First post-op PSA

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P-Ca-duceus
New Member


Date Joined Apr 2009
Total Posts : 17
   Posted 5/20/2009 8:35 PM (GMT -7)   
At six weeks post-op, I get my first set of results...0.1. It is not the ultra sensitive test, so the only better result is <0.1. How maddening! But considering that my PSA only six weeks before was 17.8, my urologist considers this a good sign. I hope and pray that he is right. Next test is in another three months. So some worry persists, and I cannot say that I am in the zero club yet.
The rest of the recovery is going well. I am back at work, using two to three lightly soiled pads daily. No erectile ability yet. I hope I can post better news next time.
12/2005-Age50-PSA 4.2-Biopsy negative
01/2008-Age 52-PSA 8.0-Biopsy negative (I should have known then)
01/2009 Age 53-PSA 17.8-Biopsy positive-Gleason 4+3, 1 of 24 cores!
Time to become my own best advocate
Special protocol MRI with Gadolinium dye at Brigham and Women's Hospital-
main tumor (1.9cm) is ANTERIOR, not accessible by biopsy. All is now clear.
04/02/2009-open RP with bilat nerve sparing- Dr. Jerome Richie (experience is #1)
Pathology- Stage T2cN0M0,Gleason 4+3, margins clear.


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 5/20/2009 8:59 PM (GMT -7)   
I was told by my doc that labs use 0.1 and <0.1 interchangably. I hope you are in the zero club in three months.

Previous 5 biopsies over 4 years negative

Dx Nov 2007, age 46

PSA 29, Gleason 4+4=8

Decided to participate in clinical trial at Duke

6 rounds of chemo (Taxotere+Avastin)

1/8/2008

33.90

1/11/2008

29.50

1/31/2008

38.20

2/21/2008

32.00

3/13/2008

26.20

4/3/2008

26.60

4/24/2008

20.60

followed by surgery at Duke (Dr. Moul) on 6/15/2008

Gleason downgraded 4+3=7, T2b N0M0, one small positive margin

PSA undetectable for 8 months, then

2/6/2009

0.10

4/25/2009

0.17

 


P-Ca-duceus
New Member


Date Joined Apr 2009
Total Posts : 17
   Posted 5/20/2009 9:06 PM (GMT -7)   
Thanks Geebra. The doc made it clear to me that the test was right at 0.1, not below it. Either way, there is nothing to do about it for three months...so I am going to enjoy my summer!
If IMRT is in my future, then I will deal with it then.
12/2005-Age50-PSA 4.2-Biopsy negative
01/2008-Age 52-PSA 8.0-Biopsy negative (I should have known then)
01/2009 Age 53-PSA 17.8-Biopsy positive-Gleason 4+3, 1 of 24 cores!
Time to become my own best advocate
Special protocol MRI with Gadolinium dye at Brigham and Women's Hospital-
main tumor (1.9cm) is ANTERIOR, not accessible by biopsy. All is now clear.
04/02/2009-open RP with bilat nerve sparing- Dr. Jerome Richie (experience is #1)
Pathology- Stage T2cN0M0,Gleason 4+3, margins clear.


mspt98
Regular Member


Date Joined Dec 2008
Total Posts : 369
   Posted 5/20/2009 9:41 PM (GMT -7)   
Well, I think you did all you could to help yourself. If your PSA is rising and the biopsy comes back negative what can you do? Nobody will operate on you with a negative biopsy. At least I dont think they will, I don't believe insurance will pay for it. My first biopsy was "suspicous" for cancer but not diagnostic for cancer, had to wait 5 months for second biopsy which found the cancer on the second shot. You do the best you can and then respond to the results. Good luck to you...........
my age=52 when all this happened,
DRE=negative
PSA went from 1.9 to 2.85 in one year, urologist ordered biopsy,
First biopsy on 03/08, "suspicious for cancer but not diagnostic"
Second biopsy on 08/14/08, 2/12 cores positive for Prostate Cancer on R side, 1 core=5% Ca, other core = 25% Ca, Gleason Score= 3+3=6 both cores,
Clinical Stage T1C
 
Bilateral nerve sparing Robotic Surgery on 09/11/08, pathological stage T2A at surgery,
No signs of spread, organ contained,
3 0's in a row now, 7 months out
Incontinence gone in early December '08,
ED remains, uro said try oral meds and then trimix for sex only now


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 5/20/2009 10:27 PM (GMT -7)   
Thanks for keeping us posted.  We'll continue to look for that less than .1 next time.  David
Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 5/20/2009 10:41 PM (GMT -7)   
Mine didn't shoot down right away either. But I had already made my mind up ~ I was adding adjuvant therapies. If you can, take a look at my post for stage 3 patients today. The information may be helpful.

Don't worry too much. You have lot's of ammo. And it was an early test...Stay Positive.

Tony
 Age 46 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Geason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 11, 2009): <0.1
 
My Journal is at Tony's Blog  
 
STAY POSITIVE!


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 5/21/2009 4:28 AM (GMT -7)   
Is your next PSA in three months or at the 3 month mark. My doctor starting me at 1 month and then lead up to the six week mark. I would think you would go back in another 6 weeks to have a PSA at the 3 month mark.
 
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
Robotic Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8, clear margins
12 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue but getting better


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 5/21/2009 6:09 AM (GMT -7)   
Do not fret - your PSA will be zero the next test!

My husband had his first PSA about 5 weeks post-op and it came back at 0.1 (prior to surgery, PSA was 6.4). The urologist called and said that his PSA test next time will come back zero - about 4 weeks after that - and it did and has remained there ever since. It can take a couple of months for the PSA to leave your blood stream so don't fret!
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 Enablex to control frequency of urination (tried Vesicare but stopped due to heart palpitations) and on Viagara 2 - 3 times a week. Recuperation from surgery was uneventful.


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 5/21/2009 12:11 PM (GMT -7)   
My surgeon doesn't even do 6 week tests unless there is a special reason to worry. He says that 3 months is a much better data point. I'll bet that you have already joined the zero club but they just haven't sent the membership card.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3 + 4 = 7
CAT scan 1/09 negative, Bone scan 1/09 negative

Robotic surgery 03/03/09 Catheter Removed 03/08/09
Post surgical pathology report. Lymph nodes negative, Seminal vesicles negative
Surgical margins positive, Capsular penetration extensive Gleason 4 + 3 = 7
At 6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4044
   Posted 5/21/2009 4:54 PM (GMT -7)   
As others have stated. My Dr. does not do a PSA for 3 months also. He said the earlier test can give results that make the patients have unnecessary anxiety. I suspect at your 3 month visit you will be able to join the Zero club with us. By the way I am the treasurer and will accept you dues at that time. Cash only please.


Good luck my friend. Don't let this send you into a spin. Lets see what your 3 month test is.
Jeff T Age 57
9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable
 ED- 5 mg Cialis daily, pump daily,


P-Ca-duceus
New Member


Date Joined Apr 2009
Total Posts : 17
   Posted 5/22/2009 4:30 AM (GMT -7)   
Thanks, folks. You all have made me feel much better. And that is why we are here after all. So, where do I send the cash!!
12/2005-Age50-PSA 4.2-Biopsy negative
01/2008-Age 52-PSA 8.0-Biopsy negative (I should have known then)
01/2009 Age 53-PSA 17.8-Biopsy positive-Gleason 4+3, 1 of 24 cores!
Time to become my own best advocate
Special protocol MRI with Gadolinium dye at Brigham and Women's Hospital-
main tumor (1.9cm) is ANTERIOR, not accessible by biopsy. All is now clear.
04/02/2009-open RP with bilat nerve sparing- Dr. Jerome Richie (experience is #1)
Pathology- Stage T2cN0M0,Gleason 4+3, margins clear.

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