how soon for first post-op PSA test?

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GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 4/11/2011 2:57 PM (GMT -6)   
I am just over 5 weeks from a RaRP and feeling great. As reported earlier, incontinence is only an extremely minor issue brought on by either beer, or a sneeze/laugh. Oddly, when the wifey is around, beer consumption goes up....laughter down....and vice versa. Hmmm.

My uro wants to see me on 4/20 with a fresh PSA test. I'm happy to comply, but is 7 weeks just a wee bit early to start this? I seem to think that 12-14 weeks is when the monitoring typically starts.

What have others experienced?

Dave
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.
PSA 7/08: 2.2; 7/09: 2.9; 7/10: 4.1; 11/10: 3.5

DaVinci surgery at Yale 3/4/11. Dr. John Coleberg THE BEST!!!

45 gram gland weight
Gl 3+3
PT2C
margins clear
no metastasis
5% of gland adenocarcinoma

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 4/11/2011 3:00 PM (GMT -6)   
This question comes up all the time... Most here like me will say three months to avoid premature false readings and heart attacks.

Post Edited (Steve n Dallas) : 4/11/2011 2:40:17 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/11/2011 3:31 PM (GMT -6)   
My doctor didn't like early readings, it waited a full 3 months for my first test.
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 2/11 1.24
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 9/10,

Casey59
Veteran Member


Date Joined Sep 2009
Total Posts : 3172
   Posted 4/11/2011 3:36 PM (GMT -6)   
GTOdave,

After RP, PSA diminishes in the body in a mathematical model similar to radioactive decay...the half-life of PSA varies person-to-person, but has been shown repeatedly to be in the 2-3 day range. The residual value in any one person's blood is a function of how high it was to start with (before surgery), that person's actual rate of decay (again, almost always between 2-3 days), and whether there is another source of PSA in their body (like progressed prostate cancer, or benign sources from nerve sparing surgery).

So in your case, you could estimate your PSA on the day of surgery at 4.0 ng/mL, and assume a slow decay rate of 3-days:
- after 3 days, your PSA would equal 2 ng/mL (or half the prior amount)
- after 6 days, 1 ng/mL
- after 9 days, 0.5 ng/mL
- after 12 days, 0.25 ng/mL
- after 15 days, 0.125 ng/mL
- after 18 days, 0.0625 ng/mL (below the threshold for "standard" PSA test)
- after 21 days, 0.032 ng/mL
- after 24 days, 0.016 ng/mL
- after 27 days, 0.008 ng/mL (below the threshold of an "ultrasensitive" PSA test with 0.01 lower detection limits)

So you can see, after 4 weeks, someone with a low pre-surgery PSA of 4.0 ng/ML would most likely be below detection limits of any PSA test. You can see that someone with pre-surgery PSA of 8.0 ng/mL would decay to the same undetectable level in just 3 more days...and so on and so forth.
 
Just to be sure, the common rule of thumb is to give a little more "margin" to these numbers. 6-weeks is common.

Post Edited (Casey59) : 4/11/2011 2:39:06 PM (GMT-6)


rob2
Veteran Member


Date Joined Apr 2008
Total Posts : 1132
   Posted 4/11/2011 3:52 PM (GMT -6)   
Some doctor's like to build up data so start checking PSA soon after surgery.  My surgeon did a PSA at 1 month, 6 weeks and then the 3 month mark.  As others have posted, the 3 month PSA seems to be the most important.

davidg
Veteran Member


Date Joined Feb 2011
Total Posts : 4093
   Posted 4/11/2011 4:07 PM (GMT -6)   
I had mine 4 weeks post catheter, 5 weeks post surgery. Then every 3 months.

Fantastic about SE being good for you.

GTOdave
Regular Member


Date Joined Oct 2010
Total Posts : 175
   Posted 4/11/2011 4:54 PM (GMT -6)   
Casey, fascinating reply....THANK YOU!

Purg.....you referred to your doctor as "it". Uh oh. Frankly, you have a pass to say anything, to anybody, for any reason. I pray for you every day, and I am decidedly not religious.

My opinion is that my doc walks on water. He wants a test, he gets it. I still hate needles though.

Thanks all!

(hmmmmm. Bronson must be napping)
52 yr old, PSA 3.5, Gleason 6 with 3 of 4 top nodes (0%;1%;10%;1%) cancerous. Bottom 2 floors are clean.
PSA 7/08: 2.2; 7/09: 2.9; 7/10: 4.1; 11/10: 3.5

DaVinci surgery at Yale 3/4/11. Dr. John Coleberg THE BEST!!!

45 gram gland weight
Gl 3+3
PT2C
margins clear
no metastasis
5% of gland adenocarcinoma

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2461
   Posted 4/11/2011 7:41 PM (GMT -6)   
My doctor want it the test done 8 weeks after surgery. This allows for any residual PSA to off

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 4/11/2011 7:53 PM (GMT -6)   
GTO, that was a typo, I hold my uro/surgeon in high esteem after all he has done for me. Good luck to you.
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 2/11 1.24
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 9/10,

DaSlink
Veteran Member


Date Joined Feb 2011
Total Posts : 713
   Posted 4/11/2011 9:59 PM (GMT -6)   
My first was at 8 weeks.
Every minute you fish or ride,adds an hour to your life!

Age 52 Dx age 53 daVinci surgery
prostate volume 32 grams
Biopsy 12 cores with 7 positive
Gleason score of 7
1st PSA 38.7 10/05/2010
2nd PSA 49.9 11/23/2010
CT neg.
BS Negative
RRP on 01/25/2011
PT3a -40% involved
margin involved-Left anterior
lymph nodes -clear
1st post op PSA-0.26-03/16/11

Mavica
Regular Member


Date Joined Jun 2008
Total Posts : 407
   Posted 4/12/2011 9:24 PM (GMT -6)   
Your Urologist/Surgeon knows you, your health history and your procedure better than anyone around here does.  This is the last place I'd be asking that question for advice.  Either you have confidence in your Urologist, or not.  If you still do, than comply with his request.  If you do "not" then find another doctor.  In the grand scheme of things, this is a minor issue for you to be worrying about at this point.  For what it's worth, my first PSA test was 3-4 weeks post-op/da Vinci.
 

Post Edited (Mavica) : 4/12/2011 8:29:53 PM (GMT-6)


Fairwind
Veteran Member


Date Joined Jul 2010
Total Posts : 3889
   Posted 4/12/2011 10:47 PM (GMT -6)   
The moment of truth...All walking on water stops.. But for 97% of the G-6 guys it's a done deal, a mere formality..Best of luck to you..
Age 68.
PSA age 55: 3.5, DRE normal.
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 3rd biopsy positive, 4 out of 12, G-6,7, 9
RALP Sept 3 2010, pos margin, one pos vesicle nodes neg. Post Op PSA 0.9 SRT, HT. 2-15-'11 PSA 0.0
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