Normal to go to six-month PSA

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Regular Member

Date Joined Jun 2008
Total Posts : 91
   Posted 9/1/2009 8:43 PM (GMT -6)   
I met with my surgeon today for a one-year follow-up. Actually, it has been about 15 months since my surgery. All of my PSA tests have been 0.0. The surgeon was over an hour behind and seemed very rushed when talking with me and it seemed that since I am "fine" he didn't have much to say. He left the office stating he was going to get me a renewed prescription for the ED drug.

His nurse then came in with the script and told me to get my PSA checked six months from the last test. Here is my question... last year, in the post-surgery PSA follow-up, the surgeon told me he wanted to "watch me closely" with a PSA every three-months for three years because of my post-surgery profile. Now, a year later, the news is a six-month PSA interval.

Does switching to six-month PSA seem right in this situation? Should I try to contact the surgeon (probably through his nurse) to verify? Any advice?? Thanks...
Husband and father of two (current ages 5 and 7).
Age when diagnosed: 47 (currently 48)
Pre-surgery PSA: 13.7
Pre-surgery Gleason: 4+3=7
CT Scan, Bone Scan, PET Scan: Clear
Robotic Surgery on May 28, 2008, at Barnes Hospital in St. Louis.
Right nerve bundle spared; left bundle removed.
Gleason: 4+3=7
Involved 10% of prostate; all quadrants involved
Extraprostatic extension at left base and apex
Extensive perineurual invasion present.
Bladder neck, lymphvasular space, seminal vesicles, 17 examined lymph nodes, and all surgical margins FREE of tumor.
Four-week post-surgical PSA = 0.1
Seven-week post-surgical PSA = .01
October 2008 PSA = 0.0
January 2009 PSA = 0.0
April 2009 PSA = 0.0
July 2009 PSA = 0.0
Next PSA scheduled for October 2009.

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4818
   Posted 9/2/2009 5:23 AM (GMT -6)   

By all means call and ask to get the ol peace of mind thing going.

Odds are that after four good ZERO results he changed his mind.

I had four good Zero results and am now on a every six month cycle.

Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.

Veteran Member

Date Joined Jun 2008
Total Posts : 1804
   Posted 9/2/2009 6:43 AM (GMT -6)   
Kark, my husband also was restaged to T3a after surgery and his urologist said he wants to monitor PSA every 3 months for the first 2 years to keep an eye on things. Margins were clean as were vesicles, but he did have EPE (extraprostectic extension) in the posterior. PSAs have all been 0.0 since surgery (17 months ago) but, as it turns out, his last result came back 0.1. He will have another PSA 4 weeks after that one to check on things. Surgeon feels there's nothing to worry about but we're going to keep a very close eye on his PSA for the next few months. We are now switching to the ultra sensitive PSA test, feeling that it might give us an edge should the PSA continues upward.

Congratulations on the zeros!
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage updated to T3a with one microscopic extension into but not through capsule. Surgical margins, bladder and SV negative for tumor. Gleason 3+4 (no change from biopsy). PSA of 0.0 every 3 months since surgery. In August 2009, PSA reading of 0.1 - urologist will retest in 4 weeks. Hoping this is a blip. Incontinence good to excellent but still having issues with leakage. ED is a work in progress (with the help of Viagra).

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 9/2/2009 5:03 PM (GMT -6)   

I'm with Steve in Dallas - your doc probably sees 4 great reports and is going to the 6 month interval sooner than expected.  However, I wouldn't just assume that - a phone call to his office would probably be good. 

My doc told me every 3 months for 2 years and he has stuck with it.  I have my next PSA on Oct 1 and then the one after that will be 2 years so we'll see what he says then.  David

Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 9/2/2009 5:35 PM (GMT -6)   
You can always ask for 3 month test. What's a needle stick against peace of mind. If you even think of it, ask for a test.

Father died from poorly differentiated PCa @ 78 - normal PSA and DRE

5 biopsies over 4 years negative while PSA going from 3.8 to 28

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)

PSA prior to treatment on 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60

RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins

PSA undetectable for 8 months, then 2/6/2009-0.10, 4/26/2009-0.17, 5/22/2009-0.20, 6/11/2009-0.27

Salvage IMRT + 6 Months ADT: Casodex started 6/12/2009, Lupron 6/22/2009, PSA 6/25/2009-0.1, T=516, 7/23/2009-<0.05, T<10, IMRT to start mid-Aug

DS Can
Regular Member

Date Joined May 2009
Total Posts : 195
   Posted 9/2/2009 7:40 PM (GMT -6)   
If you want to remain on the 3 month test cycle, do what you need to do.  A call to the surgeon's nurse should be able to get that arranged.  Also, if you have another meeting with this surgeon, you should insist on it lasting long enough to get all of your questions answered and concerns explained.  You waited for your turn to see him, he should not try to make up time by cutting your appointment short.  Be your best advocate. 

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2457
   Posted 9/3/2009 7:26 AM (GMT -6)   
My surgeon wanted me to be on a six month PSA test right after my first 8 week test. I objected and wanted it done after 3 months which I did. Now he has me on 6 months interval. I don't feel good about that but hopefully he is optimistic for a good reason.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1

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