My Freakin' 1 month PSA Results

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Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2448
   Posted 10/27/2009 1:32 PM (GMT -6)   
So here it is guys.

My one month PSA test came back at Total PSA .40

You would not believe how much I had to go through to get the results. But that is a topic for the What the Hell Are They Doing in the Medical Community discussion.

I saw my Uro at 2 weeks post surgery as a courtesy to deliver the path report and discuss my surgical experience. He flatly stated that he did not agree with my Henry Ford doctors as to the outlook and immediately wanted me to go into pro-active radiation treatment. Now this was just 2 weeks after surgery.

With this PSA test they wanted to refuse to give me the results until I scheduled an office visit. I knew then that the doctor wanted to talk to me again about radiation at "His Clinic". I told them in no uncertain terms I did not want to schedule and appt at this time and I was not leaving without the test results.

Here is my question and I open it for discussion;

I called my dr. in Detroit and asked them about the test results. They said that ideally you wanted them to come back undetectable. But it was not uncommon for them to come back at anywhere from .1 to .4 or .5. This is why they take the test at 1month and again at 4 months. They said the real test indicator is the 3 months after the first test. This is why they schedule the follow up at 4 months post surgery.

Have any of you encountered this before? Has it been discussed here before? Does this make medical sense to any of you? And, should I be looking for a short pier to take a long walk off of?

I don't need any advice on a new Uro. As of today I considered them FIRED. I have had an uncomfortable feeling from the beginning that they were trying to slide me into their revenue stream and today kinda confirmed it for me. Nothing tangible, but it is one of those feel it in my gut kinda things and I can't and won't ignore it.

Now this is in no way to be taken as a slam on the medical community as a whole and I could be totally wrong. But as we have all said and heard many times, a large part of your success in dealing with PCa is your attitude and confidence in your medical team. I just feel it is time for me to evaluate my confidence levels and re-adjust my positive attitude.

All feedback is extremely welcomed.

Sonny

Post Edited By Moderator (James C.) : 10/27/2009 12:52:47 PM (GMT-6)


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 10/27/2009 1:36 PM (GMT -6)   
From what I know - it doesn't make sense to do a PSA at one month. Three months is the norm.
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.


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 10/27/2009 1:49 PM (GMT -6)   
Sonny, all I can do is give you my experience with psa and time to clear the body after surgery. I entered surgery with a 6.7 psa. 8 days after surgery, I had a routine doctors appointment (blood work for the usual old guy problems-bp, etc) I asked them to include a psa test, since they already had the blood. This test came back 1.8, just 8 days later. I had my first psa test at 6 weeks and it came back .04. Has been that ever since. The etsting at 1 month for you MAY (and I mean May) not have allowed all of the residual psa to get out of the blood stream. Your psa pre-surgery was that almost identical to mine, so maybe that's what this is. If it were me, I would place a lot more credit on a test made at 3 months than this one, and personally not take any action until I had a clearer picture of my psa situation. Maybe request a 6 weeks test to see if it continues to drop.

By the way, I'm gonna alter the wording of your subject, there's a rule against one word in it. Freakin' ok, right? turn
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, Bimix .3ml PRN or Trimix .15ml PRN

Post Edited (James C.) : 10/27/2009 12:57:08 PM (GMT-6)


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 8128
   Posted 10/27/2009 1:53 PM (GMT -6)   
Sonny,
My PSA history might be worth noting for you. I had surgery on February 16, 2007. We knew I had issues from the surgery because I was stage 3B with 4+3=7 Gleason from the pathology. Within days of receiving the pathology info a week after surgery, I started seeing an oncologist. Here is how those tests came out:

Surgery February 16, 2007
February 28, 2007 0.9
March 12, 2007 0.1
March 23, 2007 <0.1

As you can see I still had measurable PSA until 33 days after the surgery.

I do agree that you still need to look into adjuvant therapies because of the 3A and the similar Gleason to mine. But you still want to test again to see if it is done dropping for you. You should ask for another PSA test now to see if there is a downward trend. I did see it and it was a plus to my personal mind set that it was dropping. And if it isn't, there is a solid reason to look into the "what if's".

Stay positive, my friend. You have my thoughts and prayers for a continued drop, but if it doesn't, you have many options ahead...

Tony
Age 47 (44 when Dx)
Pre-op PSA was 19.8 : Surgery at The City of Hope on February 16, 2007
Gleason 4+3=7, Stage pT3b, N0, Mx
Positive Margins (PM), Extra Prostatic Extension (EPE) : Bilateral Seminal vesicle invasion (SVI)
Hormone Therapy May '07 to September '09 ~ Currently off.
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (October 7, 2009): <0.1

My journey is at: www.caringbridge.org/visit/tonycrispino

My InfoLink page is at Tony's Prostate Cancer InfoLink Page

STAY POSITIVE!


LV-TX
Veteran Member


Date Joined Jul 2008
Total Posts : 966
   Posted 10/27/2009 1:56 PM (GMT -6)   
Sonny, I had a test 5 weeks after surgery because of a positive margin.

I think this is where your doctor is going. Due to the suggested EPE (T3 stage) and the positive margin, he is following the protocol for adjunctive therapy which is normally SRT and possibly a combination of SRT and Hormone therapy.

However it is your choice as it was mine to not move forward with additional therapy until there is solid evidence of needing it. The .4 psa is higher than I would think, but again it may still be coming down from the surgery. Hard to tell at this point.

I personally would wait for the three month test and then decide after that. And if it is still high, then look into the radiation route. The good news is (if you want to call it that), the positive margin and detectable psa after surgery usually means the cancer is still local, which salvage radiation offers another chance for a cure.


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
July 2008 - Biopsy 4 of 12 Positive 5 - 30% Involved Bilateral w/PNI - Gleason (3+3)6 Stage T1C
Robotic Surgery Sept 18, 2008
Pathology October 1, 2008 - Gleason 7 (3+4) Staged pT2c NO MX - Gland 50 cc
Seminal Vesicles and Lymph Nodes clear
Positive Margins Right Posterior Lobe
PSA 5 week Oct 2008 <.05
                   3 month Jan 2009 .06
                   6 month Apr 2009 .06
                   9 month Jul  2009 .08
                 12 month Oct 2009 .09 

Post Edited (LV-TX) : 10/27/2009 1:00:04 PM (GMT-6)


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 10/27/2009 2:38 PM (GMT -6)   
Hi Sonny,

My doc said it could take up to 6 weeks or more before all residual PSA is out of your system. My 1st PSA was 3 months post surgery. Maybe wait a few weeks? Ask your doc.

Mike
-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months 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: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-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.


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 10/27/2009 2:39 PM (GMT -6)   
Hi Sonny,

My doc said it could take up to 6 weeks or more before all residual PSA is out of your system. My 1st PSA was 3 months post surgery. Maybe wait a few weeks? Ask your doc.

Mike
-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months 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: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-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.


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2448
   Posted 10/27/2009 2:54 PM (GMT -6)   
Thanks guys for all the info and more importantly the positiveness of your feedback. I have come to expect nothing less from the folks at HW.

As you could probably tell from my post I was more upset about the hoops I had to jump through to get the results than the results themselves.

BTW, my Uro just called to apologize for what had occurred. Was really a great PR call on his part. He showed a little compassion and explained that most of his patients were not as well educated or versed in PCa matters (which I owe a lot of credit to you guys for), and it is his protocol to thoroughly talk about results like these face to face. However, he still was a little on the "let's talk" path about adjunct therapy, saying that he still did not agree with Dr. Menon's staff on their take on the pathology. He did agree that waiting until after my fourth month check up made sense. I held off telling he had been fired for the time being. I really got the impression that there was a little guilt in there somewhere.

Now I don't want you guys to think of me as conniving or willing to take advantage of anyone, but if there is another 2-3 months of the FREE Cialis samples in there somewhere I sure wouldn't turn them down.

Thanks again guys,

Sonny
61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

da Vinci 9/17/09 Dr. Mani Menon Henry Ford Medical Institute

Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
ALL NERVES SPARED
Margins: focally positive right posterior mid level
Perineural Invasion: present
Seminal Invasion: absent
Venous Invasion: absent
Angiolymphatic Invasion: absent
Left Internal iliac lymph node: reveals zero
Right Internal lymph node: reveals zero


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 10/27/2009 3:06 PM (GMT -6)   
Sonny,
I had my first psa at 6 weeks due to timing with my regular physical. But the "real" one was done at 3 months. One month seems early IMO. It seems like a chance to get an extra office visit. ;-) I'm just sayin'.
By the way, both times I called the office two days after the test and the PA called me back with the results.
DX Age 56. First routine PSA test on April 8th: 17.8.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex. No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Extraprostatic extension present; Perineural invasion: present, extensive
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 10/05 10 weeks, Still no activity
Incontinence - 8/20 4 full pads per day
. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
9/17 2 months: Still 3 pads per day.
10/5 10 weeks: Still 3 pads per day. At this rate I'll be fine in 2012.
Post Surgery PSA - 9/3 6 weeks- 0.05, 10/13 3 months- 0.004 undetectable.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 10/27/2009 3:36 PM (GMT -6)   
Sonny,

Just got home. Was shocked at first about your PSA result, but then my brain got to ticking. My own uro/surgeon strongly believes in waiting for a full 3 month after surgery, whether it be Robotic like yours or open like mine. I am thinking back ,and he said late last year, that any test earliers may read high and aren't consider and accurate reading. I am surprised you had one that soon, forgot already that its only been a month or so.

I know you came out of surgery as a stage 3, but the rest of your pathology was pretty clean. If it were me, and brother, not at all pretending to tell you what to do, I would sit tight, have it re-tested by the same lab at the 3 month mark. If that test confirms that number,I wouldnt sit around waiting for the standard 3 rises in a row. If it came back more in line as hoped, i.e. a zero, then I would wait and confirm reoccurance with another reading.

If it really is .4 in 3 months, I wouldn't hesitate to begin SRT and/or SRT with HT. You definitely want to work on it before it hits or passes .5
That is something that all the radiation oncologists I met with agreed upon.

I was so hoping you were checking in for the zero club. When my first one came in at .05, both my dr and I kind of knew what direction I was heading in.

I am here for you. All the way brother.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out  38 days, 9/9 - met 3rd rad. oncl., mapped  9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sessions/72 gys.


geezer99
Veteran Member


Date Joined Apr 2009
Total Posts : 990
   Posted 10/27/2009 4:00 PM (GMT -6)   
First of all, take a deep breath. There is no reason not to talk to a radiation onc right now and get an added opinion. That said, my uro only does three month tests. He said that he had three reasons, first that one month tests were not reliable, second that radiation (if needed) seemed just as effective after 3 months, third that spending time healing was going to make radiation (if needed) more tolerable.

What a painful roller coaster -- our hearts and prayers go out to you.
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
6 mo. PSA 0.00 -- 1 light pad/day


dkob131
Regular Member


Date Joined Apr 2008
Total Posts : 364
   Posted 10/27/2009 4:27 PM (GMT -6)   

Sonny:

I agree with Geezer, go ahead and speak to a rad. onc. if you don't need him fine but if you do you already have a jump on it.  There is quite a bit of info. out there suggesting that if you are doing adjunct or salvage it's best to start below.50 for best results.  I would be proactive here just in case.

Just my opinion.

David


 54 y.o.
 Diagnosed 4/10/08
 DRE Normal
 PSA-5.5
 Biopsy- 12 cores, 4 positive highest 4+4=8
 Bone scan, CT scan and Chest X-ray clear 4/16/08
 Urologist suggested surgery 4/16/08
 MRI on 4/24/08 clear no suggestion of lymph node   involvement.
 4/24/08 -Started on Lupron and Casodex preparing for HDRT and IMRT in late July.  This treatment will not preclude me from surgery if I change my mind.
Decide to have DaVinci surgery after another consult with surgeon.
6/19/08- DaVinci surgery at University of Washington.
6/25/08- Path report, clear margins, no noted extension
9/12/08- PSA <0.02 
12/05/08-PSA <0.02 Six months after surgery 
3/02/09-PSA <0.02 Nine months after surgery
5/02/09-PSA .10
8/17/09-PSA .21 Begin HT and set up for SRT to begin in 2 months.
 


reachout
Veteran Member


Date Joined May 2009
Total Posts : 739
   Posted 10/27/2009 4:33 PM (GMT -6)   
Sonny
Sorry to hear about your PSA.  But as others have said, one month is really early.  My surgeon told me to wait three months, so I had my blood drawn today and will find out next week.  For the last month or so I've been wondering why I had to wait so long, since other docs do the first PSA earlier.  But your case illustrates that testing too early can lead to (hopefully) high results that haven't had enough time to come down.  As well as a lot of needless anxiety if the next test comes down.  It doesn't surprise me that your PSA was still high, since you had the positive margins, so there were/are cells there still producing PSA that may be in the process of dying off (again hopefully).  So, hang in there, take a deep breath, and wait for the next test. 

Age 64 yrs
DX 5/2009
8 out of 12 cores positive
PSA 5.6
Gleason Score 3+4=7
Stage T2a
Da Vinci Surgery 08/07/2009
Upgrade Gleanson Score 4+3=7
Stage pT2c
Neg Margins and Nodes
Neg Extraprostatic Extention
Dry immediately
Waiting for first PSA


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 10/27/2009 5:12 PM (GMT -6)   

Hi Sonny.  All things considered I know you would have rather had a lower number.  As others have said, one month is pretty early for a follow-up test.  That being said, if it were me in this situation I'd probably want another test in a month or so rather than waiting the full 3 months.  As Tony indicated, he saw a steady decline in his PSA as it was tested and it would be good to know that yours was headed in the right direction - down. If it isn't headed in the right direction in another month or 6 weeks, I'd probably be looking to start my followup. 

Sonny, we'll be praying for you in these days of waiting and decision making. Keep us posted. 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


goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2692
   Posted 10/27/2009 7:24 PM (GMT -6)   
Sonny,

We all suck in our breaths with you at first glance.

But, then we also say Hey ! Wait a cotton pickin minute. Like the rest of the guys, I feel confident that your next test will be lower.

This old PC never seems to behave like we think it should, but just hang in there.

Keep us informed.
Age 58, PSA 4.47 Biopsy - 2/12 cores , Gleason 4 + 5 = 9
Da Vinci, Cleveland Clinic  4/14/09   Nerves spared, but carved up a little.
0/23 lymph nodes involved  pT3a NO MX
Catheter and 2 stints in ureters for 2 weeks due to anatomical issues with location of ureters with respect to bladder neck.  Try 3 tubes where no tubes are supposed to be for 2 weeks !
Neg Margins, bladder neck negative
Living the Good Life, cancer free  6 week PSA  <.03
3 month PSA <.01 (different lab)
5 month PSA <.03 (undetectable)


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 10/27/2009 8:07 PM (GMT -6)   
Sonny,
My doctor told me that it takes approx. 8 weeks post surgery for ant PSA already in the blood to clear out. I had my first PSA at 8 weeks post surgery.
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


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 10/27/2009 8:21 PM (GMT -6)   
Hi, Sonny

Ditto all the folks above. Three months is the standard for initial testing, so don't get too worked up on this result. Give it time and if you decide to fire this guy, then there is a lot of free Cialis at the other doctor's offices ,too. They don't pay for it so it's no sweat to them to give it out. If it eases your mind, wait 6 weeks, have your primary doc. draw blood for a new PSa test, and see what happens. If it shows a downward trend, wait until the 3 month mark and do it again. There's no set timeline for the test. Do it on your time if that's what you want.
Keep your head up.
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 
 9 month Psa,  0.2  Doubled! Criminy!
 Meet with rad. oncologist 10/15


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2448
   Posted 10/27/2009 9:33 PM (GMT -6)   
Well, well, we have a unanimous agreement. I should definitely not freak out now and just wait till the January test.

Also, it ain't a bad idea to have already talked to an oncologist and bring them up to speed just in case. My wife was on the phone with her MD Anderson cancer doc today and explained the possibilities and he said he will have their prostate guy and rad guy give me call to set up an appt. Won't cost me anything and I can get some interviews out of the way.

You guys no me, always trying to find the bright light in every dark cloud. Well I found mine with this test.

It would seem that because I served in Nam at a certain time I am eligible for Veterans Disability associated with PCa. Now if I had know about this before I had surgery I would have qualified for full disability at the rate of about $3000 per month until the cancer was no more. But since I have had the surgery, I now qualify for abt 50% if I have continence and ED issues. Okay sign me up.

Called back today before I go down to fill out the forms and told them abt the PSA test. The guy says come on down now. The test indicates that I still have the presence of PCa and may have to have future treatments. So he has no problem submitting my claim for the full disability amount.

Found my little rainbow in the dark cloud on this one.

Lest anyone think it, I am not overly worried about this. Especially with the positive support I receive from you guys. I still believe every day is a bonus and it is what it is.

In fact I am stepping onto the ball field tomorrow morning at 10am to work my first college game since the first of June. Am really excited about this, I even talked my partner into letting me do the plate. I told him I was much more comfortable with being back there than running around all over the field. Haven't been doing a lot of the running lately.

Big step for me. Working a couple of hours and holding in my water. I know the head coach pretty well and will explain the situation before the game just in case I have to make a mad dash for the john. At least at this school the john is in the dugout.

I'll let you know how it goes.

Thanks a lot again for all of your advice and support. To me this is what HW is all about. Support, and good information to digest.

Sonny
61 years old
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
<5%, 90%, 40%
Gleason Score (3+4) 7 in all positive cores
CT Organ Scan - negative
Nuclear Bone Scan - Negative

da Vinci 9/17/09 Dr. Mani Menon Henry Ford Medical Institute

Post Surgery Pathology:
Gleason: Changed to (4+3) = 7
Stage: T3a
Tumor Volume 12.5%
ALL NERVES SPARED
Margins: focally positive right posterior mid level
Perineural Invasion: present
Seminal Invasion: absent
Venous Invasion: absent
Angiolymphatic Invasion: absent
Left Internal iliac lymph node: reveals zero
Right Internal lymph node: reveals zero


IdahoSurvivor
Veteran Member


Date Joined Aug 2007
Total Posts : 1015
   Posted 10/28/2009 12:31 AM (GMT -6)   
Hi Sonny,

My surgeon took a PSA test at six weeks. However, she cautioned me that it very well could be detectable and not to worry since many people are still detectable at six weeks. She said if it was detectable, we'd just use it as a benchmark and take another test at three months.

Based on this experience, I think you'll still okay. I'm sorry for the shock and surprise.

Be strong and lean on your friends at HW.

Barry
Surgery: Da Vinci; July 31, 2007; 54 on surgery day;
Pathology: PSA: 4.3; Gleason: 3+3=6; T2a; Confined to Prostate;
Post RP PSAs: 09/07 <0.04; 12/07 <0.04; 03/08 <0.04;
06/08 <0.04; 12/08 <0.04; 06/09 = 0.06 (hmmm...);
Latest PSA 09/09 <0.04 (back to undetectable)


lewvino
Regular Member


Date Joined Jul 2009
Total Posts : 384
   Posted 10/28/2009 6:20 AM (GMT -6)   
Sonny, THis has been an interesting discussion and as usual with this disease it seems like there are numerous opinions and options!
First sorry to hear about the PSA but it is an early test as you know.

My first PSA was done at about 8 weeks. Was supposed to have been at 6 weeks but had the cruise that we were on so worked out at 8 an a 0 as you know.

I second the opinion to go ahead and at least talk with rad folks and get another test at about the 3 month mark.

I had read somewhere that they usually don't want to start radiation until about 6 months post surgery to let you heal from surgery first.

Not sure if that is true or not.

Your friend,
Larry
Age 55 / age at diagnosis 54, PSA 5.1
Biopsy 04/08/09 12 cores, 5 positive
Gleason 3 Cores at 4+3=7, 2 Cores at 3+4=7
Perineural Invasion Noted on biopsy

Robotic surgery 08/12/09 at Vanderbilt, Nashville TN. 
 
Post Surgery - Dr. Spared 100% of Nerves on the left side.
Estimated that 50 - 70% of the nerves were spared on the right side.
 
Final Path report
20% of the prostate Invovled
Tumor graded at T2C
Overall Gleason 3+4 (7)
Lymph Glands Clear
Positive Margin Noted in Right Apex
 
First post Surgery PSA - 0


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 10/28/2009 6:23 AM (GMT -6)   
I had a 1 month PSA but was always told 3 month was the one to wait for. I recall "googling" residual PDA after surgery and read that it could take 6+ weeks to get all the PSA out of the system. So yes, the waiting game begins again.
 
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


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 10/28/2009 6:58 AM (GMT -6)   
Sonny,
I think that bright spot you found is actually the glint of gold. I'd gladly volunteer to be paid 100 bucks per day for peeing in my pants. I'm doing that now - for free.
My birthday number was 192 so now I'm paying you 0.0001 cent to do it.
You're welcome.
Jeff

Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 314
   Posted 10/28/2009 9:13 AM (GMT -6)   
Sonny,

about your appointment with the MD Anderson prostate and rad guys:

Been there, done that.

My experience was that the doctors were very good; however, if you let them, the PA's and staff will then take over and start giving you orders like you were in the Army or something. My advice is to establish early and firmly that you are in charge.

Also, funny/tragic story. I saw a young doctor while waiting for the prostate & rad guy. He gave my wife and me a basic overview of PC (which I already knew). My wife asked if there was any chance she could "catch" cancer from having sex with me. I smiled and waited for the answer I knew was coming - only to have him amaze me and tell her that it was "theoretically possible." Needless to say, I haven't had sex since.

Good luck.

Zen9

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3739
   Posted 10/28/2009 9:21 AM (GMT -6)   
Hey Zen,
My wife caught ED the moment the Uro snipped my nerve bundles. I guess it is communicable. ;-)
Jeff

wesd40
Regular Member


Date Joined Sep 2009
Total Posts : 41
   Posted 10/28/2009 12:30 PM (GMT -6)   
Sonny3, Glad to hear from you on here. You and I share the same surgery date. My first  post op psa test is scheduled for Dec. 11th. I'm still doing good using 1 pad a day and night. Good luck with everything, Wes.
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