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wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 6/22/2009 3:29 PM (GMT -6)   
Okay guys, my Uro still does the DRE nono every three months along with a PSA even though the old walnut is removed. A year and a half later with zero PSAs the nono is getting old.

Anyone else get the DRE after surgery?

nono
12/06/07 DaVinci and open prostate surgery after difficulties in breathing stopped the davinci.


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 672
   Posted 6/22/2009 3:41 PM (GMT -6)   

I was told to expect them for a while. I have 3 month post-surgery PSA with DRE at the end of next month.

Mike 


Lower left groin hernia: mesh and large scar: surgery early 2006
Nov/Dec 07 and March 08 and now Dec 08: Severe perineal pain (between scrotum and rectum). Septra/Bactrim for 8 months (Nov 07-Jun 08) for diagnosed prostatitis.
PSA start of 2008: 5.3..... PSA June of 2008: 7.3
14 DRE all benign or nothing felt
TRUS Biopsy Nov 08: Got copy of pathology (see below). Prostate about 40 cm sq.
General Health: pretty good, 5' 10", 180 lbs, slim.
Bone scan Dec 08: Negative
Barium enema X-ray (March 09 due to several days of blood in stool)
MRI with endorectal coil (April 09 as part of a study)
3D advanced TRUS (April 09 as part of a study)
CT (April 09 as part of a study)
Biopsy Pathology: 5 of 8 cores positive, adenocarinoma in both lobes. 30%-65%. One core perineural invasion. 2 cores "foamy" and suspicious. All +ve cores, 3+3 GS 6.
Open RP surgery: May 5/09 Surgeon spoke to my wife and was very positive. Said both nerve bundles spared and not damaged. Bilateral lymph node dissection performed. Discharged 48 hours after surgery. Staples out, catheter out and pathology sheduled for May 21.
Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
Physical State: Getting back to working out slowly. Urinary control pretty much from the time of catheter removal. Rectal pain, sometimes bad but, told is normal. Erectile function at best 25-30% of presurgery. Trying Levitra...first 10 mG dose gave me nasal congestion, 50% chubby and a 24 hour headache...may go away with more use or change of meds. Considering pump. Recovery from surgery going very well.
Mental State: Pre-surgery anxiety gone. Positive attitude. Some anxiety about seeing radiation oncologist and upcoming 3 month PSA. 


Jersey Boy
New Member


Date Joined Apr 2009
Total Posts : 6
   Posted 6/22/2009 3:47 PM (GMT -6)   
I got the DRE up to one year. Now will see the nurse who runs the "survivors group at 24 months.
Jersey Boy
 
Age 63
Surgery 2/19/08
Gleason 6
Last Post-op PSA -- non-detectable
On trimix -- good results
Levitra/Viagara -- not good enough


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 6/22/2009 4:23 PM (GMT -6)   
Well, I had a DRE at my 6 months post surgery visit, just had another today after a special 6 week after the 6 month checkup PSA. They don't hurt as much, as there's not much for the dr. to feel around for, he said he would feel better if I agreed, just wanted to make sure there was nothing to detect.

He surprised me and said if he felt a lump, he could perform a single digit biopsy, where one of his fingers feels the lumps and guides a single core extractor of some sorts.

I originally thought that after prostate surgery no more DRE or prostate related biopsy, wrong!

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 


Geebra
Regular Member


Date Joined May 2009
Total Posts : 476
   Posted 6/22/2009 7:09 PM (GMT -6)   
I too was hoping the DREs would stop, but as one of my docs said that I did not read the fine print redface .
 
I get it evry time I see a doc - Uro, Onc, Radiation. I think by now I had as many post surgery DREs as pre-surgery mad .
 
I am so used to it by now that it is hardly any more upsetting than listening to your lungs turn .
 
As my dance instructor says - it's all good.
 

hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 6/22/2009 7:53 PM (GMT -6)   
Guess it depends on the Urologist. I haven't had one since my surgery in May, 2008. PSA has been at zero since then.
Age 60
PSA 2007 4.1
PSA 2008 10.0
Diagnosed April 2008
Biopsy: 6 of 12 cores positive
Gleason 4 + 5 = 9
CT and Bone Scan negative
Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared
Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th
pT2c
lymph nodes negative
PSA Sept 28, 2008 0.00
PSA Jan 22, 2009 0.00
ED Status- Currently using Trimix, Levitra daily for increased blood flow.
Noctural Erections have completely returned on a nightly basis, same hardness as before.


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 6/23/2009 8:47 AM (GMT -6)   
As medical tests go a DRE is cheap, fast, and has very little chance of causing harm (your dignity doesn't count) so it makes sense even if finding something would be a low probability event.
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.


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1858
   Posted 6/23/2009 11:56 PM (GMT -6)   
I assume the doc is looking for a possible nodule on the wall between where your prostate was and the bowel. Given that Gleason grade 3 cells produce roughly 4 Ng/mL of PSA per Cu. Cm of tumour tissue (2Ng for grade 4 cells) then a reading of 0.1 Ng/mL would be produced by 1/40th of a CC.
A lump 3.5mm in diameter (1.5 times a match head) using the following formula
(4/3)x(π)x(1.75x1.75x1.75) gives us about 22 cu. mm.
which would produce marginally under 0.1ng/mL on a blood test. Mind you it would have to be in exactly the right spot and he better have a great sense of touch (there is basically nothing firm behind it) to feel it.
So concludes today's math lesson.
smilewinkgrin
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)
PSA February 09 <0.01

Post Edited (BillyMac) : 6/24/2009 1:24:19 AM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 6/24/2009 8:14 AM (GMT -6)   
Great lesson, Prof. Billy, I didn't know that math relationship, I learned something
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 


wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 6/24/2009 9:16 AM (GMT -6)   
LOL as long as I am not the only getting the nono
Thanks guys for all the replies.
12/06/07 DaVinci and open prostate surgery after difficulties in breathing stopped the davinci.


Galileo
Veteran Member


Date Joined Nov 2008
Total Posts : 696
   Posted 6/24/2009 10:29 AM (GMT -6)   
That's a very funny use of nono !!

My uro, after prostatectomy, agreed with Patrick Walsh that there wasn't much use of doing a DRE as long as PSA remained undetectable. Of course, my PSA climbed, and I got the exam.

Then I got an DRE from the radiation oncologist in my initial interview. And, even though my PSA has done fine after radiation, the R.O. does a DRE every time. He always says "I'm a doctor, and I examine my patients." It's not a huge deal for me any more. With no prostate, it's not as uncomfortable as before, and if it makes my R.O. feel like he's doing his due diligence, that's fine with me. Better to err on the side of caution.

But I was happy when recently he put me on 6 month checkups rather than 3 months.
Galileo

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1
http://pcabefore50.blogspot.com


coxjajb
Regular Member


Date Joined Nov 2008
Total Posts : 184
   Posted 6/24/2009 5:46 PM (GMT -6)   
I got the DRE at 3 month and 6 month post op. Skipped the DRE at 9 months but doc said I will get a DRE at 12 month exam. blush
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, No issues. Levitra no longer needed!
First post op PSA 11/11/08, 0.00
Second post op PSA 2/10/09, 0.00


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 6/24/2009 6:15 PM (GMT -6)   
Have not had a DRE since before surgery, and I'm not complaining.  I was just happy that the Uro. had skinny, short fingers.  I didn't want the trauma of prison life returning.  Just kidding.
Bob
 
 AGE:57
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01
 Gleason downgraded to (3+4)7
 6 month Psa , 0.1 
Fully continent...ED progressing as expected.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 6/24/2009 6:24 PM (GMT -6)   
After all we have gone through in our PC journeys, having an occasional DRE should be the least of our worries.
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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, 5/9 .10, 6/9 .11, July 13 - meet with radiation oncologist
 
 

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