1st PSA, not quite 4 weeks after RALP

The 0.06 value tells you the test was not a standard test. 26 days is too early for the first PSA test because the surgery spills lots of PSA into the blood stream. 90 days is the standard for most surgeons and 6 weeks is about the earliest. At less than 30 days, a PSA of 0.06 is not a terrible value that predicts the surgery was a failure.

A 9mm margin in EPE is a large margin (5/16”) and with your husbands age I suspect adjuvant radiation and ADT may be recommended even if he is undetectable an a few weeks.

He has gotten a break that he wasn’t 3b, negative nodes, the G was down graded a bit. I would get a second opinion on the G score and get a Decipher test done.

Post Edited (Duck2) : 6/2/2021 9:29:22 PM (GMT-6)

That's a good PSA and the next might be even a bit lower. I second a Decipher test on his RP tissue. If it should come back low risk for mets, his docs may advise early salvage RT if his PSA begins to rise rather than adjuvant RT after a healing period. My hunch is that ADT will not be advised without evidence of mets,

There should be no need for PSA anxiety, since 0.06 on an ultrasensitive test is equivalent to a <0.1 "undetectable" on the standard test for men with prostates usually done for the first post-op PSA.

Djin

We did not ask why Uro tests so soon after surgery. We have been wondering about that as well. It's definitely added stress! Guess we'll see what Uro says when he contacts us. We are beyond frustrated with him at this point.
Thanks to all for your input. I told my hubby, if we can't get info from your Dr, then we'll get input from the guys on the forum! Your experience is very much appreciated!

The decision for ART does not have to wait for 3 months. I was discussing ART with my URO 28 days post surgery and I made the decision then.

When the ADT and radiation starts is dependent on continence. You don’t want to rush either because the ADT will effect the pelvic muscles.

________________________________________________________

YOB 1957

DX 12/18, GS 8, 4+4 6/12 cores, LL Apex 100%, LM Apex 60%, LL Mid 50%, LMM 40%, LL Base 5%, LM <5%, Right side negative.

3/6/19. Pathology - Grade Group 4 Intraductal Carcinoma
T3aNO, <1 mm EPE, GS8, 21 mm uni-focal tumor involved 10% of prostate.
7 Nodes, SV, SM, PNI, and BNI were negative.

LVI and Cribriform pattern present.

Decipher .86 High Risk.

Post Surgery PSA
3/25/19 .03. (25 days)
4/25/19 <.03. (2 months)
5/25/19 <.02 (3 months)
9/10/2019. <.02 (7 months)
11/27/2019. <.02. T < 3 (9 months)
5/19/2020. <.02 (15 months)
11/2/2020. <.02 (21 months)
5/11/2021. <.02 T <3 (27 months)


3 Part Modality Treatment Completed

2/25/19 Robotic Laparoendoscopic Single Site Surgery outpatient Cleveland Clinic, Dr. Kaouk, surgery #41 in US.
ART - 7/25/-9/25 2019 (78 Gy, yes, I glow in the dark).
ADT - 5/19- 5/21

Post Edited (Duck2) : 6/3/2021 8:33:05 AM (GMT-6)

Cleveland Clinic tells their patients erectile recovery can take 2 years. Nerves grow back slowly and it takes a lot of time.

My guess is less than 5% have function at 2 months. Orgasm does not require an erection.

Post Edited (Duck2) : 6/3/2021 9:41:12 AM (GMT-6)

BWeaver said...
Yes, we have read/been told that as well. I think the frustration comes from not knowing how much recovery there will be. Have to do the rehab & find out!

Psych yourselves out for potency: instead of Recovery Phase, call it the Discovery Phase

Djin

Psych yourselves out for potency: instead of Recovery Phase, call it the Discovery Phase

Djin

Semantics are very important!