Who had a DRE after surgery?

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rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 2/23/2009 9:39 PM (GMT -6)   
 
I am curious to how many people have had a DRE after surgery.  I am 10 months post op and doctor has not done the DRE.  The doctor has my PSA tested every 3 months but has not done a DRE.  I heard they were done with after surgery but have noticed some people on this site that has had a DRE after surgery.
 
Age 49
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


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1211
   Posted 2/23/2009 10:10 PM (GMT -6)   
I never had one after surgery, but about 6 weeks after EBRT I had one!? Was told everything feels nice and smooth!?
Go figure.

Magaboo
Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
open RP 28 Nov 06, Post op staging T3a
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 tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA on the 26 Jan., 09, =0.05. PSA tests now every 6 month


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 2/23/2009 10:16 PM (GMT -6)   
I started getting mine at 3 months, and have gotten one each time since-each 3 months. The doc says he needs to examine for any unusual growths, scar tissue buildup and general colon health. So I still have a lifetime of them to look forward to. I will say they aren't anywhere as bad/painful/uncomfortable now as before surgery. Now before, it just plain hurt to have the prostate palpated like that by an expert at it... turn Now it just an inconvenience..
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


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/23/2009 10:31 PM (GMT -6)   

    I can not remember when my first one after surgery was but they have still been a part of my routine checkup's.

    KW


    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey.  Working Great, only light drips and dribbles.
    Jan, 31st, 2009 - PSA 0.00  Next test in July, 2009  


creed_three
Veteran Member


Date Joined Jan 2007
Total Posts : 762
   Posted 2/24/2009 1:41 AM (GMT -6)   
My husband has never had a DRE after surgery, however this is now a question for the 2 year check-up with the surgeon coming up. You never stop learning! Thanks for the post rob. We will check out "why not?" and listen carefully to the answer. cheers
Creed_three
Husband 51 yrs (49 years at diagnosis)
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 April 2007. Gleeson 3 + 4 = 7.   Undetectable PSA since Surgery (< 0.1) specifically,  
June 2007: 0.01; Oct 2007: 0.02; April 2008: 0.02: October 2008: 0.03: November, 2008 (repeat PSA with instructions to lab to calibrate carefully) = 0.02.
 


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 2/24/2009 8:07 AM (GMT -6)   
Rob, my husband just had his 11 month visit with the urologist. I asked him to ask the doctor if and when a DRE would be done - the urologist said no need for a DRE. My guess is that a DRE is done in certain situations, perhaps where the clinical stage of the disease indicated a localized spread or where the pathological report indicated a spread outside the prostate. This is another one of those areas where there are differences of opinion among medical professionals - our doctor said that no DRE is necessary and that it wouldn't tell him anything since my husband's PSA continues to be zero. It's possible that should PCa reoccur, a DRE might be in order - again, only guessing here.
Husband diagnosed in February 2008 (age 57). Cancer discovered during routine annual physical. Clinical Stage T1c, Gleason 7 (3+4), with 2 out of 10 cores testing positive. Perineural invasion identified on biopsy. DRE was negative.

Robotic surgery in March 2008. Pathological stage upgraded to T3a, Gleason still 7 (3+4). Miniscule invasion into prostate capsule but no cancer found outside capsule (surgical margins and seminal vesicles were clean).

1st PSA 3 weeks post op: 0.1; 2nd PSA 7 weeks post op: 0.0. PSA remains at 0.0, and will continue to be checked every 3 months for the first 2 years due to capsular penetration.

Currently on Vesicare to control frequency of urination and on Viagara for ED issues. Recuperation from surgery was uneventful.


Ken S
Regular Member


Date Joined Nov 2006
Total Posts : 120
   Posted 2/24/2009 8:43 AM (GMT -6)   
I have one every year during my annual physical and my radiologist does one when I see him. My oncologist has checked but my urologist has not. Was told the same thing James was told, looking for scarring or any unusual bumps.
Age 54 (2006)
PSA: 2005 - 3.2, 2006 - 3.7
Biopsy 8/06, Gleason 6 (3+3), T1c
Radical Retropubic Prostatectomy 11/3/06
Memorial Hospital, Pawtucket, RI
Post-Op Biopsy, Gleason 6 (3+3), T2c,
right apical margin positive
CT Scan 1/07, tumor discovered on right
kidney (unrelated to PCa)
Partial Nephrectomy 3/9/07
R.I. Hospital, Providence, RI
IMRT (37 Treatments) 4/23/07 - 6/14/07
PSA: 11/08 - 0.03


Frank1205
Regular Member


Date Joined Feb 2008
Total Posts : 308
   Posted 2/24/2009 10:59 AM (GMT -6)   

I am am 11 months post op.  My surgeon is yet to do one. And with a bad margin I went to a radiaiton oncologist and he did one.  Also my annual physical with my internist does one as well.

I used to hate them but now,  anybody wants to take poke is more than welcome if it has a purpose.

Frank

 

 

 


Age 54
DRE normal , 2004 Biospy negative - 2008 Biopsy positive (01-08-08)
10 cores, 1 positive and at 1% of that one core
PSA @ surgery 6 
Bone and Ct scans negative
clinicaly Staged at T1C - Gleason 3+3 = 6
Robotic Da Vinci performed March 27th, 2008, University of Chicago.
Catheter out in 7 days normaly expected leakage
Post Pathology T2C, Gleason 7, (3+4) 10 % of both portions of prostate
Seminal vessels clear, fat tissue clear, single positve margin at apex measuring less than 1/2mm. 
PSA Six week < 0.1 4 month PSA <.05 6 month PSA<0.01,9 month<0.01
Watching PSA @ 3 months for 2 years,  will do salvage radiation if necessary.
Fair to Good results with Viagra,  side effects are bothersome at times. 
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/24/2009 11:03 AM (GMT -6)   
Frank, after all I am sure you have been through, what's one more poke among friends! lol.
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 2/24/2009 5:37 PM (GMT -6)   
I received a DRE at my six month post op. Doctor said he was checking for any growth. His actual words were, "I need to see if it grew a tail"  shocked
Age 51, (50 at DX)
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
Second post op PSA 2/10/09, 0.00


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 2/24/2009 9:08 PM (GMT -6)   
Rob2 -

I'm just over 9 months out, like you. My doctor has never MENTIONED a DRE, and in fact, has never laid a hand on me for any reason after the catheter came out. My biofeedback physical therapist did a mini-DRE, but she just reached in far enough to feel the sphincter muscles work - which is not very far at all.

I have not been to a GP for a general physical (you are supposed to go once a year, you know, so they can check for things like, um, prostate cancer) so I don't know how that will go. I'll let you know.

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.
Feb 2009: PSA at 9 months was undetectable.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25382
   Posted 2/24/2009 9:15 PM (GMT -6)   
despite my recent bout of PC, I still am faithful to seeing my long term GP, it was his dillegence that pushed me on the path toward my PC dx.
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 2/24/2009 10:18 PM (GMT -6)   
To all those who are still getting DRE after surgery and have an undetectable PSA ...................... perhaps your doc views you as more than a patient? shocked devil
Only joking of course.
Bill

RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 2/24/2009 10:19 PM (GMT -6)   
I am 9 months post successful surgery. I have been to two urologist since the surgery for routine followup matters. The first urologist (an older gentlemen) did no DRE. He suggested I go to the second urologist because he is more up on the latest ED procedures. The second urologist is young (not long out of medical school) and he did a DRE. What I take from this is that as someone else stated, it is a matter of doctor discretion and opinion.

RB
Age 61 (now 62)
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04
2nd Post PSA <.01 10/30/2008


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 2/25/2009 10:41 PM (GMT -6)   
thanks for the posts. I see there are differing opinions among doctor's on dre's after surgery. I thought I was done with DRE's - maybe not.

kcragman, we are both high gleason with no dre. our surgeon's might be from the same school of thought!
 
Age 49
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


califlostnspace
Regular Member


Date Joined Jan 2009
Total Posts : 51
   Posted 2/28/2009 1:00 AM (GMT -6)   
I had my week 9 post op Dr. visit today and no DRE! 

6'3"
205 lbs.
age at diagnosis:  51
diagnosed summer of 08
no symptoms
PSA  4.4
bone scan was normal
Radical Robotic Prostatectomy done with Da Vinci at UCSF on 12/23/08 by Dr. Peter Carroll
catheter removed 1/7/09
my local urologist referred me to a urologist at UCSF for the Da Vanci operation mainly because I had two
mesh panels in lower abdomen due to 2 hernia repairs 12 and 16 years ago
3 weeks post op I get a path report:   
 Your pathology results looked great.  Your final tumor grade was a Gleason 3+3, which was the same as your biospy grade.  The tumor did not extend outside of the prostate and all surgical resecetion margins were negative (meaning no tumor left behind).  The tumor did not involve the seminal vesicles.
Basically, the pathology is about as good as we could have hoped for.
8 weeks post op had first PSA test, result was <.01


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 3/14/2009 7:08 AM (GMT -6)   
Final thought on this: This topic has been gnawing at me since I read it. If you've had surgery, and you have negative margins, and you have undetectable PSA, why would they do a DRE?

I've had colonoscopies, sygmoidoscopies, and barium enemas (my god, what ELSE can they stick up there?) and I know those procedures look for different things - but with all of those things available what could the doctor possibly be looking for with a DRE?

(The barium enema drill on the tilt table was an ugly experience, but the sygmoidoscopy was the worst. They essentially take a 3-foot garden hose and go up there looking for something. They can't go nearly as far as a colonoscopy, but it is a fully awake, in-office procedure, and getting a garden hose to make all the twists and turns in the lower parts of your large intestines is not a fun process. Most of these procedures have been because I have fought constipation all my life. Lucky me.)

Life is good,
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.
Feb 2009: PSA at 9 months was undetectable.


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 3/14/2009 6:54 PM (GMT -6)   
thanks kcragman. Your treatment and mine have been about the same (other than my doc wanting psa tests starting at a month). I agree with you. I was going to ask my doc about the dre but now if he doesn't bring it up I won't bring it up.
 
Age 49
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


KrisP
Regular Member


Date Joined Mar 2008
Total Posts : 162
   Posted 3/15/2009 10:57 AM (GMT -6)   
I've never had one done after surgery. Need to find out why from urologist next visit.
[color=blue><FONT>Occupation: Mechanical Engineer


[color=blue><FONT>Biopsy:
3/5/2008; Pre surgery: Gleason 6 (3+3), involving left lobe
t2b. DaVinci Surgery on 4/21/2008 in Austin by Dr Randy Fagin.

Pathologist report upgraded to a Gleason 7 (3+4); Margins: Clear

Second PSA (10/27/08) = < 0.1 Undetectable

Third PSA (02/11/09) = < 0.1 Undetectable

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