PSA in 2 weeks--nervous

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compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 6/7/2010 10:17 AM (GMT -6)   
My second post-op PSA is scheduled for 2 weeks. Already I can sense the stress. I HATE this disease. My life is now in 3-month intervals (really 2 months when you count the 2 weeks before each PSA test).
 
My first post-op PSA was 0.01. Knowing me, I would probably not be thrilled with a follow-up test of 0.02 or 0.03. I would be wondering, "is this the beginning of a trend?"
 
Silly, huh.
 
End of this mini-vent!
 
Mel

63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.


Zen9
Regular Member


Date Joined Oct 2009
Total Posts : 310
   Posted 6/7/2010 10:21 AM (GMT -6)   

compiler,

I'm told that PSA test anxiety substantially abates after about 10 or 15 years.  smilewinkgrin

Zen9


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6945
   Posted 6/7/2010 2:50 PM (GMT -6)   
For me it's like a three day pass. I'm not going to start worrying about it until I have to.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/7/2010 3:12 PM (GMT -6)   
I think the vast majority of us, suffer from some form of PSA anixety, I think it just comes with the turf of PC. I got another post SRT one coming up first week of July, already thinking about it, hoping that my one time back in the zero club stays that way. Hoping its a trend, not just a one time shot, so I know the feeling. I will still be doing every 3 months ones for another year, just to be on the safe side.
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


Magaboo
Veteran Member


Date Joined Oct 2006
Total Posts : 1210
   Posted 6/7/2010 8:03 PM (GMT -6)   
Hi Mel,

I'm like David and have to have my next test in July. I've had these darn tests now for just about 4 years and it's not getting any easier (hopefully it will after 10-15 years). The only thing that makes it a bit better now is that I only get tested every 6 month, but the stress, 1-2 week prior, is enough to give me sleepless nights. Isn't this Pc wonderful :-(.
All the best to you.

Magaboo
Born Sept 1936
PSA 7.9
-ve DRE
Gleason's Score 3+4=7, 2 of 8 positive
Open RP 28 Nov 06 (nerve sparing), Post op staging T3a
Gleasons still 3+4=7
Seminal vesicles and lymph nodes clear
Catheter out 15 Dec 06, Dry since 11 Feb 07
All PSA tests in 2007 (4) <.04
PSA tests in 2008: Mar.=.04; Jun.=.05; Sept.=.08; 3 days before Rad Start=0.1
Salvage RT completed (33 sessions - 66 Grays) on the 19th Dec., 08.
PSA in Jan., 09=0.05; July 09=<0.04; JAN 10=<0.04


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/7/2010 8:21 PM (GMT -6)   
mag, that's part of the charm of us lucky guys having the "good" kind of cancer to get. you get it, you get treated, its gone, end of the story....not.
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


deer hunter
Regular Member


Date Joined Jan 2010
Total Posts : 246
   Posted 6/7/2010 8:56 PM (GMT -6)   
I don't think it gets any easier taking the test and waiting for the results I got a regular app next week for psa test with regular rad doc I hope my numbers are down and stay down!!!!!!!
DEERHUNTER
dx age 57 01/06 open RP 4/06 psa in 01/06 8.1  surgery path report Gleason 3+4=7 poorly differentiated  tumor was 90%involved in both lobes surgical margins postive. in the right apex and right radial margins tumor grade G3  perineural invasion present high grade of PIN found  T2c NX MX PSA 0706  .01 10/06 .02 01/07 .03 04/07 .04  06/07 .05  07/07 .08 07/07 bone scans pelvic ct neg. 08/07 proscintic scan neg.9/07 psa.10 net with rad onc. wanted to do SRT but i did not do it 10/07  saw a new dr at Emory University [my old dr urg. suggested second opinion ]  bone scans negs ct scans pelvics neg. biopies of the bladder and adrinal glands neg.another proscintic scan neg.12/07 Psa .11 clinial trial Emory injected with protons to try and find the cancer cells no luck 3/08 psa .17 06/08 psa .23 psa 09/08 psa .32 12/08 psa .39 3/09 psa .39 6/09 psa .43  meet with medical onc. he said  i might have waited to long to start SRT 7/09 psa .50  another bone scan ct scan all neg.MRI neg. meet rad. psa the last of 7/09was .55 onc. 7/09 started casdex 50mg 1 day for 30 days 2 shots of lupron started rad treament 10/09 40 treatments 75 gm 12 shots each time all aroud pelvic finished 12/09  psa .07 and psa 01/10.05 next dr visit 03/10 wait and see 3/10 psa.05 5/14/10  family doc done blood work at my request her lab psa .01  


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 6/7/2010 10:23 PM (GMT -6)   
deer hunter, i hope you get another big fat zero-nothing-nada with your next reading. waiting for the next psa is like buying a lottery scratch ticket, and hoping you win nothing.
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, no problem post SRT
Post Surgery  PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one:  July
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 43 days, 1/19 - Corr Surgery #4,  Caths #11 and #12  same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17


Carlos
Regular Member


Date Joined Nov 2009
Total Posts : 486
   Posted 6/8/2010 4:14 AM (GMT -6)   
Mel,  An acquaintance of mine had Brachy 18 years ago and saw his PSA start to rise last year.  He said he had stopped worrying about the annual tests many years ago.  I guess he has the right attitude.  Like you, I get my next one in a few weeks and have already started thinking about it.
 
Carlos

Diagnosed 2/2008 at age 71, Gleason score 5+3=8, stage T1c, PSA 9.1. 
Robotic surgery 5/2008, nerves spared, stg. pT2c, N0, MX, R0, Gleason 5+3=8 
PSA <0.1 at 20 months and each test since surgery.


Arno
Regular Member


Date Joined Apr 2010
Total Posts : 54
   Posted 6/8/2010 5:51 AM (GMT -6)   
compiler said...
My first post-op PSA was 0.01. Knowing me, I would probably not be thrilled with a follow-up test of 0.02 or 0.03.

Mel


There are labs which won't give a number below 0.1: they only report PSA <0.1, although they measure 2 decimals.
Do you really want to know ?
March'06: PSA 3.6
Diagnosed at age 63 Sep'09: PSA 575, GS 7 (4+3)
3 positive cores in 6
Bone scan: as a fully lit christmas tree
With Zoladex+150mg Casodex PSA <0.1
Additionally 4-weekly Zometa (zoledronin acid)


Sonny3
Veteran Member


Date Joined Aug 2009
Total Posts : 2447
   Posted 6/8/2010 6:13 AM (GMT -6)   
Mel,

I must be once again among the land of the confused and mislead. The way my PSA has been bouncing around since my surgery and SRT, I actually don't mind the follow-up tests. At least I have a current understanding of where things are. Now with the determination of a MET, I am left thinking, what else can occur in the 3 months before the next test.

I don't dwell on this stuff all the time, but by the same token I sure like to know what's going on inside. The uncertainty is the part that gets my goat. Just let me know and let's figure out a way to deal with it seems to be my MO.

Sonny
60 years old when diagnosed
PSA 11/07 3.0
PSA 5/09 6.4
Diagnosis confirmed July 9, 2009
12 Needle Biopsy = 9 clear , 3 postive
Gleason Score (3+4) 7 in all positive cores
da Vinci 9/17/09
Post Surgery Pathology: GS 4+3=7
Stage: T3a
Tumor Volume 12.5%
positive margin, extra-prostatic extension
30 day PSA 0.4, 50 day psa 0.53, 64 day psa 0.6
IMRT completed 1/15/10 35 treatments- 70Gy

2/24/10 FIRST POST RAD PSA 1.0---CARRRP --waiting for the next test.
3/22/10 Second Post RAD PSA 1.5 Dammmmnnn stubborn son of a gun
4/19/10 YAHOO PSA dropped to 1.2 Moving in the right direction.
5/7/10 PSA test 1.3 Sodium Fluoride PET Scan & CT SCAN -scheduled
5/20/10 PSA test 1.2 Holding off on future tests for 3 months- single lytic lesion found and scheduling radiation.


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 6/8/2010 9:32 AM (GMT -6)   

Arno:

Yeah, I want to know.

The doctors at Ford don't even like the ultra sensitive test due to the anxiety causes.

But, you know, if my PSA went from say .01 to .03 to .05 to .06, then I think we have a recurrence and we could get started on the next step. Studies show it is not good to wait too long to go to SRT.

 

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 6/8/2010 6:48 PM (GMT -6)   
I have been <.04 since 1 month post op. Even after 2 years, I still stress and think about the next PSA test. I hope it gets better. I have even thought about talking to a therapist about it. I seem to put off decisions "until the next PSA tests". I know it seems crazy but I have always been a worrier and stresser.
 
Age 48 at diagnosis
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
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue


compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7203
   Posted 6/8/2010 7:20 PM (GMT -6)   

Rob2:

You nailed it exactly. I seem to be living my brief post-op life in 3-month intervals!

 

Mel


63 years old . PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (Free PSA 24%),  after 45 days on cipro! DREs have always been normal. PCA-3 was about 75 (way above the 35 threshold). That led to:

Biopsy on 11/30/09. 5 out of 12 cores positive. Gleason 4+3. 2 cores were 3+3 (one 5% and the other 30%) on one side. On  other side:2 cores are 4+3 (5%)--1 core 3+4 (30%) no peri-neural invasion. prostate is 45 grams. Stage: T1C.  

Surgery with Dr. Menon at Ford Hospital, 1/26/10. He says all looked good. Spared nerves. Unfortunately: Pathology Report: G 4+3 (65%-35%). Cancer in 15% of gland. Lymph Nodes: Clear.  Perineural Invasion: yes. Seminal Vessical Involvement: No.  Extraprostatic Extension: yes.  Positive Margin: Yes-- focal-- 1 spot .5mm. Final Weight is 52.7 gms.  (Second opinion from Jon Epstein at Hopkins confirmed these results)

 Incontinence: joined that club-- definite leaks—1 pad/day. Night is dry, was  using 1 pad at night for security, but pretty much dispensed with that most nights. Update: no pads at night. No pads while at home, but still very uncomfortable. Use 1 pad for out-of-house activities. Suddenly got MUCH better on 3/10/10, almost overnight. Still some urgency but no pads about 90% of the time.  As of 3/12/10--completely continent! Uh...OH. As of about 3/16/10 problems with constant urgency although no pads needed--feels like an infection but none showing in urine.

Update: since late March all is well in that area. I would say 99.9% continent (a spurt here and there, maybe 5 spurts per week).

First post-op PSA on 3/10/10--DRUM ROLL: 0.01 Next PSA in mid-June.


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1131
   Posted 6/10/2010 9:26 AM (GMT -6)   
I didn't want to highjack Zen's thread on the probability of recurrence of cancer but have some thoughts. Before we were diagnosed with cancer, did we go to the doctor for annual physicals thinking we were going to be told we had cancer. I did not. However, post cancer, it scares the xxxx out of me to wait and get the results of my PSA tests. I admire the group here that do not worry but I guess cancer changes everything. Anyway, it has for me. I put the #'s in the models etc. There is no model that will come back with 100% accuracy so the worry continues.
 
Age 48 at diagnosis
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
22 month  PSA <.04
continent at 10 weeks (no pads!)
ED is still an issue


pasayten
Regular Member


Date Joined Mar 2007
Total Posts : 437
   Posted 6/10/2010 6:56 PM (GMT -6)   
The anxiety as much as I hate it comes with the territory for me whether I like it or not. I am pretty good when they are one year apart and can forget about it.

The one thing I have decided, is no tests October thru December... Whatever it is, it can wait til January... I do not want to ever go thru a Thanksgiving/Christmas season like last year...

pasayten
After 3-4 years of annual PSA 4-6, biopsy recommended
59 y/o
3/13/2007 - 12 point biopsy - Left 0/6  Right 1/6 Gleason 3+3 T1c
4/24/2007 - DaVinci performed at Virginia Mason hospital in Seattle
5/2/2007 - Catheter Out! Final pathology of Gleason 6  T2c Nx Mx, approx 20% of prostate involved, positive margin, but only at 2 focal points.  
6/28/2007 9 weeks incontinance... Overnite, went from 4-6 soaked pads a day from prev 8 weeks to 2 barely wet pads a day.
7/12/2007 11 weeks post-op  Minimal leakage...  one small pad a day
7/18/2007 First Post-Op PSA...  0.01 !!! 
9/10/2007 Pad free and ED at 75% with 100mg Viagra generic
6/26/2008 2nd Post-OP PSA at 14 months...  0.02 
12/2/2008 3rd Post-OP PSA at 20 months...   0.03
10/30/2009 4th Post-OP PSA at 31 months...   0.13 (moved and diff lab)
11/3/2009 Retest at my original lab...  0.11  (followup with Doc sched 11/10)
11/10/2009 Discussion indicated biochemical reccurrence and need for salvage radiation treatment. 
1/21/2010 Another PSA test at 34 months...  0.14
1/26/2010 IMRT Salvage Radiation Treatment started
                  32 sessions for 64 gys total.
3/12/2010 Finished 32 sessions...  No side effects to date except a little
tiredness.  Slight changes in bowel movements the last week...  
4/8/2010  Some rectal prostitis, but no change in urgency.  No urinary effects at all.  Now just waiting for the upcoming PSA test in June.
6/7/2010 First 3 month PSA result after SRT = 0.02   WAHOO!  as good as could ever be expected at the 3 month mark!  Thank You Jesus!
 

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