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6 week Surgery Appt?

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Posted 9/20/2018 9:21 PM (GMT 0)
Hello. My husband has an appointment with his surgeon, 6 weeks after surgery. What usually happens at that appointment? I am thankful for this board and the help you all have unknowingly already provided us but am nervous about another apt, while grateful for the care he is receiving.

My husband had a PSA under 10, recent diagnosis with no symptoms. He had tests before surgery that did not see anything in his bones nor soft tissue. Gleason from the biopsy was 8 confirmed by Epstein as you all suggested here. After surgery pathology report gleason 7, 3+4. Margins positive and a lymph node involved. The seminal vessel was involved too I believe, still processing results.

Post Edited (stepbystep) : 9/20/2018 3:57:02 PM (GMT-6)

Posted 9/20/2018 9:32 PM (GMT 0)
Most likely nothing will happen other than the surgeon will check that he's healing, will review the pathology report, and go over any questions you might have. mostly a non-event.

Has your husband had a post-op PSA test yet?

That number will really be the one you need to see.

hang in there and let us know what the doctor says,
Andrew
Posted 9/20/2018 9:53 PM (GMT 0)
Great, a non event sound good. Feeling better about the appt.

No he hasn't had a post surgery PSA,. We will inquire about that at the appt. Thanks for the info, will keep you posted.

Post Edited (stepbystep) : 9/20/2018 3:57:40 PM (GMT-6)

Posted 9/20/2018 10:01 PM (GMT 0)
Your husband will likely be referred to a Radiation Oncologist in reference to the positive lymph node and margin. But for now, step by step. Your username shows a good way of viewing the process.
Posted 9/20/2018 10:57 PM (GMT 0)
I think that this visit will mostly be about recovery from the surgery. The firs PSA test will be at about three months, and that will tell yo a lot. But the positive result for the seminal vesicles and lymph node means that he is at high risk for recurrence. In cases of adverse pathology, the recommended path is often to wait for everything to heal up and then begin adjuvant radiation therapy. But you will discuss all this with the surgeon. I think it would make sense for you to read up on adverse pathology and treatments so that when you talk to the doctor you are as informed as possible, and will be able to engage in a useful discussion, rather than just sitting there while he or she tells you things.
Posted 9/21/2018 12:12 AM (GMT 0)
The 6 week PSA test, is a bit early, some doctors do it, others dont. For those that do, its more for a datapoint than anything. The 3 month test will be the tell.

With that said, and as fiddlecanoe pointed out, he is a high risk case. So Adjuvant Radiation Therapy and / or Hormone Therapy could be on the horizon. But it will be his (and your) choice, if the PSA is undetectable, you may want to wait.
If you do Adjuvant radiation you will want to wait until things are pretty much healed up inside - and his continence and hopefully erectile function are recovered.
Posted 9/21/2018 12:53 AM (GMT 0)
The doc may order a PSA at 6 weeks--the important thing is to not put too much importance on it. It will be low--since he started at 10 it may be less than 1, but still detectable. That's not an issue--the 3 month test is determinative.

The doc will probably ask him how his continence is doing--and whether he's having any erections. And about pain or weird sensations. How his physical recovery is doing--how much energy does he have, stuff like that.

And, since he is SVI and lymph node positive, he will probably talk about the next steps--and he should provide a referral to a radiation oncologist to start the ball rolling.
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