Duration between biopsy and surgery

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New Member

Date Joined Apr 2011
Total Posts : 6
   Posted 4/28/2011 1:39 AM (GMT -6)   
Hello, I'm 62 years old diagnosed with prostatic cancer two weeks ago.
I've talked to several urologists which gave me two different surgery time date.
Half of them says the surgery needs to be done 1.5 months after the biopsy.
The Other half says it's better to wait 3 months after the biopsy.
They say that the recovery from the biopsy (bleeding, Inflammation) is an important factor to the success of the surgery.

My biopsy results are: 1 out of 12 tissues was found with cancer.
Gleason score is 4+4=8.
My PSA has rised about 4 ng/ml in about a year to a value of 10, and then stays around 9.

I really don't know what to do...

Any advice will be appreciated!!

Veteran Member

Date Joined Mar 2009
Total Posts : 739
   Posted 4/28/2011 2:21 AM (GMT -6)   
Welcome Tom, to our club, that nobody wants to be a member of. We are however pleased you have found us, there are some very knowledgeable fellas here, that will be able to help you with your questions.
I waited 6 weeks from biopsy to surgery, and I believe this is the recommended soonest time, which suited me. I knew I had an aggressive form of cancer, and it was my personnel decision to get it out as soon as possible. I didn't see the sense in waiting, and risking it breaking through the capsule. Lucky for me I caught it in time, but it was certainly knocking on the door. Good luck with your decision, but I certainly had no complications with the 6 weeks after biopsy. Cheers................Kev
Kev 53yrs [Gold Coast Qld, Australia]
PSA 4 Gleason 7 [3+4=7]
RP 24/12/08 Dr Philip Stricker [Sydney]
Upgrade Gleason Score 7.6 [4+3=7]
Stage 2 Margin status- Focal Involvement
ED- okay with Meds.
PSA at 2 yrs, no change remains 0.03
"Every-day in Every-way I Get Better"

Veteran Member

Date Joined Feb 2011
Total Posts : 4093
   Posted 4/28/2011 3:25 AM (GMT -6)   
I waited 6 weeks upon advice from my surgeon. My urologist wanted to wait 4 weeks.
40 years old - Diagnosed at 40
Robotic Surgery Mount Sinai with Dr. Samadi Jan, 2011
complete urinary control and good erections with and without meds
Prostate was small, 34 grams.
Final Gleason score 7 (3+4)
Less than 5% of slides involved tumor
Tumor measured 5 mm in greatest dimension and was located in the right lobe near the apex.
Tumor was confined to prostate.
The apical, basal, pseudocapsular and soft tissue resection margins were free of tumor.
Seminal vesicles were free of tumor.
Right pelvic node - benign fibroadiopse tissue. no lymph node is identified.
Left pelvic node - one small lymph node, negative for tumor (0/1)

AJCC stage: pT2 NO MX

Veteran Member

Date Joined Jun 2008
Total Posts : 1804
   Posted 4/28/2011 6:12 AM (GMT -6)   
Tom, when my husband was diagnosed in February 2008, the urologist said he would not do the surgery for 7 weeks after the biopsy. It's possible things have changed in the past 3 years but waiting 3 months seems a bit long. What type of surgery are you considering: robotic/laproscopic or the traditional "open" surgery? This could make a difference since with the robotic, the prostate is pulled through an incision above the navel and if it's still inflammed from the biopsy, the surgeon may have a tough time getting the little bugger out.

I use to be a fish
Regular Member

Date Joined Mar 2011
Total Posts : 57
   Posted 4/28/2011 9:55 AM (GMT -6)   
In Dr. Patrick Walsh's Guide to Surviving Prostate Cancer is says on page 267-268 that there should be a delay of about six to eight weeks between the time a man's prostate cancer is diagnosed and the time he can undergo surgery.  The reason being is that immediately after the needle biopsy, the body reacts with inflammation and bleeding. Now is not the ideal time for surgery.  Even after two weeks, the punctures may have healed, but the prostate is now adherent to the rectum; it remains stuck to the rectum until the inflammation resolves.  If surgery were attempted at this point, it would not be easy to release the rectum from the prostate.  After giving it a few more weeks, the inflammation heals, and the prostate is no longer sticky. 

Worried Guy
Veteran Member

Date Joined Jul 2009
Total Posts : 3743
   Posted 4/28/2011 10:16 AM (GMT -6)   
I was told to wait 6 weeks. I wish I had waited a litle longer. 8 to 9 weeks would have given me more time to: get my house in order, exercise and build up my body, and work on emptying my prostatte as often as possible.

Had I only known...
Age: 58, Mar 35 yrs, 56 dx, PSA: 4/09 17.8 6/09 23.2
Biopsy: 6/09 7 of 12 Pos, 20-70%, Gleason 4+3 Bone, CT Neg
DaVinci RP: 7/09, U of Roch Med Ctr
Path Rpt: Glsn 3+4, pT3aNOMx, 56g, Tumor 2.5x1.8 cm both lobes and apex
EPE present, PNI extensive, Sem Ves, Vas def clear, Lymph 0/13
Incont: 200ml/day ED: Trimix
Post Surg PSA: 10/09 .04, 4/10 .04, 7/10 <0.01, 12/10 <0.01
AdVance Sling 1/10/11 Dry

Veteran Member

Date Joined Sep 2009
Total Posts : 664
   Posted 4/28/2011 10:41 AM (GMT -6)   
I was just short of 6 weeks from biopsy to surgery.

Veteran Member

Date Joined Feb 2011
Total Posts : 713
   Posted 4/28/2011 10:48 AM (GMT -6)   
Welcome;my surgery was 8 weeks after biopsy.
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

Regular Member

Date Joined May 2010
Total Posts : 264
   Posted 4/28/2011 11:07 AM (GMT -6)   
My uro said to wait at least 4 weeks after the biopsy but I waited 6 weeks for the operation. My uro seems to be on the fast end of things for all things related to my treatment (such as surgery time, getting catheter out and resuming normal activities, etc).

This reminds me of how the impact of my cancer news clouded my judgement in many respects, and created irrational and highly unlikely fears far beyond what was logically justified. I wondered a lot (between scheduling my surgery and first post op PSA) if I made a big mistake not getting the operation at 4 weeks thinking that the cancer could escape the prostate in those extra two weeks. Now that seems almost ridiculous knowing what I know now (thanks to this forum).

Here are some of my stats:
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

Veteran Member

Date Joined Jan 2010
Total Posts : 1011
   Posted 4/28/2011 11:13 AM (GMT -6)   
My surgeon told me 10 weeks. I think that he was just busy and needed to put me off. I needed up having surgery 15 weeks after biopsy.
Dx PCa Dec 2008 at 56, PSA 3.4
Biopsy: T1c, Geason 7 (3+4) - 8 cores, 4 positive, 30% of all 4 cores.
Robotic RP March 2009
Pathology Report: T2c, Geason 8, organ confined, negitive margins, lymph nodes - tumor volume 9%, nerves spared, no negitive side effects.
PSA's < .01, .01, .07, .28, .50. ADT 3 5/10. IMRT 7/10.
PSA's post HT .01, < .01

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2461
   Posted 4/28/2011 11:31 AM (GMT -6)   
My doctor wanted to wait 6 weeks after biopsy to do the surgery. I was DXed on December 30th and had surgery on Feb. 9th.
Age: 67 at Dx on 12/30/08 PSA 3.8
2 cores out of 12 were positive Gleason (4+4)
Davinci surgery 2/9/09 Gleason 4+4 EPE,
Margins clear, nerve bundles removed
Prostate weighed 57 grams 10-20% involved
all PSA tests since (2, 5, 8, 11, 15, 18, 21, 2 years <.008? ) undetectable
27 months: .005

Veteran Member

Date Joined Jan 2010
Total Posts : 2845
   Posted 4/28/2011 8:05 PM (GMT -6)   
- my initial thoughts were concern of possible sepsis due to trauma to the prostate and rectum area with the biopsy - but that was dismissed by my urologist/surgeon.

-I had my RP surgery four (4) weeks after biopsy.
-no regrets.

Age:55 -gay with spouse of 14 years, Steve -Peterborough, Ontario, Canada
PSA:10/06/09 3.86
Biopsy:10/16/09- 2 of 12 cancerous, 5% involvement -Gleason 7 (3+4)
Radical Prostatectomy:11/18/09
Pathology:pT3a -Gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
PSA:04/08/10 -0.05 -Zero Club
PSA:09/23/10 -0.05 -Zero Club
PSA:03/24/11 -0.02 -Zero Club
PSA:03/24/12- TBA

Regular Member

Date Joined Jan 2011
Total Posts : 42
   Posted 4/28/2011 11:49 PM (GMT -6)   
I had my biopsy done on 11/30/2010 and my robotic performed on 12/27/2010.
Age 54, Bx 3+/12, G9, psa 4.3, post surgery (pT3a, N0, MX), psa <0.1, Calypso RT in progress - 40 treatments

Elite Member

Date Joined Oct 2008
Total Posts : 25393
   Posted 4/29/2011 12:27 AM (GMT -6)   
my open surgery was 7 weeks from my 3rd and final biopsy.
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 margin
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, 4/11 3.81
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
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