Post surgery DRE

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Regular Member

Date Joined Jul 2009
Total Posts : 47
   Posted 9/4/2009 7:05 PM (GMT -6)   
I had my first follow-up with my uro today, 8 wks post surgery.  He is concerned with the "slight positive margin" which he believes is an "artifact from surgery" but isn't totally sure.  He did a dre (what are you feeling for I asked!) and said it felt "tough not soft" ans it should.  Scare tissue?  More cancer? Just a tough rectum!? (Hard-ass!) My recent psa was .05 and he does not want another psa check for 6 months.  He said that he would be concerned if the psa started to climb.  But he wants to wait 6 months?  That means we won't see a trend, if there is one, until this time next year. 
Any thoughts on this would be helpful.
He also put me on Cialis 20, even though Willy seems to be waking up on his own!  I hate taking drugs on any sort!
Dad dx at 72 with Pca; RP at 73; Died 11/08 at 88 from Pca met.
3 Uncles have had Pca; 2 deceased from Pca met.
Me: Age 51: Joyfully Married; father of 7!
Routine Physical 11/07 PSA 1.73 DRE normal
Routine Physical 1/09 PSA 2.77 DRE abnormal.
1st Urologist visit 2/09 DRE normal, small - PSA 6.3!
Biopsy 3/17- St. Patty's Day! 3 of 12 cores positive with 5-8% Pca
3+3 Gleason; Visit Johns Hopkins 3/26/09 and decide for surgery.
Lapro RP 6/29/09; discharged 6/30/09
Cath out 7/9/09 Gleason unchanged 3+3;
"Larger amount of cancer" than expected.
Organ confined Pca, positive margin as "artifact" of surgery.
All other tissues clear.
7 wk psa 8/20/09 - 0.05

"We walk by faith, not by sight."

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 9/4/2009 8:18 PM (GMT -6)   
Well, with a Gleason of 6 your doc may not feel much urgency, but if this will cause you worry tell him and ask to have it checked at 3 months. Heck, there are walk-in clinics where you can have it checked no matter what he says.

A lot of guys here, and their docs, think that the use of ED drugs is important for penile rehabilitation so this may be what your doc has in mind. Sort of "change the filters and throw new spark plugs in it." as part of a tune-up. If this bothers you, then don't do it, but it does seem to be your doctor's advice. Of course, it may be that he just throws ED meds at everyone whether they need it or not, but it is legitimate therapy.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 9/4/2009 8:27 PM (GMT -6)   

with a first number of .05, just like I had, surprised he didn't want to do another one in 3 months, but every uro is different.

when i had my surgery this past november, thought i would never have to deal with another dre in my life, wrong, have had 3 since then, lol.

david in sc

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 9/5/2009 11:53 AM (GMT -6)   

Greetings, Theo.  My doc has a schedule for everyone on PSA tests and seems to stick to it.  Every 3 months for 2 years, then every 6 months for 2 years and annualy thereafter assuming everything stays good.  My doc always asks me how I'm doing and if I have anything I want to tell him.  You might just bring up to your doc the idea of doing another PSA in 3 months rather than waiting 6 months. 

As to the cialis, my doc said he wanted me to take either cialis or levitra and gave me samples of each.  Shortly after my catheter came out I was able to get about 70 - 80 percent erections and so didn't take the meds (I did call and talk to the nurse, but not the doc - should have talked to him).  I never got above that 70 - 80 percent level and in fact started to regress.  As soon as I started to take the meds 2 times a week, I was at 100% of presurgery firmness.  Bottom line for me, if I had it to do over again I would have followed my doc's instructions and started the meds right away. 

Glad things are coming around.  Look forward to continued good reports. 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

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