Thinking of skipping my 2 month PSA test

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Ger42
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Date Joined Apr 2010
Total Posts : 189
   Posted 11/20/2010 12:41 PM (GMT -6)   
I have a 2 month followup appt with my urologist on 12/16. If he wants to do a PSA level I think I'm going to tell the him I rather wait for another 6 months. I'd rather have a stress free holiday then worry about what I'm going to do if it's high. Am I crazy?? Wife thinks i am.

James C.
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Date Joined Aug 2007
Total Posts : 4462
   Posted 11/20/2010 1:09 PM (GMT -6)   
Were it me and if this is the first test after treatment, I don't know if I could wait 6 months more. Are you speaking of a 2 month followup to an earlier test or is this the first one after treatment? As an alternative, maybe delay the test until January would work? That first test after treatment is really important. I really can't recall anyone who went more than 3 months after to get their first one. Some docs use 6 weeks, some 3 months, but that's your decision, of course. If it's a 2 months followup after an earlier test, then I suppose the answer would depend on what that earlier test result was and why he would want a 2 month follow up. .
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., all clear except:
Probable microscopic involvement of the left apical margin -GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh
ED continues: Bimix .30cc & Trimix .15cc PRN

F8
Veteran Member


Date Joined Feb 2010
Total Posts : 3800
   Posted 11/20/2010 1:36 PM (GMT -6)   
that would not be "stress free" for me.
 
ed
age: 55
PSA on 12/09: 6.8
no symptoms, no prostate enlargement
12/12 cores positive....gleason 3+4 = 7
HT, BT and IGRT
received 3rd and last lupron shot 9/14/10

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7204
   Posted 11/20/2010 2:10 PM (GMT -6)   
Holidays end in early January.
 
Mel

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 11/20/2010 2:25 PM (GMT -6)   
Count me in with your wife.

Think about it, unless you have a very high denial ability and can convince yourself that all is well for 6 more months you'll be thinking about it, wondering at odd times, for me that would be a holiday ruining thing.

If you get tested and end up "0" you can enjoy the holidays stress free, if it's not "0" then you can work on acceptance with a disease that is caught 6 months earlier than otherwise.

BTW, I got my Biopsy early December last year and had to go through the holidays knowing I had a G-8+ tumor that had probably "left the barn" it didn't really bother me during the holiday events as time with family etc kept me busy. It was the wondering what the future would bring during the quiet times that was the killer.
Diagnosed 12-09 age 55
07-06 PSA 2.5
01-08 PSA 5.5 (PCP did not tell me of increase or schedule follow-up!!!!)
09-09 PSA 6.5 Sent for consult with Urologist
11-09 Consult, scheduled for biopsy, found out about PSA from '08 (yes I was pissed)
12-09 Biopsy, initial Gleason 9 (4+5) later reduced to 8 with tertiary 5, ain't much but I'll take it.
01-10 Bone Scan, "appears negative"
03-01-10 RRP in Durango CO by Dr Sejal Quale and Dr Shandra Wilson, no naked eye evidence of spread, Vesicles and lymph nodes taken for microscopic exam.

03-16-10 Removal of cath' and pathology results of samples.
Multifocal carcinoma with areas of Gleason pattern 3, 4 and 5, Overall Gleason grade 4+4 with tertiary 5, Bilateral involving 21% of left lobe, 3% of right lobe, Invasion of left Seminal vesicle, Tumor focally present at left resection margin, 9 lymph nodes removed all negative, Tumor staging pT3b NO MX

04-23-10 PSA <0.04....... 06-07-10 PSA <0.04..... 08-03-10 <0.04
05-03-10 1 week without pads
06-28-10 ;-)

Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3742
   Posted 11/20/2010 2:25 PM (GMT -6)   
If your goal is to relieve stress, I don't think your plan will accomplish that.
Age 68.
PSA at age 55: 3.5, DRE normal. Advice, "Keep an eye on it".
age 58: 4.5
" 61: 5.2
" 64: 7.5, DRE "Abnormal"
" 65: 8.5, " normal", biopsy, 12 core, negative...
" 66 9.0 "normal", 2ed biopsy, negative, BPH, Proscar
" 67 4.5 DRE "normal"
" 68 7.0 third biopsy positive, 4 out of 12, G-6,7, 9
RRP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT, Dec

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 11/20/2010 2:41 PM (GMT -6)   
Just my thought. Get it done and move on. The anticipation is always the most difficult part.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

goodlife
Veteran Member


Date Joined May 2009
Total Posts : 2691
   Posted 11/20/2010 2:52 PM (GMT -6)   
Ditto, ditto, ditto. The unknown is almost always worse than the known.

Good luck, and have a great holdiday. Don't let PC rob you of that.
Goodlife
 
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 .
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)
6 Month PSA <.01
1 pad a day, no progress on ED.  Trimix injection
No pads, 1/1/10,  9 month PSA < .01
1 year psa (364 days) .01
15 month PSA <.01

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 11/20/2010 3:07 PM (GMT -6)   
...and one more ditto. Git 'er done in January! If you had treatment in Sept-Oct get it done in Jan so you have a nice solid 3 month baseline. That will be valuable down the road.
Sometimes, it's what you don't know that gets you.
Listen to your wife.
Here... practice with me.... "Yes, Dear."

Jeff (the leaking one)

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6947
   Posted 11/20/2010 4:59 PM (GMT -6)   
Daveshan wrote it well. I had my first PSA at 7 weeks (my uro does it at 8 weeks normally, but Chistmas was in the way).
Mine was "undetectable", but <0.1 - not an ultrasensitive test.
Regardless, knowing something was better than the unknown.
 
"Don't put off the test" would be my suggestion.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/20/2010 5:17 PM (GMT -6)   
Ger,

I will back your decision,, its a very personal choice, and I understand your feelings. I was suppose to have my 4th post-SRT test this month, and due to my recent major surgery and in the midst of a long recovery period, I chose to put mine off until Feb of 2011. My wife was fine with it, my Uro was fine with it. My medical problems have ruined the past 2 holiday seasons in a row, and wasnt about to do that to my family again if the news was negative. Whatever my number is, it will still be there.

You have to do what you think is right for you and your family.

David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

mycroft
Regular Member


Date Joined Oct 2010
Total Posts : 54
   Posted 11/20/2010 7:50 PM (GMT -6)   
Prostate cancer can kill you.

To skip status tests is, IMO, simply suicidal. It's not like skipping a haircut.

"The price of freedom from prostate cancer is eternal vigilance."
--paraphrasing Thomas Jefferson

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/20/2010 8:13 PM (GMT -6)   
mycroft:

don't you think "suicidal" is a bit of overkill for someone that simply wants to by choice to skip a single PSA test due to the upcoming holidays?
nothing terrible is going to happen to him in that short period of time, whether he knows or doesn't know the number.

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 11/20/2010 9:33 PM (GMT -6)   
Here's how I viewed the same scenario:
 
My surgeon removed my cancer.  Living a longer and healthier life is my main priority.  I follow the reasonable advice of the medical professionals who monitor and care for my health.  I don't try to use replace trained, experienced medical advice with my own lack of knowledge.  Not having the PSA test would cause me more stress than having it. 
Age: 61 (58 at diagnosis - June, 2008)
April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior
June '08 had biopsy, 2 days later told results positive but in less than 1% of sample (Gleason's 3+3=6)
Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days
Dr. recommended robotic removal using da Vinci; Surgery 9/10/08
Northwestern Memorial Hospital, Chicago, IL; Dr. Robert Nadler, Urologist/Surgeon
Post-Op Gleason's: 3+3, Tertiary 4; Margins: Free ; Bladder & Urethral: Free
Seminal vesicles: Not involved; Lymphatic/Vascular Invasion: Not involved
Tumor: T2c; location: Bilateral; Volume: 20%; Catheter: Removed 12-days after surgery
Incontinent: Yes (1 to 2 light (woman's style) pad per day)
ED: Combination of Cialis and MUSE (alprostadil) once weekly: started 9-27-08
Returned to work 9-29-08 (18-19 days post-op)
PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0; 3/10: 0.0; 9/10: 0.0

Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 11/21/2010 6:34 AM (GMT -6)   
Ger, I can understand waiting until after the holidays for a PSA test but waiting 6 months so soon after surgery....wouldn't do it if I was in your shoes.  I certainly understand your anxiety over the results but waiting 6 months is too long.  If you must, put it off til early January but I wouldn't go later than that.

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4829
   Posted 11/21/2010 6:53 AM (GMT -6)   
From another thread...Ger42's signature says:
 
Age 68 weight 185 height 6'
Samples taken 4/19/2010 sent to Bostwick
3 out of 12 samples cancer
1) gleason score 3+3 involving 65%
2) gleason score 3+3 involving 65%
3) gleason score 3+3 involving 10%
PSA 3.5 Mar 19
PSA 2.5 Apr 4
Bone scan clean CT scan clean
Da Vinci 10/12/2010 DR Paul Kahn all nerves spared
Home 10/19/20
Cath out 10/22/2010
Prostate 56 gm. Gleason grade 3+4 = 7
 
If you can handle not knowing - then consider early January like others have suggested.

Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 11/21/2010 8:33 AM (GMT -6)   
So this is, in fact, the first post surgery PSA. I'd do it at 3 months and not wait until 6 months.
(I had tests done at 6 weeks and at 3 months but my pre-surgery PSA was 23+ so there was a bit of extra concern.)
Jeff

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/21/2010 9:26 AM (GMT -6)   
i think the rest of you are grossly overeacting, and you are proving the point how PSA fear can over run your lives and mind. there's almost a tinge of panic in some of the answers, i one thing we try to learn how to handle. give the guy a break, he may change his mind and have it done as soon as the holidays over.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 11/21/2010 9:29 AM (GMT -6)   
I will revise what I stated before. I jsut saw that you were a G3+3. With that in mind it would probably be fine to wait for the 3 month check. If your sergical pathology rerport was a good one there really should be no problem. There is a certain abount of excitment about joining the zero club. We are looking for someone to buy the next round of beer. :)

On the other hand, joining the zero club for the hollidays may be a great way to enjoy them.

Best of luck on your decision and you test.

I will have my PSA run this very wk. I am 25 months out.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

Ger42
Regular Member


Date Joined Apr 2010
Total Posts : 189
   Posted 11/21/2010 10:11 AM (GMT -6)   
Thanks for all the comments. Can I enjoy the holidays and get the test in January? The answer is yes. I guess 6 months out from December is too long. I also realized if I wait till january I'll be in a new medical insurance cycle so I'll be paying for the test and office visit because I will not have met my $1,500 deductible for 2011. So the almighty dollar money has changed my mind. I'll be doing what the doc wants in December.
I think I'll wait a few weeks before I tell my wife. I might win a few points if I tell her I decided to go along with what she wants. I have to hope she doesn't read this post.
Age 68 weight 185 height 6'
Samples taken 4/19/2010 sent to Bostwick
3 out of 12 samples cancer
1) gleason score 3+3 involving 65%
2) gleason score 3+3 involving 65%
3) gleason score 3+3 involving 10%
PSA 3.5 Mar 19
PSA 2.5 Apr 4
Bone scan clean CT scan clean
Da Vinci 10/12/2010 DR Paul Kahn all nerves spared
Home 10/19/20
Cath out 10/22/2010
Prostate 56 gm. Gleason grade 3+4 = 7

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 654
   Posted 11/21/2010 10:13 AM (GMT -6)   
Everybody seems to have an idea so here's mine, I personally would get the psa done on schedule but hey, I"m not you. When you think about it, it won't make any difference in your outcome. Say, for example ,it would have come back 0.3 or 0.4 at the planned first check, you wouldn't sent you off for post op treatment at that point, probably. So you go at six months and it's bad news you are in pretty much the same place either way. If your stats were really bad pre-op then it would be different, but yours don't look bad at all.
Ron
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent after 3 mo. PT
ED, pre-op severe, post op total
10/10 Dr Boone, Baylor recomended AUS
AUS and IPP scheduled 1/11/11
post op psa's 0.04,<0.1,<0.1

Ger42
Regular Member


Date Joined Apr 2010
Total Posts : 189
   Posted 11/21/2010 10:40 AM (GMT -6)   
Thank you all for your input. Love you all. Jeff, yours was the best. You think he would have learned "Yes dear." after almost 35 years, but I guess not. Thank you all again for making MY holidays stress free by convincing him to follow through with the tests.

Gerry, you are BUSTED. Now, make the darn appointment!!

Gerry's wife

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7204
   Posted 11/21/2010 11:13 AM (GMT -6)   
David:
 
Your posts are often quite insightful and thought-provocative. As you know, we often seem to disagree on little points, although I think we agree a lot on major points. But you made an interesting point that at least philosophically got me thinking. You said:
 
"You have to do what you think is right for you and your family."
 
Now, on the surface, who can argue with that? It's like motherhood and apple pie. But I really have to disagree. Suppose Ger said that he was not going to do a PSA for 5 years because the stress of doing so is too much for him and his family. I would hope that folks would point out that thiis is foolishness, given what we currently know. In other words, under the guise of "You have to do what you think is right for you and your family" folks can do some foolish things, perhaps fatally so. Maybe one should add..."within the realm of reasonableness?" Also, you keep supporting Ger's assertion but then you keep referring to "after the holidays." THAT IS VERY DIFFERENT FROM HIS ORIGINAL POST. He was talking about waiting SIX MONTHS for his first post-op draw. This flies in the face of prudent medical advice. I think the suggestion to wait until January is excellent. Your decision to wait until February is not unreasonable and certainly fits being what you think is right for you and your family.
 
I am doing the same thing. Incidentally, like Ger, I'm going to do delay my 12/21 PSA only until about 12/31 to take advantage of the fact that my medical insurance will cover it 100% (I am over the max).
 
Anyway, David, just another one of our disagreements. Again, it is a small point but an interesting philosophical point!
 
Mel
 
 
 
 
 
 
 
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 11/21/2010 12:17 PM (GMT -6)   
mel, in your counter point, your illustration of the guy going out 5 years to get tested is absurd and totally out of context with both the original poster's intent, and the intent of my answer. and my point that many of the answers here, do show how fearful some of our folks are about having subsequent psa tests really are in their mind. they say they are enjoying life day by day, etc, but in reality, are still spellbound by fear of psa tests. i guess my view changed, when i used up my last curative card. if its proven that my srt failed, then there is no cure hope for me.
still feel you tried to read too much into my answer. do you do that with everyone you answer?

david
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 Not taking it
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/23/10

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7204
   Posted 11/21/2010 3:44 PM (GMT -6)   
David:

You read my posts. Do I do this with everyone I answer? Probably not, but only because your posts are often good food for thought. As I said, you and I are generally in agreement. You seem to be taking personally these small areas of disagreement. Please don't and be assured that I am responding to the CONTENT of a post and not to the POSTER.

Yes, my example is absurd although certainly not out of the realm of possibilities, as we all have fears. My point is that sometimes under the rationale of doing right for oneself and for one's family, we might do the wrong thing. I think Ger's original idea of waiting 6 months would be the wrong thing. I believe almost every poster (but you?) agrees with that comment. Waiting until January is more reasonable.

You said, " they say they are enjoying life day by day, etc, but in reality, are still spellbound by fear of psa tests."

That is an excellent, insightful point. I know when I get uptight about an upcoming PSA test and post about it, I do get folks who indicate that they do manage to enjoy each day and they imply that an upcoming PSA is of little concern. I'm impressed by those who can pull it off. But, again David, that's a great point.

Mel
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. 9/21/10--0.06
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