My First Post Surgery PSA Results

Well, the test came back.  My first post-surgery PSA results were .05  The dr was hoping for lower, but he said it was still good, and that in 3 months he hopes it will adjust downward a bit, not upward.  He said the lab person was mistaken telling me that they could test to .001.

I hope this qualifies me into the "zero club".  He set me up for another test in 3 months, which will be my six-month mark.  He did explain in detail how the half-life of psa works, and that being slightly less than 3 months out from surgery, the psa can still drop.

Right now, I am happy with this, and I hope it stays good for a long time.

David in SC

Thank you, Brother James, I needed someone to tell me this. It's what I thought. My dr/surgeon is a deep thinker and he knows I am well read, so I think he was just thinking out all possibilities. I am happy with it, I really am.

David in SC

Thank you so much, Doting, seems a long time coming, I hope this is a long long trend for me, I am looking forward to being among the living and less like a patient

thanks astro and ohiostate

David:

Thinking about you today - glad to see that the first number was a big fat zero. We have our first of two appointments with robotic guys on Wednesday. Already have my "open" guy in NYC at MSK.

Back to you... you have a good initial PSA score and lots of options still available. You did your research and made the right choices - that's all any of us can do.

Peace and health, brother.

Tony

Thanks Godfather and Jersey, that's all we can hope for each of us. My best to the two of you

Congrats David

I was waiting to see this today.

Cheers,
Rich

THanks Mark, Billy, Rich, and Rip, just thrilled to have made it to this threshold. I will see my doc again in May for the 6 month mark.

David,

I am glad you are a zero but I am interested in why people go for the u/s test.

Are you requsting it, or is that what your Dr. is ordering?

Scott

Way to go David...congrats on the Zero Club Membership....here is hoping that it will be a lifetime membership as well.

scot (gpg) what is the u/s test, lost me there.

gpg,
There are two schools of thought. I have seen arguments supporting Ultrasensitve PSA testing as a much earlier indicator of possible relapse as is described here under "What is an Ultrasensitive PSA Assay":

www.prostate-cancer.org/education/preclin/McDermed_Using_PSA_Intelligently2.html

and arguments for not having the ultrasensitive test from the same source:

PSA Anxiety:

The Downside of Ultra- Sensitive Tests

You've had the radical prostatectomy, but deep down, you're terrified that it didn't work. So here you are, a grown man, living in fear of a simple blood test, scared to death that the PSA- an enzyme made only by prostate cells, but all of your prostate cells are supposed to be gone -- will come back. Six months ago, the number was 0.01. This time, it was 0.02.

You have PSA anxiety. You are not alone.

This is the bane of the hypersensitive PSA test: Sometimes, there is such a thing as too much information. Daniel W Chan, Ph.D., is professor of pathology, oncology, urology and radiology, and Director of Clinical Chemistry at Hopkins. He is also an internationally recognized authority on biochemical tumor markers such as PSA, and on immunoassay tests such as the PSA test. This is some of what he has to say on the subject of PSA anxiety:

The only thing that really matters, he says, is: ''At what PSA levels does the concentration indicate that the patient has had a recurrence of cancer?'' For Chan, and the scientists and physicians at Hopkins, the number to take seriously is 0.2 nanograms/milliliter. ''That's something we call biochemical recurrence. But even this doesn't mean that a man has symptoms yet. People need to understand that it might take months or even years before there is any clinical physical evidence.''

On a technical level, in the laboratory, Chan trusts the sensitivity of assays down to 0. 1, or slightly less than that. ''You cannot reliably detect such a small amount as 0.01,'' he explains. ''From day to day, the results could vary -- it could be 0.03, or maybe even 0.05'' -- and these ''analytical'' variations may not mean a thing. ''It's important that we don't assume anything or take action on a very low level of PSA. In routine practice, because of these analytical variations from day to day, if it's less than 0. 1, we assume it's the same as nondetectable, or zero.''

Now my head is spinning,
Bill

David,
Reading your other posts on your ED (or rather lack thereof) that is probably an alternate explanation for your very slight ultrasensitive PSA reading. It is not uncommon for a very small amount of healthy benign prostate tissue to be attached to intact nerves when nerve sparing surgery is carried out.
Bill