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1st Follow-up after RALP

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Posted 7/31/2017 7:57 PM (GMT 0)
I had my first follow up appointment this morning with my Urologist. Ultra sensitive PSA test result was 0.02 after 5 weeks. Doc says PCa was completely organ confined with negative margins, negative lymph node intrusion and negative seminal vesicle invasion, so my PSA should continue to decrease. Pre-op PSA was 3.75. Should I be worried that I wasn't at <0.01 at 5wks or does it actually take a few months to be less than zero? Doc says that they tested me too early however, I'm pretty much undetectable. We scheduled another PSA test for my 3 month appointment. I hope all continues to go well in the future.
Posted 7/31/2017 8:15 PM (GMT 0)
You are golden! Five weeks is to early for some of that old PSA to clear.
Posted 7/31/2017 8:22 PM (GMT 0)
Great news!

PSA can hang out awhile, the 3 month test should be better.

but .02 great in any case.

Andrew
Posted 7/31/2017 8:52 PM (GMT 0)
Thats a good number
Posted 7/31/2017 9:09 PM (GMT 0)
Based on a starting PSA of 4 and 4 day half life

5 weeks = 35 days = 9 half life cycles

4
2
1
0.5
0.25
0.125
0.0675
0.03375
0.016875 == 0.02!!!

Congrats !!!
Posted 7/31/2017 9:40 PM (GMT 0)
No need to worry. I am almost 4 years post surgery and my PSA has fluctuated up and down from .006 to .04.
All of my docs told me anything less than .1 is good.

You will never see a steady 0.000, a radiation onccolgist once told me our salvia glands produce small amounts of PSA
Posted 7/31/2017 10:48 PM (GMT 0)
U are doing fine.. 0.02 with just 5th weeks is a good figure
Posted 8/1/2017 1:03 AM (GMT 0)
Thanks for the reassurance. I've already been on edge enough during this entire ordeal. I had no idea that PSA had a natural half life. I assume if I waited one more week for my PSA test it would have been <0.01. Realizing that is pretty uplifting. Doc wants me to stay positive, stay active with exercise and eat a healthy diet. I'm still working on my incontinence with kegels (1-2 pads/day) and I'm on 5mg of Cialis daily for penile rehab. I still have some 20mg Cialis and 100mg Viagra. I may take one of those periodically just to see what happens.
Posted 8/1/2017 1:20 AM (GMT 0)
six weeks seems the current standard, although some wait 2-3 months for the first PSA.

You've got a lot of healing left to do. Patience is the key.

That and a good diet and smart exercising.

Before you know it, this will all just be a bad memory.

Andrew
Posted 8/1/2017 4:28 AM (GMT 0)

ddyss said...
Based on a starting PSA of 4 and 4 day half life

5 weeks = 35 days = 9 half life cycles

4
2
1
0.5
0.25
0.125
0.0675
0.03375
0.016875 == 0.02!!!

Congrats !!!

Ain't math elegant!
Posted 8/1/2017 1:18 PM (GMT 0)

InTheShop said...
six weeks seems the current standard, although some wait 2-3 months for the first PSA....Andrew

My first PSA check was six weeks post surgery.
Posted 8/1/2017 2:15 PM (GMT 0)
Lots of surgeons recommend a PSA at six weeks, but they do tell us (mine did), that it's to 'note the trend', and will further say that the definitive word is at 3 months. Besides, they don't start ART until at least 3 months post surgery to allow for healing of the tissues.
Posted 8/1/2017 2:56 PM (GMT 0)
The 3 month test should give you and your doctor a more definitive result. Your pathology would indicate your PSA should go down further.

Good luck.
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