No drop in PSA after RP

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brute290
New Member


Date Joined Mar 2009
Total Posts : 2
   Posted 3/4/2009 6:39 PM (GMT -6)   
Hi all can someone give me a hand,, my Dr. told me this morning he is perplexed.
 
June of 08 had a TURP do to poor urination (history of BPH)
PSA was 2.4
 
TURP chips sent to lab 1 of 8 contained 3+3=6 the one chip was totally inundated.
 
Aug 08 PSA dropped to 0.43
Negative DRE
 
Dec 08 PSA still 0.43
 
Dec 08 prostate biopsy 12 cores taken, 1 core 1.1mm 3+3=6 1%
 
Jan 30-09 Da Vinci RP
Prostate sent to 2 labs one of which was John Hopkins
No cancer in prostate was the report from both
 
March 03-09 PSA 0.42 (one month later)
 
I see here on the boards guys have 0.00 post RP after 30 days. What is up with me? I actually question the method the lab in Bakersfield used when slicing the prostate for biopsy. There must be a mistake made somewhere. Dr. says wait 30 days. I think I'll take one in 30 days then 60. What do I do now to determine if in fact I still have cancer . All indications were that mine was contained. Dr. did no samples of nerves , seminal vescles or lympth nodes due to low PSA. He described my prostate as extremly small and he had a difficult time with it, could there be prostate tissue still there showing a PSA? I don't know I'm confused and upset. it's been 30 days and I am still using 4-5 pads a day for urine. I am just recently starting to hold in urine enough to urinate in the toilet. Night time I go about 2 times and still leave a pretty good amount in the diaper. (small progress) Any help would be greatly appriciated.
Bill 
 
 

Swimom
Veteran Member


Date Joined Apr 2006
Total Posts : 1732
   Posted 3/4/2009 7:15 PM (GMT -6)   
It takes as much as 8-10 weeks for PSA to completely clear in some cases. This is why most surgeons wait 3 months to do a postoperative PSA. Wait it out until enough time has passed before worrying. Good luck and hang in there Bill.

Swim
 


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 3/5/2009 8:52 AM (GMT -6)   
Brute....uh...did you say that the path report showed no cancer? The biopsy showed 1% and after surgery nothing was found...very strange indeed. The PSA was very low to begin with...did you have a second opinion on your biopsy before the surgery? Do you have the actual path report...it almost sounds like some tissue was left that is still producing PSA...however I agree completely with swim...wait another month and see what direction the PSA is going.

I am still wondering why you chose surgery with the low PSA and the biospy report showing such a small amount to begin with...didn't your doctor recommend waiting before taking that route?

The incontinence will take some time...your early out on the surgery...give it a few more weeks and it should improve some.
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


brute290
New Member


Date Joined Mar 2009
Total Posts : 2
   Posted 3/5/2009 10:56 AM (GMT -6)   
"I am still wondering why you chose surgery with the low PSA and the biospy report showing such a small amount to begin with...didn't your doctor recommend waiting before taking that route?"
 
Correct, path showed no cancer, after 2 labs examined it.
 
No, and I didn't see one Dr. Iv'e seen 4, none reccomended that I wait. I figured why not recover from it while I'm young instead of at 65. Looking back on it I probably would have waited and simply watched my PSA. My original diagnoses was from the TRUP , in the transitional zone. Deep in the prostate, more than likely from 25 years of untreated BPH. In the biopsy Dr. tells me he could not determine where the one positive core came from, so it could all be transitional and not peripheral, which changes things slightly, the TURP may have blown much of what I had out. I am still disturbed about the wierd PSA ,, I want to thank you guys for commenting it realy helps when it seems as though others are in your corner.
Bill
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