HealingWell
Search Close Search
☰

psa after robodic surgery

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
1 23
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/27/2017 2:20 PM (GMT -5)
Took my 2nd PSA which puts me at my 3rd month post surgery,picked up my post op pathology report,it reads as following...prostate size...41g...primary pattern 3..secondary pattern 3,,,gleason score 6...grade group 1....prostate involved by tumor 10%.....confine to prostate....seminal vesicles and resection margines univolved....6 lymp nodes negative for mestastatic carcinoma[0/6]....did not speak to doctor,should get results on 6/30...he did perform bilateral neuvasclar bundle preservation..do you guys think thats where my psa came from...hoping psa drops,,,,,
Posted 6/27/2017 8:44 PM (GMT -5)
GGs last reading (well over a month before his surgery) was 23.4. At 9 weeks post surgery, his psa was 0.03, so JackH, I'm not sure the "8 weeks is more than fine for starting PSA of 24" might entirely fit everyone's situation. Seems this thing is just so different for everyone...
Posted 6/27/2017 10:43 PM (GMT -5)
Joker, your final path report looks really good, I would say even great - low risk prostate cancer, G6 grade group 1 ...clear margins...10% of the gland...
You post OP PSA number looks odd...take a deep breath and wait for your 3 month PSA results, lets hope you'll get great news!
Posted 6/28/2017 9:43 AM (GMT -5)
praying and believing its just benign left behind tissue to preserve nerves,,
Posted 6/29/2017 5:49 AM (GMT -5)
Hey Joker,
First check out my name. Got it? Now take everything I say with that in mind.

The post from Tall Allen re. Johns Hopkins study should be a heads up for you. You can (sorta kinda) ignore the 0.18 at 8 weeks but your 3 month test result should be <0.04.
TA had an excellent post on the subject here: https://www.healingwell.com/community/default.aspx?f=35&m=3495340

Quoting: "Once again, a cutoff of 0.03 ng/ml on a first ultrasensitive PSA test seems to be an excellent indicator of eventual traditional biochemical recurrence (0.2 ng/ml). In other words, if the PSA reaches 0.03, it will most likely (77% of the time) reach 0.2. Treating before PSA reaches 0.2 offers good lead time advantage, increasing the probability that early salvage radiation will be curative. And by waiting until PSA reaches 0.03, it will spare a lot of men from unnecessary overtreatment.

The following article explains the Johns Hopkins data and discusses several other recent studies that came to a similar conclusion for men in various situations following surgery:

Johns Hopkins: ultrasensitive PSA after surgery predicts biochemical relapse "
Posted 6/29/2017 6:41 AM (GMT -5)
Most surgeons...for some reason, order a PSA at 6 weeks, even though they know the definitive word won't come for 3 months. For the OP, with a confirmed G6 post surgery pathology report, his chances of BCR are almost nil anyway.

Bottom line is...the 6 week test shows the trend, (dramatically downward), but it it not definitive. Even if he needs ASR, it can't start this soon after surgery.
Posted 6/29/2017 12:47 PM (GMT -5)
I was a "high risk" guy: PSA over 20, doubling time less than 6 months, T3, 7 out of 12 positive cores. etc.
My Uro ordered the first PSA at 6 weeks so we would have a jump on the next treatment if the value was high, above 0.5 or something like that (I don't remember.)

Fortunately my 6 week PSA was 0.05. I did not have to worry about the next step. Whew!
Jeff
Posted 6/30/2017 2:03 PM (GMT -5)
just got back PSA results..8 wks was ,,0.18..0.13..at 12 weeks....has to be some benign tissue left from bilateral nerve saving RP...this is mind boggling...almost perfect erections and bladder control since 3rd and 4th week after surgery..maybe next month .....<0.1..any idea's what going on ..havent talked to uro yet...
Posted 6/30/2017 2:29 PM (GMT -5)
also it takes a act of congress to get blood to flow out of me ,,had about 6 pokes with the needle just to get a vein with blood for the PSA test,so just maybe thats why its taking so long for it to drop..im just throwing things out and praying for the best..so the 0.13 today from the 0.18 thirty days seems promising to me???????
Posted 6/30/2017 4:46 PM (GMT -5)
is dropping good,,instead of rising....anyone ever had a case like this..thanks guys for all the previous answers.
Posted 7/1/2017 8:45 AM (GMT -5)
my father had prostate cancer died at age 84 not from prostate cancer,my oldest brother has prostate cancer he is 64 yrs old,he had the seeds and so did my father,we all had low grade,i have one more older brother,i dont know if he has been checked,and three younger brothers,dont know if they have been checked,but what im most worried about is my son ,he is 25 yrs old,is there a test he can take to determine if he will develope it.
Posted 7/1/2017 7:46 PM (GMT -5)
PSA retest in 1 month or 3 months
Posted 7/1/2017 9:10 PM (GMT -5)
read this just now,hope it pertains tome........................................The use of very low PSA thresholds risks overtreating patients whose PSA level is detectable due to residual benign prostatic tissue. For example, one recent report demonstrated that a single PSA elevation of less than 0.4 ng/mL after radical prostatectomy is associated with subsequent stable, nonprogressing disease in up to 50% of patients.28 Thus, while outcomes are better when salvage radiotherapy is administered earlier in the course of recurrent disease, physicians should avoid the risk of overtreatment by confirming a trend of increasing serum PSA levels rather than simply relying on a single PSA cut point to establish clinically significant disease recurrence.
Posted 7/1/2017 11:32 PM (GMT -5)
If it were me, I'd...

1) See what my doc has to say
2) Send the slides to JH for a second opinion to make sure there's no grade 4 cells
3) Wait 3 mos. to re-test
4) Take comfort from the fact that G6 never killed anybody.

I think that...

!) It would freak me out that my case is different
2) I'd make dam sure that's it's cancer that's causing the psa before more treatment
3) Be talkin' to JH about my case...specifically asking about their study...in regards to...how much credence should be given it....given that few (any?) of the participants of their study had a path this benign
4) Be wondering how much of my (healthy) prostate was left in my body...in an attempt to save nerves.
5) Get a decipher test

another psa in 4 weeks would not be in my game plan. (unless my doc told me to)

I'm unconvinced it's cancer. If it is...it was missed by the pathologists....which I would think *very* unlikely that that much (grade 4) cancer could be missed.

The above is my best guess at what I would do in your shoes....
Posted 7/1/2017 11:45 PM (GMT -5)
then again...I might would chuck it all and wait to see what the 3 mos. psa is....and go from there. (I think I'd still send my slides)

if my doc wanted another test in 4 weeks...I believe that would prompt me to get JH in on things sooner
Posted 7/2/2017 5:28 AM (GMT -5)
thanks, I read on one one of the topics on here that said[ post op path dont lie and to believe in it],,,,think ill wait to see what his office has to say after the holiday,they just sent me the results,doc does not be in office on friday,,,do healty prostate tissue left behind eventully die? I had very high blood pressure before surgery in the 160's and just in the last month went on meds to control it,maybe that has somthing to with how slow its dropping,, on my first results the nurse told me not to worry it happens all the time,the surgeon that did my surgery, robotic is all that he do,i wont say his name but i researched him and he had all great reviews,I read that the final determanation as far as doing nerve saving is up to the doctor once he gets in,,I asked my urologist which is not my surgeon since i just had one spot on my prostate could they just put seeds around that spot and not in the whole prostate,but he said they would have to kill the whole thing,and my research showed that those seeds sometimes eat through stuff that its not suppose to,,so if he left good tissue to save my nerves im fine with it,because on the right side of my prostate was clear and the one spot was in the apex..i cant wait three months maybe two to take another psa test,it should go to undetectable by then,ill call it left over benign tissue,,,and test every three months,,SOUNDS GOOD DONT IT..
Posted 7/2/2017 5:33 AM (GMT -5)
AND AS LONG AS PSA GOING DOWN and not up is good,right,,just hoping someone on here has been or is going through what in experencing right now....
Posted 7/2/2017 6:29 AM (GMT -5)
Joker, my opinion, take it for what it's worth....with a G6 diagnosis, your chances of recurrence is really, really low. The PSA is dropping...and you can go crazy with weekly or monthly tests...or you can find a way to roll with it.

The anxiety is getting you. Think about this...even if you do eventually need follow up radiation, they can't do it this early after surgery anyway...things need to be healed up first. You say you're fully continent and no ED? Great. Have the adult beverage of choice and then spend some quality time with your intimate partner and forget about PC for a while
Posted 7/2/2017 8:20 AM (GMT -5)
Ok sound good,best advice yet,,,thanks .........GONE FISHING
Posted 7/3/2017 8:51 PM (GMT -5)
doc wants to see me in three months and do PSA test then,,guess ill work on losing weight and start lifting weights and exercising...
Posted 7/4/2017 12:00 PM (GMT -5)
Go fishing!! I went and run 5k this morning slow but still happy I can do it back to mayo July 19th for pet scan n psa then decide next course of action
Posted 7/4/2017 1:32 PM (GMT -5)
I wish you the best in what ever the next step of your journey is..
Posted 5/8/2018 1:11 PM (GMT -5)
Finished up Ht and rt Feb..... 3 month post ht and rt PSA.. ....06..SAID THAT THE LOWEST THEIR MACHINE TESTS.. ..35 rt treatments and 4 months ht. ..and 1 month of bica pills.. .thanks everyone for your knowledge and prayers.. .
Posted 5/8/2018 3:04 PM (GMT -5)
Huh???
Posted 5/8/2018 3:28 PM (GMT -5)
After my failed RP surgery April 2017,psa 6 months post surgery of .18 ..then. 13..then. 21 then. 24 then. 31..started lupron and bicau pills in Nov. Started 35 RT treatments in Dec to Feb.. My first 3 month PSA test today post radiation of <.06 the lowest they can test down to... Thanks everyone for your knowledge. Next test in AUG.
✚ New Topic ✚ Reply
123