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Thread: Psa after prostate removed

  1. #1
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    Psa after prostate removed

    How can the doctor check my psa levels after the prostate is removed?

  2. #2
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    He will use the same blood test as before. Normally they will wait about three months for the first test as PSA stays in the body for awile. With the prostate removed, if there is still PSA the only other source would be cancer. So if you don't reach a low level then the doctors know they have some more work to do. Most of us have PSA tests every three months regardless of the type of treatment we have undergone. PSA doesn't confirm the presence of cancer, but it is the best indicator at the present time.

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    There are two types of test..The regular PSA test which produces results that look like 0.0 and the ultra sensitive test, a hundred times more sensitive, with results that look like 0.00 Anything below 0.1 expressed <0.1 is considered to be undetectable with either test. The ultra-sensitive can produce a lot of needless anxiety as the numbers can bounce around a lot so many doctors just use the standard test....Ideally, 8 weeks after surgery, your PSA should drop to undetectable. If it does not, your journey is not over....
    PSA at age 55: 3.5, DRE negative.
    65: 8.5, DRE " normal", biopsy, 12 core, negative...
    66 9.0 DRE "normal", BPH, (Proscar)
    67 4.5 DRE "normal" second biopsy, negative.
    67.5 5.6, DRE "normal" U-doc worried..
    age 68, 7.0, third biopsy (June 2010) positive for cancer in 4 cores, 2 cores Gleason 6, one core Gleason 7. one core Gleason 9. RALP on Sept. 3, 2010, Positive margin, post-op PSA. 0.9, SRT , HT. Feb.2011 PSA <0.1 Oct 2011 <0.1 Feb 2012 <0.01 Sept 2012 0.8 June 2013 1.1, Casodex added, PSA 0.04 10/2013. PSA 0.32 1/14. On 6/14 PSA 0.4, "T"-5.

  4. #4
    Newbie New User waffler's Avatar
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    You will have a check up every 3 months for the first year . You will give a urine sample each time and the Dr will stick his finger up your butt to see if he can feel any growths . You will also do bloodwork .
    Radical Prostectomy Da Vinci 13th Jan 2011

    Amateurs Built the Ark
    Professionals Built the Titanic

    You can take the Boy out of Stoke on Trent . But you cant take Stoke on Trent out of the boy.

  5. #5
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    Quote Originally Posted by waffler View Post
    "the Dr will stick his finger up your butt to see if he can feel any growths."
    The infamous DRE again, I thought I would be done with that.
    Age @ DX - 61
    3-2011 - PSA 4.2
    5-2011 - DX - Gleason 6, T1c, 2 positive cores
    8-2011 RRP - pathology report confirmed Gleason 6, no positive margins
    9-2011 First post op PSA @ less than 0.1

  6. #6

    depends

    Quote Originally Posted by quickstep View Post
    The infamous DRE again, I thought I would be done with that.
    It depends on the doctor. Walsh (in his book) says the DRE with an undetectable PSA isn't necessary. My urologist agreed, to my relief. Unfortunately, my PSA came back, and so did the DRE.
    My radiation oncologist insists on a DRE every visit (6 months) saying as a doctor he wants to examine his patients--in spite of my undetectable PSA after salvage radiation.Since he may very well have cured me--time will tell--I don't argue. At this point in my career as a prostate cancer patient, it's getting to be routine. Also, I think the DRE isn't as uncomfortable, now that there's no longer a prostate to push against the bladder.
    Replicant

    Dx Feb 2006, PSA 9 @age 43
    RRP Apr 2006 - Gleason 3+4, T2c, NXMX, pos margins
    PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
    Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
    PSA 6/07 0.1, 9/07 (and thereafter) <0.1
    http://pcabefore50.blogspot.com

  7. #7
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    Hi chevyguy and quickstep. - Replicant is correct in that it depends on the Doctor. MOST urologists do not do (DRE) exams after the Prostate has been removed, since the PSA would normally warn of any possible PCa recurrence prior to anything that could be felt manually. So for PCa detection, it is generally agreed, that DRE is no longer necessary, following SURGERY. There are other reasons for doing a DRE, however, such as other abnormalities/ Anal Cancer, etc. and since radiation can SOMETIMES be related to other problems/complications, that MAY be the reason that the Radiation Oncologist wishes to continue to do them.

    Perhaps, however, he just feels it provides a more thorough exam, that can't be questioned because of including additional diagnostic benefit, not necessarily related directly to PCa itself. In spite of what some people seem to think, DRE's are not particularly fun for the Physician either and most don't mind skipping them when justified. - John@newPCa (aka) az4peaks

  8. #8
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    @ Replicant and az4speaks

    Thanks to the both you for the lesson. As I am less than a month after surgery, I won't be surprised if my urologist does a DRE at my next checkup.
    Age @ DX - 61
    3-2011 - PSA 4.2
    5-2011 - DX - Gleason 6, T1c, 2 positive cores
    8-2011 RRP - pathology report confirmed Gleason 6, no positive margins
    9-2011 First post op PSA @ less than 0.1

  9. #9
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    quickstep
    It would also be wise to have a couple of other items checked during your next blood test. One is your testosterone level and the other a Vit D check. Base line numbers are valuable if one may or may not require additional treatment down the road.
    PSA at Dx 105 at age 68, 4/04. ADT, RRP, 5/04. 66 grms, GS 4+5=9, SVI, Staged pT3b N0 MX, 3D rad, 40 treatments, 8/04. PSA 1/05 <0.01. ADT (Lupron) till 7/07. PSA 0.03 12/08, 0.07 4/09, 0.13 8/09, 0.19 12/09, 0.30 4/10, 0.41 8/10, 0.47 12/10, 0.60 4/11, 0.64 8/11, 1.10 12/11, 1.03 1/12, 0.95 2/12, 0.92 4/12, 0.86 8/12, 0.757 11/12, 0.92 3/13, 0.93 7/13, 0.861 11/13. Will start ADT3 after PSA reaches 1.2.

  10. #10
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    Thanks Putt, I will be sure to inquire.
    Age @ DX - 61
    3-2011 - PSA 4.2
    5-2011 - DX - Gleason 6, T1c, 2 positive cores
    8-2011 RRP - pathology report confirmed Gleason 6, no positive margins
    9-2011 First post op PSA @ less than 0.1

 
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