Follow up Quarterly URO Exams

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wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 1/12/2010 3:36 PM (GMT -6)   
Guys it has been two years since surgery with post surgery level of 3+3 and everything contained and all PSAs have been .01. Now I am thinking about stopping these follow up DRE/ PSA exams especially with the new guide ines out there.

Good idea? Bad idea?
12/06/07 DaVinci and open prostate surgery after difficulties in breathing stopped the davinci.


Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 1/12/2010 3:39 PM (GMT -6)   
My Dr after 1 year moved me to every 4 months for Year 2. I am told that after year 2 on to 6 months ckup.

JEFF T
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

10th month PSA <0.01
1year psa <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next. Next step injections.
15 months out injections Caveject (success)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/12/2010 3:40 PM (GMT -6)   
wd, congrats on such a good record 2 years out. jealous in a good way. probably get a lot of opinions on this one. Being a Gleason 7, hard for me to think Gleason 6, lol. But if were me, I would probably at least go once a year until at least the 5 year mark, and have a single PSA test done at the same lab you been using, and it wouldn't hurt to have the unpleasant DRE continued at that rate too. Then you can re-access your situation at 5 years out. Good luck
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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


CPA
Veteran Member


Date Joined Feb 2008
Total Posts : 655
   Posted 1/12/2010 3:52 PM (GMT -6)   
Greetings, WD40.  I too am almost at the 2 year point.  My doc said before I ever had surgery - first 2 years get a PSA every 90 days.  I only see him every 6 months so I go in every 3 months for the blood work and see him every other time.  Now that I am at 2 years he says we'll move to blood work every 6 months.  Assuming that goes well, after 2 more years (4 years post surgery) we go to annual checkups. 
 
By the way, I haven't had a DRE since surgery by either surgeon or primary care doc.  Didn't think they had anything to look for up there!  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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 1/12/2010 4:29 PM (GMT -6)   
David/CPA, geez you are lucky. In the 14 months or so since my big surgery, I have had at least 3 DREs by my uro, and at least 2 by the radiation oncologist. The last two I didn't mind as much, as she had small hands and narrorw fingers, lol. With no prostate there, to be honest, there is no longer any discomfort having them done.

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
Incontinence:  1 Month     ED:  Non issue at any point post surgery
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 1/12/2010 4:34 PM (GMT -6)   
Why do they do a DRE?
 
Mel
63 years old
PSA-- 3/08--2.90;  8/09--4.01; 11/09--4.19 (Free PSA 24%), this after 45 days on cipro! DREs have always been normal.  
History of BPH/prostatitis. PCA-3 test: 75.9 (bad news, guaranteeing I have to do....): Biopsy on 11/30/09. Result of biopsy:

5 out of 12 cores positive. Gleason 4+3. More specifically: 2 cores were 3+3 (one 5% and the other 30%) on one side. On the other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C

REVISED BIOPSY REPORT: The previous was read by Umich. Slides were then sent to Dr. Menon at Ford Hospital. Here is their report (much better) -- changes in bold print below:

5 out of 12 cores positive. Gleason 3+4. More specifically: 2 cores were 3+3 (one 5% and the other 20%) on one side. On the other side, 3 cores were 3+4 (5%, 5%, 20%)

 Latest: Surgery with Dr. Menon at Ford Hospital, set for 1/25/10

 


wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 1/12/2010 4:39 PM (GMT -6)   
My URO insist on DREs every visit. I keep wondering if he didn't get bit by a law suit years ago and now want take the chance anymore.

I really appreciate the thoughts on this. Nothing better than to read different view points. It helps me from being single minded.
12/06/07 DaVinci and open prostate surgery after difficulties in breathing stopped the davinci.


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 1/12/2010 6:21 PM (GMT -6)   
WD, I am 20 months out from surgery and have not had a DRE since. My current uro says there is no need unless my PSA starts to rise. His thoughts are in line with Walsh's recommendations.   I'm currently on a six month cycle until I reach the 5 yr. mark.

Carlos


Diagnosed 2/2008 at age 71, PSA 9.1, Gleason 8 (5+3)and stage T1c. 
Robotic surgery 5/2008, nerves spared, All margins, SV and lymph nodes were neg. 
Staged pT2c, Gleason sum 8 (5+3).
Continent at 6 weeks. 
PSA <0.1 at 20 months, Jan. 4. 2010.

Post Edited (Carlos) : 1/12/2010 5:34:08 PM (GMT-7)


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 1/12/2010 6:23 PM (GMT -6)   
Mine kept me on 3 months for the first year and half, then 6 months after that. He says after 3 years he will probably go yearly. Yes,
I get a DRE every time. He says he's feeling for abnormal tissue growths, thinning of the rectum wall and general pelvic and bladder health, so I don't mind.
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, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 1/12/2010 7:17 PM (GMT -6)   
My Uro wanted me on a 6 months interval after my initial 2 months PSA. I didn't like the idea because of my high Gleason and insisted on 3 months intervals. His argument was that I had negative margins and didn't need a test every 3 months, reading this forum convinced me that negative margins prove nothing when it comes to recurrence. I'm having my one year test later this month (my annual physical) and then in April with my Uro.
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 in circumference.
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
8 months PSA test 10/9/09 result <0.1

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