a DRE. My doctor hasn't ever suggested one. perhaps I should ask him why?
 
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
9 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 2/10/2009 8:33 PM (GMT -6)   
David, looks like your Dr. may be serious.

rob2, I noticed your signature. We have more in common than pc and gleason 7. I see you're an accountant. Me too, I'm a CPA
Age 50
Pre - Op PSA, 4.3
Gleason 3+4=7
Stage T1C
da Vinci Prostatectomy 8/1/08
No issues with incontinence since day 1 after catheter removal
ED, need a little help from Levitra
First post op PSA 11/11/08, 0.00


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 2/10/2009 8:56 PM (GMT -6)   
coxjajb, I will be 49 in a few days. Looks like we do have more in common. Now I wonder why my doctor didn't do the DRE. Crazy isn't it? It is the accountant in me!
 
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
9 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 2/11/2009 8:55 AM (GMT -6)   
I dunno Rob...so far my uro hasn't indicated he will be doing the DRE...and to be truthful...I will not be disappointed if he never does one again either.
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 : 25382
   Posted 2/11/2009 9:02 AM (GMT -6)   
well cox and rob, we are all in similar positions, I am currently unemployed, but usually work as either CFO or Controller in mostly manufacturing firms.
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
 
 


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 2/11/2009 12:50 PM (GMT -6)   
I've always been told that prostate surgery is your "get out of jail free" card for DREs. The first thing a PCa surgery friend told me was just carry your patho report to your GP every time you have a physical. They take one look at that and you are DRE-free.

My uro has never mentioned doing one post surgery.

But I am always struck by how different the info is that we receive from different doctors around the country.

kcragman
Age: 53; 52 at DX
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.
Feb 2008: PSA 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were
              cancerous and the 6th was suspect.  
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph node and nerve samples taken, and appeared to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.


gpg
Regular Member


Date Joined Jan 2009
Total Posts : 180
   Posted 2/11/2009 1:04 PM (GMT -6)   
My urologist told me that post surgery there would be no routine DRE. I have since been examined by two other Drs. who did but not for routine reasons. It seems that this like all other aspects of this disease is a matter on which no one agrees.

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


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/11/2009 1:43 PM (GMT -6)   
Another idea for why. The finger insertion is also part of the routine exam for colon cancer , ie looking for blood and getting a stool smear for the instant reaction test slide. Not necessarily a dre, but since they're there....... turn The DRE evidently isn't exclusive for prostate exams. There's other things , such as bowels, etc.
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
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/11/2009 1:58 PM (GMT -6)   
james, didnt know the other uses for a dre, always thought it was prostate only
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
 
 


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/11/2009 2:08 PM (GMT -6)   
David, you know my love of links: tongue

www.intelihealth.com/IH/ihtIH/WSIHW000/9339/23954.html

www.webmd.com/colorectal-cancer/digital-rectal-examination-dre
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
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/11/2009 2:13 PM (GMT -6)   
I love your links, James, I am not good at find/posting them.
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
 
 


AndrewJ
Regular Member


Date Joined Jul 2007
Total Posts : 25
   Posted 2/11/2009 2:28 PM (GMT -6)   
Here in Germany the very comprehensive health insurance system can lead to overservicing and the cultural inclination is to be very cautious. The standard post-op routine is 3 monthly PSAs and this includes not just a DRE but a very nasty ultrasound probe (think of the light saber from Star Wars) - which could be why I walk funny for a few hours afterwards. I get to see the pretty pictures on the screen, and the first time he did it he pointed out some tissue which he thought should have been removed in the surgery. When I asked him whether it was really necessary, he said he would stop if I really wanted him to, but he wants to monitor the tissue. Although I hate it, I figure I will live with anything which will detect a recurrence early.

Every 12 months I have the full battery of MRE, CAT, etc. and all the cancer screening tests. Ah, the joy of compulsory, government-regulated health insurance. But without it, I probably wouldn't have found PCa at 45 years of age and may not have have been around so long.
46 years old (45 at diagnosis), 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 every 3 months since. Fully continent immediately after removal of catheter on Day 8.
No potency issues but still taking small doses of generic Levitra "as required" as my security blanket.
This man knows he has been VERY lucky.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/11/2009 2:49 PM (GMT -6)   
Andrew, what you say about the healthcare in Germany may silence some of the critics of socialized or nationalized medicene. Sounds like you are getting excellent care. Your signature looks really good, I hope you continue to do so well in the future.

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, 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
 
 

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