What questions to ask at 3 month post RRP appt

At three months post RRP, PSA should be in the non-detectable group. Depending on the specific test run, it might be <0.1, <0.05, <0.02, or some other value. The key is the "<" symbol. That means that the value is too low to be measured by the method they are using. Either way, if he's "<", he's in the zero club.

So, the questions for discussion, assuming he's a zero, are going to be about continence, erectile function, and his ability to do physical activity. By now, he should be pretty well able to do whatever he was doing before surgery.

The questions you ask will largely depend on the PSA score. If it's undetectable you'll have a pretty short list of questions. If it's detectable you'll probably be having a conversation about additional treatment.

Some of the questions you might ask regardless of the PSA score include:

* How do you recommend doing kegel exercises?
* Should he be on Viagra or Cialis as part of a rehab program?
* Is his current level of exercise/activity appropriate?

If his PSA is detectable:

* Do we need additional treatment at this point, or should we retest in three months and see what the PSA doubling time is?
* Is radiation appropriate at this point or are there less aggressive alternatives we should consider?
* Do you recommend radiation at this point? If so, in what dosage and for how long?
* Can you refer us to a radiation doc?
* Are there alternatives to radiation as an adjunctive treatment?

I'd also suggest that you should seriously consider getting a second opinion if your doctor recommends any additional treatment. He may be 100% right, but it doesn't hurt to get a different perspective.

Good luck tomorrow. I hope the news is that his PSA is undetectable and the prescription is to enjoy your life. I'll keep a good thought.

Best,

Jonathan

If you get a chance, you should read the joint guidelines issued by the AUA and ASTRO, also endorsed by ASCO. These guidelines are from 2013 and relate to the question of adjuvant radiation therapy post surgery for adverse pathology, which includes T3b. Those guidelines call for at least a discussion of post surgical treatment no matter if te first PSA is good. That does not at all mean your husband needs or should get that treatment with an undetectable PSA, but that you and the doctors should at least talk about it, understand the pros and cons, maybe think about a consult with a radiation oncologist given these guidelines and his pathology. Having that discussion is not dependent on PSA results for higher risk pathologies. Good luck with the test. So much of what you will read and hear is really confusing. Lots of conflicting studies with no clear cut direction that makes decision making a challenge due to side effect risks vs uncertainty if treatment is really needed and what impact early secondary treatment has on overall survival and pc specific survival. It's a journey. Again, good luck!!

Hi! teacher
your hubby will be fine...
should return with good PSA result
All the best....

Oh bless you all! As I'm sure you can tell, I'm so very nervous about this first test. I feel like peace will now come in three month increments, until it doesn't. Andrew I hope your psychotic prediction is spot on for us too!

Hi Teacher...Congrats!
Good result....undetectable.
Next....a speedy recovery.

That's a great report. Keep us posted on his progress towards trifecta. Sounds like a great day for a nice dinner out.

Wonderful news. Congratulations, and enjoy his good health.