A website to provide support for people who have or have had any type of cancer, for their caregivers and for their family members.
Page 1 of 3 123 LastLast
Results 1 to 10 of 22

Thread: Done with Post op Appt

  1. #1

    Done with Post op Appt

    A Lil bummed. I was hoping we got a 5/6 week psa test just to see where we were but doc will see us in 2 mths which is at 3 mths post op. He did advise we will do a Ultra sensitive test.. His hours are my same working hours so I may go to Labcorp so that we can do weekends for testing. How much does Labcorp normally cost? Is that covered under insurance? See my sig below.. Praying we become Lifetime zero Club members. Not going to stress and worry til test, that won't do us any good. About to enjoy not thinking about this for now.. Hopefully we had a good enough final path to get to the infamous zero Club. I'm still learning so please be patient with me.

    Update.. Labcorp is not in my network. Quest is.. I called my insurance carrier and they said it has to be listed as medically necessary. Would this be considered necessary.. Is one place betre than the other.. Should I just pay our of pocket for Labcorp or will quest give me the same. He does want UPsa done. Does Quest do this..?
    Last edited by Honeybun078; 07-11-2019 at 11:14 PM.

  2. #2
    A lot of doctors want the patients to get their blood drawn outside of the office nowadays. Its easier for the lab,and the doctor's office, that way. The lab doesn't have to make a pickup.

    Its probably covered under your insurance, and if its not, you can probably have it done at Quest.

    So far, you have a good pathology report, lower risk, no upgrades. There is no reason to think it won't be fine.
    Nov 2013 PSA 4.2 Biopsy Jan 2014- 1 core positive, 20% Gleason 6, doctor highly reco'ed robotic RP - 2nd opinion at UPMC April 2014, put on active surveillance. 2nd biopsy Feb 2015, results negative. PSA test Feb 2016, 3.5. 3rd Biopsy Feb 2016. 3 positive cores less than 5%, Gleason 6. Octotype DX done April 2016, GPS Score of 24--rated "Low risk". PSA test 8/2016, 3.2. PSA test 1/2018 2.2 (after 7 months of proscar) PSA test 7/2018 2.3, PSA test 7/2019 2.0


    DOB 1956, in Pittsburgh, USA

  3. #3
    While Labcorp calls its 3-decimal test Ultrasensitive PSA, Quest doesn't use that adjective for its 2-decimal test. But it, too, is considered a uPSA, also intended for men post RP. Perhaps if your doc says Labcorp's is necessary, your insurance would cover it. Quest's test is perfectly fine for a confirmed G6 with a perfect surgical outcome, IMO. I think your doc will agree. Do not pay out of pocket just to have Labcorp's; it is not necessary.

    I believe the lowest measurable value with Quest's test is 0.02, so you are looking for the "essentially undetectable" result, which would be <0.02. The important less-than sign signifies that the actual PSA level is too small to be detected/measured by the test.

    Keep in mind the golden rule for PSA testing: always get the same test at the same lab. Get a written copy of the actual lab report for your records.

    What did your doc say about your husband's pain/discomfort?

    Djin
    Last edited by DjinTonic; 07-12-2019 at 12:33 AM.

  4. #4
    He said could have aggravated a nerve back there during surgery but didn't seem To concerned. He sais should go away but if persistent we will go from there.. He also wasn't too much worried about the stomach ache. He said that it would be normal if he over extended himself. We will monitor this also. He pretty much said he's still healing.

  5. #5
    Senior User
    Join Date
    Jan 2019
    Posts
    479
    Quote Originally Posted by Honeybun078 View Post
    A Lil bummed. I was hoping we got a 5/6 week psa test just to see where we were but doc will see us in 2 mths which is at 3 mths post op. He did advise we will do a Ultra sensitive test.. His hours are my same working hours so I may go to Labcorp so that we can do weekends for testing. How much does Labcorp normally cost? Is that covered under insurance? See my sig below.. Praying we become Lifetime zero Club members. Not going to stress and worry til test, that won't do us any good. About to enjoy not thinking about this for now.. Hopefully we had a good enough final path to get to the infamous zero Club. I'm still learning so please be patient with me.

    Update.. Labcorp is not in my network. Quest is.. I called my insurance carrier and they said it has to be listed as medically necessary. Would this be considered necessary.. Is one place betre than the other.. Should I just pay our of pocket for Labcorp or will quest give me the same. He does want UPsa done. Does Quest do this..?
    If you intend on using LabCorp, call ahead and see if the will do the test without an order from your Doc. LabCorp in my area will not without an order. You can go on line an pay $25 to get an order. I was quoted $176 for a uPSA.
    DOB 5/1957

    PSA - 11/2010=1.9, 6/12=2.3, 12/13=2.19, 12/14=2.64, 3/17=5.29, 3/17=3.91, 6/17=3.47, 12/17=4.50, 12/17=3.80, free PSA low risk (local (Uro, “My opinion you don’t have cancer), 8/18=5.13, 10/18=5.1, 10/19 ISO PSA 56% risk cancer. All DREs negative.

    DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative, (Uro opinion “This has been going on for a year”.... ah, more like 2 years ). Bone scan/CT negative

    2/25/19 R-LESS (Robotic Laparoendoscopic Single Site Surgery) outpatient Cleveland Clinic,

    3/6/19. Pathology - Grade Group 4 with Intraductal Carinoma
    T3aNO, GS8, 21 mm unifocal tumor 10%. -7 Nodes, - SV, - Margins, - PNI,
    - bladder neck neg., +LVI, + EPE non focal apex/mid lateral 1mm max extension, Cribriform pattern present. Decipher .86 High Risk.

    PSA 3/27/19 .03. (29 days)
    4/25/19 <.03. (58 days)
    5/25/19 <.02. (88 days)

    ADT - 6/3/19
    ART - 8/5/19

  6. #6
    Top User garyi's Avatar
    Join Date
    Apr 2017
    Posts
    1,293
    Quote Originally Posted by Honeybun078 View Post
    ....Not going to stress and worry til test, that won't do us any good....
    It will do you absolutely no good after the test either, so try to chill. If you're stressing your husband will know it, and it will do him no good either.

    As Dijn explained, Quest will be fine for you. It's possible to get a uPSA at Labcorp, out of pocket, for $109....but why?

    Try to relax. Your husband is in good shape.
    72...LUTS for the past 7 years
    TURP 2/16,
    G3+4 discovered
    3T MRI 5/16
    MRI fusion guided biopsy 6/16
    14 cores; four G 3+3, one G3+4,
    CIPRO antibiotic = C. Diff infection 7/16
    Cured with Vanco for 14 days
    Second 3T MRI 1/17
    Worsened bulging of posterior capsule
    Oncotype DX GPS 3/17, LFP risk 63%, Likelihood of Low
    Grade Disease 81%, Likelihood of Organ Confined 80%
    RALP 7/13/17 Dr. Gonzaglo @ Univ of Miami
    G3+4 Confirmed, Organ confined
    pT2 pNO pMn/a Grade Group 2
    PSA 0.32 to .54 over 3 months
    DCFPyl PET & ercMRI Scans - 11/17
    A one inch tumor still in prostate bed = failed surgery
    All met scans clear
    SRT, 2ADT, IMGT 70.2 Gys @1.8 per, completed 5/18
    Radiation Procitis, and Ulcerative Colitis flaired after 20 years
    PSA <.006 9/18, .054 11/18, .070 12/18, .067 2/19, .078 5/19, .074 7/19
    We'll see....what is not known dwarfs what is thought to be fact

  7. #7
    Hi Honeybun078! Be very confident & uplifted that your URO Surgeon feels there is no valid reason for a PSA test earlier than 3 months post RP! Consider this Very Good!

    Re uPSA: Again, being "Medically Unnecessary" is Good!

    IMO, having a single uPSA somewhere around the 3-4 month post RP mark will provide a baseline against which any future results can be compared in the event that recurrence may be suspected.

    In your case, I think that all you need to do is: Simply keep an eye on the haystack and don't waste any time or effort trying to find a non existent needle within!

    Time to relax, focus on continued recovery, have fun and FORGET about PSAs!

    MF
    Last edited by Michael F; 07-12-2019 at 01:56 PM.
    PSA: Oct '09 = 1.91, Oct '11 = 2.79, Dec '11 = 2.98 (PSA, Free = 0.39ng/ml, % PSA Free = 13%)
    Referred to URO MD
    Jan '12: DRE = Positive: "Left induration"
    Jan '12: Biopsy = 6 of 12 Cores were Positive: 1 = G7 (3+4) and 5 = Gleason 6
    Referred to URO Surgeon
    March '12: Robotic RP: Left: PM + EPE. MD waited in surgery for preliminary Path Report then excised substantial left adjacent tissue(s) down to negative margins and placed 2 Ti clips for SR guidance, if needed in future.
    Pathology: Gleason (3+4) pT3a pNO pMX pRO c tertiary pattern 5 / Prostate Size = 32 grams / Tumor = Bilateral: 20% / PNI: present
    3 month Post Op standard PSA = <0.1 ng/ml
    1st uPSA at 7 months Post Op = 0.018 ng/ml
    uPSA remains "stable" at 84 Months Post Op: Mean = 0.021 (20x uPSAs: Range 0.017 - 0.026) LabCorp: Ultrasensitive PSA: Roche ECLIA
    Continence = Very Good (≥ 99%)
    ED = present

  8. #8
    Top User
    Join Date
    Aug 2016
    Posts
    1,653
    There is no valid reason for testing sooner than 3 months for you. Get used to this anxiety and learn the head conversation to dismiss it. Just like doing kegel exercises, but even more important is keeping your head clear, it requires work.

    Knowing you should be doing kegels doesn't mean you will. Knowing an early PSA test doesn't make a difference doesn't mean you will not hope it does.

    Wax on. Wax off. This is the long game.

  9. #9
    The Quest test is called PSA Post Prostatectomy and is test code 14808.

    https://testdirectory.questdiagnosti...808/?cc=MASTER
    There is no right or wrong decision for treatment. Make the decision you are comfortable with and can live with and not second guess if all does not go optimally.

    6/2016 PSA 5.1, negative DRE
    6/2016 Urologist PSA 6.0, %free = <10% chance cancer, negative DRE
    12/2016 PSA 7.7, %free = 50% chance cancer, negative DRE
    2/2017 biopsy Bostwick 5/12 3+3, perineural invasion. Hopkins 5/12, 4 3+3, 1 3+4 (5% 4), perineural invasion
    5/17/2017 Open RP by Dr Alan Partin - Hopkins (5500+ prostate cancer surgeries, open & robotic)
    5/2017 Pathology 3+4, T2x, +margin (6mm, 3+3), organ contained except unevaluable at +margin, moderate tumor extent
    seminal vesicles, lymph nodes all neg
    Age: 62 @ surgery
    8/2017 PSA < .1
    11/2017 PSA <.1
    5/2018 uPSA .06, standard .1
    8/2018 uPSA .07, standard .1
    11/2018 uPSA .10, standard .1
    12/29/2018 6 month Lupron shot
    1/22/2019 start SRT, 39 treatments, 5 days per week
    3/15/19 ended SRT with no significant side effects

  10. #10
    Top User
    Join Date
    Aug 2016
    Posts
    1,653
    The Quest 14808 post RP is a two decimal test, <0.02. They also have a patient portal that is at least a one to two week wait if ordered by the doc. For me in the midwest, it is shipped and processed in CA.

 

Similar Threads

  1. 4 weeks post RALP, 1st Dr follow up appt today
    By tpjames in forum Prostate Cancer Forum
    Replies: 17
    Last Post: 12-21-2017, 08:33 PM
  2. another swollen lymph node post. pre-appt questions
    By fesler in forum Worried About Possible Cancer
    Replies: 3
    Last Post: 01-11-2014, 04:35 AM
  3. Upcoming appt for Mom
    By Pootie in forum Lung Cancer Forum
    Replies: 2
    Last Post: 10-23-2007, 12:23 PM
  4. Oncologist appt
    By momsick in forum Breast Cancer Forum
    Replies: 7
    Last Post: 03-17-2005, 02:06 AM
  5. Onco. Appt.
    By Muttsmom in forum Breast Cancer Forum
    Replies: 6
    Last Post: 02-18-2005, 08:51 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •