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What tests did you do just prior to prostatectomy?

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Posted 10/3/2011 5:32 PM (GMT 0)
Hi everyone -

My husband is planning on DaVinci with Dr. Ahlering at UCI in the beginning of December. He would like to have other tests done prior to surgery to get a good idea of extent, etc. I am wondering if you can tell me what is typically done, and/or what you did? He is thinking along the lines of PET, MRI, testosterone, bone scan, etc. He also just thinks it is a good idea to have a baseline of all these tests so that in the future if he needs to have another, there is something to compare results to. His sister recently passed away of colon cancer so he would like to do colonoscopy before-hand as well...

Are we being paranoid, or smart?

What should we be requesting? Sigh...

Hope you all had a good weekend :)
Posted 10/3/2011 5:49 PM (GMT 0)
My uro/surgeon prescribed:

- CT scan

- Bone scan

- release for surgery from GP

- release for surgery from Colo-rectal doc (I've had past colo-rectal surgery)

Colo-rectal guy:

- scope to check my past surgery sites

- review of past colonoscopy report (ins. would not pay for another, too soon for them)

GP:

- General review, prod & poke, about a one hour check, but not at all a full physical.

- Seasonal flu shot

- Pneumonia vaccine (took special approval, I am in theory too young, but they passed it due to the surgery).

- my usual 6 month blood work (normal panels & kidney/liver markers for my age group)

Hospital required (and did at the hosp. one week before surgery):

- chest xray

- blood work (not sure what they tested, but included hiv, blood type, hepatitis, etc.)

- stress test

- breathing / volume

- ekg

- $$ for all expected non-covered or deductibles

No one asked for, but I have done at the GP since, just to know:

- Vit. D blood work

- Testosterone level

Posted 10/3/2011 6:01 PM (GMT 0)
Very helpful reply! Thanks so much...exactly what I was looking for. Guess I have lots of phone calls to make!
Posted 10/3/2011 6:55 PM (GMT 0)
The usual suspects, CT scan, chest X-ray, bone scan, and biopsy. Second opinion doc did a cystoscopy. (?) Checked the bladder with a scope). Only tests that showed evidence of disease was the biopsy. I was not hospitalized as in surgery so I did not do the EKG or the pneumonia shot. Probably a good idea to get the second if you will be in the hospital.

I had a colonoscopy done four months after completing RT. Nothing of note. Second one done about two years later when I had some rectal bleeding (turned out not related to PCa). Removed polyp that was pre cancerous. Follow up in two years.

Don
Posted 10/3/2011 10:50 PM (GMT 0)
Bone and CT scans would be worthless at the stage and gleason indicated. They are used only for high risk cases when psa is over 20. It is very unusual to pick up anything on a bone or CT scan unless psa is over 40 and more likely in the hundreds. Some tests that may provide more information about tumor location, tumor volume and extra capsular extensions would be an MRIS at UCLA of UCSF or a color doppler ultrasound from Dr Bahn in Ventura Ca. The color doppler is less expensive and would probably be of more value in looking at seminal vessicle invasion, nerve involvement and extracapuslar extension, all are important when considering surgery. PET scans are also worthless at this psa level unless done with the newer Choline 11 which is only done at MAYO.
Before any surgery a chest Xray, EKG and blood panel are also recommended. Colonostopy is also a good idea if he hasn't had one in 5 years.
JohnT
Posted 10/11/2011 7:32 AM (GMT 0)
Has Dr. Ahlering mentioned Active Surveillance as an option?

Also the Prostate Forum of Dr. Charles "Snuffy"Myers is very helpful

My doctors in Toronto recommended surgery, but after Colour doppler with Dr. Bahn in ventura and a consultation with Dr. Myers in Virginia they both recommended Radiation as my 2 cm lesion was at the apex where it is harder to reach the cancer and so the risk of a Positive margin ( cancer left over after surgery requiring radiation ) and urinary/erectile problems is higher

Finally decided to treat last week with Hyperthermia in Germany and 6 months hormone therapy ( cost me $10,000 ) to avoid potential risks of surgery or radiation


60 yr old DX Feb. 1 2011 Gleason 7 (3+ 4) 2 cores of 12 positive 30% + 40%
PSA Was 4.9 before Treatment and will be testing again soon.

Will only know in 8 months, when I get tested by Dr. Bahn again, if all the cancer is actually gone
Posted 10/11/2011 11:08 AM (GMT 0)
My URO didn't recommend bone or MRI scans prior to my surgery. My GP and the hospital recommended that I do a nuclear stress test on my heart due to family history of heart disease. Good news was no signs of any heart disease. Since I had a colonoscopy done 2 years ago and it was 100% clear there was no need  for this test either.

Terry TWG

Posted 10/11/2011 2:36 PM (GMT 0)
I am 51. 6 weeks prior to surgery, against all Dr.s advice I had my first colonoscopy. 5 polyps removed, 4 being precancerous. No problems with recovery other than normal incontinence and ED. Very glad I am the boss of my body.
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