timing of post surgery PSA

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Regular Member

Date Joined Jun 2004
Total Posts : 231
   Posted 11/12/2007 4:39 PM (GMT -6)   
Dr Walsh's book says not to get retested for 3 months, and some of you here have been tested at 6 weeks.  Why?  Dr Walsh says that that is way too soon.
Les and DB

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 11/12/2007 5:04 PM (GMT -6)   
The standard is not clear. For me the drop to <0.1 was a six week deal, but I am not the norm. Because I had advanced disease I was tested three weeks out, then 5 then 6 and have had 7 tests since my surgery in February. Some I requested some scheduled. I was able to follow my drop from 13.7 pre-operative to undetectable. At my peak I was originally tested at 19.8. The next week it was 18.7, then the 13.7 just before biopsy. These are vast ranges and I wanted to know more about my physiological behavior. So I asked for the tests. And to be honest, I don't think Walsh is wrong and he is quoting the standard. My Oncologist does not agree with Walsh on this one. He tested right out of the gate. He stated that a drop of 50% per day was what he expected. But I have seen other posters here not drop that quickly, including myself. Here's how those tests went:

October 3, 2006: 19.8
October 10, 2006: 18.7
Biopsy December 12 (3+4=7 4 of 8 positive up to 80%)
Surgery February 16,2007
March 12, 2007: 0.9
March 18, 2007: 0.1
March 25, 2007: <0.1
Tests in April, May, July, and September have all been <0.1

Looking at my histogram, I was ably to determine that I was a 30% per drop after surgery. I am also lucky to have my advanced disease get down to zeros. Walsh was right but so was my oncologist. Six weeks is enough time and 3 months will be accurate.

Age 45 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007
Post-Op Pathology was poor: Gleason 4+3=7, 4 positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
My PSA did drop out after surgery to undetectable.  It has not returned and I will continue HT until January '08.
My Life is supported very well by family and friends like you all.

Regular Member

Date Joined Sep 2006
Total Posts : 211
   Posted 11/12/2007 5:20 PM (GMT -6)   

In the context of "residual PSA" the usual theory is that there should be little chance of it still being there after 6 weeks.

Scardino indicates that Residual PSA is flushed from the bloodstream in a few weeks.

Veteran Member

Date Joined Oct 2006
Total Posts : 626
   Posted 11/12/2007 5:49 PM (GMT -6)   
Les & DB,

I do not know why it was at six weeks other then that was the standard for my urologist. My PSA was undetectable at six weeks and I was released to do any physical activity I wanted at that point.

Diagnosed 7/6/06, 1 of 10 core samples, 40%,Stage T1c, Gleason 3+3
Da Vinci on 11/01/06, Catheter out on 11/13/06
56 Years Old
Post Op Path, Gleason 3+3, Approx. 5% of prostate involved
Prostate Confined, margins clear
Undetectable PSA on 12/18/06
No more pads as of 1/13/07
Began injections in April '07
Undetectable PSA on 6/25/07

Regular Member

Date Joined Jun 2004
Total Posts : 231
   Posted 11/13/2007 2:09 PM (GMT -6)   
Thanks all, I still have much to learn.  My brain is getting tired, but I will not stop till I feel confident that we kinda know what we are facing.  With you all, I know we can do it.
Les and DB

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