Question on First Post-Op PSA Timing

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rcroller
Regular Member


Date Joined May 2011
Total Posts : 327
   Posted 6/3/2011 5:59 AM (GMT -6)   
I had my open RP on 5/18 and am scheduled for a one month Uro follow up on 6/16.  The nurse gave me a lab slip to have my first post-op PSA drawn before the visit and she suggested I go the Friday before the appt. (6/10) to have the PSA done just to be sure they have the results by the time of my appointment.  My question is this: does the timing of this first PSA post-surgery matter?  If I get it done on the 10th it will have only been slightly over three weeks post surgery.  Could it yield a different result than if I waited another week until closer to the appt?(even if they don't have the result by the time of my visit) This will provide a baseline and I don't believe I will be able to get another PSA for three months so I'm looking for the best chance at obtaining the lowest possible number. Any advice appreciated. Thanks!
Age 53-PSA 8/10 3.0 PSA 2/11 3.5
4/15/11 BX
4/21/11 Path Report: 3 of 12 Left side PCa , 3+3, 3+4, 4+4
4/29/11 PCa DX, Gleason-8
5/6/11 BS: Negative
5/18/11 open RP Performed
5/24/11 Post Op Pathology Report: G-7, 4+3 T3A N0M0
6/1/11 JP Drain/Cath removed-Dry so far.

Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 6/3/2011 6:15 AM (GMT -6)   
Course you can get a PSA test anytime/anywhere you want...
 
The average around here is to wait 3 months for the first test. Cause you can get a false reading if done too soon.

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 6070
   Posted 6/3/2011 7:10 AM (GMT -6)   
3 weeks is early, 6 -8weeks ist post op then every 3mos from there.
Diagnosed 8/14/09 psa 8.1 66,now 67
2cores 70%, rest 6-7 < 5%
gleason 3+ 3, up to 3+4 @ the dub
RPP U of Wash, Bruce Dalkin,
pathology 4+3, tertiary5, 2 foci
extensive pni, prostate confined,27 nodes removed -, svi - margins -
99%continent@ cath removal. 1% incont@gaspass,sneeze,cough 18 mos, squirt @ running. psa std test reported on paper as 0.0 as of 12/14/10 ed improving

rcroller
Regular Member


Date Joined May 2011
Total Posts : 327
   Posted 6/3/2011 7:11 AM (GMT -6)   
Thanks. I don't believe my insurance will pay for more frequent testing.  Does anyone know how much it would cost if you paid out of pocket?  It doesn't sound like a few days either way will make a significant difference. Wonder why my doc does a one month baseline if the norm is two or three months? Guess I shouldn't get too excited if the number isn't great at the three/four week point but should rely more upon the three month number. At best I would hope it would show a significant decrease between the two and at worst would have a head start toward RT if it went the other direction. Guess I will just follow the drs. orders and hope for the best. Thanks again.
Age 53-PSA 8/10 3.0 PSA 2/11 3.5
4/15/11 BX
4/21/11 Path Report: 3 of 12 Left side PCa , 3+3, 3+4, 4+4
4/29/11 PCa DX, Gleason-8
5/6/11 BS: Negative
5/18/11 open RP Performed
5/24/11 Post Op Pathology Report: G-7, 4+3 T3A N0M0
6/1/11 JP Drain/Cath removed-Dry so far.

Post Edited (rcroller) : 6/3/2011 6:42:20 AM (GMT-6)


English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 6/3/2011 8:11 AM (GMT -6)   
After surgery the left-over PSA in your body gets processed away and takes a certain number of days to reduce by half (like a radioactive half-life) - I think it may be 4/5 days. (I think James may know the exact number of days concerned,) Thus if you had a PSA of say 8 then it takes about a month to go down in steps: 4, 2, 1, 0.5, 0.25, 0.125, 0.06 etc, but that is very approximate. I had surgery in July and was tested in November.
Alf

RobertC
Veteran Member


Date Joined May 2011
Total Posts : 1313
   Posted 6/3/2011 8:35 AM (GMT -6)   
I'm guessing a PSA test would be about $20 if you got a group rate. Its cheaper at an independent lab than at a hospital.
Gleason (3+4) 7, PSA 5 in November 2011
cryoablation in January 2011.

Post Edited (robertcool) : 6/3/2011 7:39:44 AM (GMT-6)


HD_Rider
Regular Member


Date Joined Apr 2011
Total Posts : 416
   Posted 6/3/2011 8:37 AM (GMT -6)   
I would think that PSA tests are not very expensive. I only say that because our local Sam's Club stores are doing free PSA screenings this weekend.

And I would expect that the doctor understands that it's only been 3+ weeks since your operation and that your PSA is not to zero just yet. But I think I would still go ahead and get the test because at a minimum it should show a significant downward trend to that zero mark. I would be comfortable in seeing that myself. Then just wait for another three weeks (six weeks post-op) and go get another test to see how it compares to the first one.
John (HD_Rider)
Age: 49
PSA: 3.5, 6/07
PSA: 4.5, 3/11
Biopsy, 12 cores: 04/13/11
Dx: 04/19/11
Gleason: 3 cores at 3+3=6 and one core at 3+4=7 (primarily on right side with <5% on left side)
DaVinci: scheduled for 06/09/11, hoping and praying for the best

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 6/3/2011 8:42 AM (GMT -6)   
More like a little less than 3 days or so, according to this Nature article:

www.nature.com/pcan/journal/v5/n2/fig_tab/4500567t2.html

Also, depends some on the individual and the race. In my case, mine dropped from 6.7 to .8 in 8 days. That's in line with the study results of less than 3 days.

Also, here's a link to an earlier thread:

www.healingwell.com/community/default.aspx?f=35&m=1716044 which confirms the 2-3 days figure.
James C, 64, East TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Prob. microscopic inv.-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30

Post Edited (James C.) : 6/3/2011 8:04:54 AM (GMT-6)


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 7082
   Posted 6/3/2011 8:43 AM (GMT -6)   
My (big national) lab charges $125 plus $25 blood collection fee as retail. The "negotiated" rate that the insurance pays is much less.  If you do go retail, at least they offer a small discount if you pay on-line.
 
My uro had mine drawn at 7 weeks post-op, but was careful to warn me that the results could be positive, and if so, would be very suspect for timing. He wants 8 weeks minimum, but there was a major holiday in the midst.
 
Three weeks seems a guarantee for a positive number, and an obligatory re-test. I would rather wait.

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 6/3/2011 9:05 AM (GMT -6)   
Note; rad the fine print on those do it at home mail-in blood testing kits. They only read down to .6, usually, in accuracy. Not much use for post-surgery or radiation guys.
James C, 64, East TN
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% inv, lf. lobe, GS6
9/07: Nerve Spar. open RP, Path: pT2c, 110 gms., clear except:
Prob. microscopic inv.-left apical margin -GS6
3 Years: PSA's .04 each test until 4/10-.06, 9/10-.09, 12/10-.09, 2/11-.08, 5/11-.08
Bimix .30

rcroller
Regular Member


Date Joined May 2011
Total Posts : 327
   Posted 6/3/2011 9:27 AM (GMT -6)   
So, if I understand this half life correctly and using three days as the half life, assuming my PSA was 3.5 prior to surgery, then the time progression should yield the following:
18-May 3.5
21-May 1.75
24-May 0.875
27-May 0.4375
30-May 0.21875
2-Jun 0.109375
5-Jun 0.0546875
8-Jun 0.02734375
11-Jun 0.013671875
14-Jun 0.006835975

Which means I could very well be in the .01 range by June 11th if all went well. Seems like I should proceed and see where I'm at in comparison to this information...at least should be in the ballpark, right?
Age 53-PSA 8/10 3.0 PSA 2/11 3.5
4/15/11 BX
4/21/11 Path Report: 3 of 12 Left side PCa , 3+3, 3+4, 4+4
4/29/11 PCa DX, Gleason-8
5/6/11 BS: Negative
5/18/11 open RP Performed
5/24/11 Post Op Pathology Report: G-7, 4+3 T3A N0M0
6/1/11 JP Drain/Cath removed-Dry so far.

English Alf
Veteran Member


Date Joined Oct 2009
Total Posts : 2218
   Posted 6/3/2011 9:29 AM (GMT -6)   
Thanks James - I knew you'd be able to find that old thread better than me (even though it was a thread I had started myself!)
Alf
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