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Post- RP 11 week, PSA 0.06

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Posted 7/21/2016 8:54 AM (GMT -5)
Greetings from Hong Kong!

Thank you so much for all the invaluable sharing of knowledge and experience! It's amazing to come across this forum and I have been lurking around here since the diagnosis of PCa of my dad, aged 74.

He had his PCa confirmed in April 2016, with details in the signature.
Today, he had his post- RP first PSA result = 0.06.
Keep observe................

Would appreciate any comments or anyone of you with similar past experience to share.
My best wishes to you all warriors!!
Posted 7/21/2016 9:07 AM (GMT -5)
Welcome to HW.

That's a very good number. Sounds like the RP did it's job!

Andrew
Posted 7/21/2016 9:10 AM (GMT -5)
Welcome from across the many miles! That sounds like a great report. How is his continence? How about his sexual function? Hopefully he's in for a long period of regular blood draws and not much else.
Posted 7/21/2016 9:15 AM (GMT -5)
Thank you InTheShop and halbert. Just wonder, is it a must for the PSA to be totally undetectable instead of 0.06?

He has been totally continent since a few days ago with completely dry pad.
He has been taking Cialis as recommended by our urologist... but at his age, sexual function is not very much of his concern indeed.
Posted 7/21/2016 9:20 AM (GMT -5)
After surgery, a very low number like that is considered undetectable.

He's doing very well and it's likely the doctors got all the PC. You have every reason to be very happy with the results.

Andrew
Posted 7/21/2016 9:51 PM (GMT -5)
From a gl 4+5 TO A GL 3+4...thats wonderful...trust me on this your dad at 74...will not die of Pca period... I'd turn the corner on the whole kit and caboodle and live again...thats right no more psa tests...no more anxiety...And you young man allow that if thats what he wants...He has earned that... right...from a 73 year old who is doing just that...with a post op bunch of gobbly gook that make your dad's look even sweeter...
Posted 7/21/2016 11:23 PM (GMT -5)
That's not undetectable. I'm sure you would like to see an undetectable PSA ideally, but his low Gleason score (3+4) and his favorable pathology are good signs. If it were me, I'd wait a few months and re-test. What did his doctor say?

It's odd that there was such a big downgrade between his biopsy Gleason score (4+5) and the pathology Gleason score (3+4). Do you have confidence in the pathologist?

- Allen
Posted 7/22/2016 5:38 AM (GMT -5)
At this point, all you can do is test every few months. Here in the US, the typical protocol is to do PSA every 3 months for at least a year, or maybe 2, then spread it out. The thing to watch for is a trend upwards. It's also important to have the same lab run every test, because there can be variations between labs that can make a false positive appear.
Posted 7/22/2016 9:16 AM (GMT -5)
Yes, the urology team suggested observation of the PSA trend as well. I am mentally preparing for ?rise after 3 months. What concerns me is whether my dad is a candidate for IMRT. He also has high grade fistula in ano for many years without active infection. I am worrying if the IMRT will complicate the issue.

For the significant downgrade in his Gleason score, I felt unbelievable too... I have been searching extensively online regarding the possibility for such downgrade. Yet, our urologists said it is not uncommonly encountered in their daily practice.

To supplement, the closest margin at the right side of the gland was 0.1mm. Does it ring a bell?
Posted 7/22/2016 9:32 AM (GMT -5)
I have been telling myself to calm down and be satisfied. Being diagnosed at this age but not 10-15 years earlier is already something earned.

Will take him and my mom for a trip to Japan soon, after this PSA result is out. Live on when he is still up and about.
Posted 7/22/2016 10:05 AM (GMT -5)

tingting0114 said...
I have been telling myself to calm down and be satisfied. Being diagnosed at this age but not 10-15 years earlier is already something earned.

Will take him and my mom for a trip to Japan soon, after this PSA result is out. Live on when he is still up and about.

At this point, it's ALL about living life to the fullest. It IS a gift, so embrace it!

By the way, how old are you? If you're over 50, are you getting checked?
Posted 7/22/2016 11:46 AM (GMT -5)
You could send the original biopsy slides and post op pathology to Epstein for a second opinion..{peace of mind} 0.1 mm is pretty small...btw he will be up and about for a long time...the way you put it...edges close to a mind set..you really don't want to put on him...not a scold...just what I see...and connect...receive it that way...ok?

Enjoy Japan...its a wonderful country...
Posted 7/22/2016 5:41 PM (GMT -5)
I am his daughter in my thirties... Haha... I need to do another different set of checkup regularly instead.
Posted 7/22/2016 6:49 PM (GMT -5)
OOPs, I assumed.....and shouldn't have.
Posted 7/22/2016 9:07 PM (GMT -5)
I would stay up on testing and seeing if PSA increases or is stable. By the way, your father is very fortunate to have such an attentive daughter watching out for him. I know he must be so proud of you.
Posted 7/22/2016 11:24 PM (GMT -5)
Thank you rob2. I am more alert as I am also an endocrinologist myself. I have my colleagues and friends in different specialties helping us a lot... In front of PCa which is an area outside my daily scope of work, I am no different from a layman...
Learning a lot here in the forum from you all as well, esp the first hand personal experience.
You are all brave and positive.
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