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Early PSA

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User
Posted 14 Jan 2020 at 12:08

I am now 4 weeks post op and no more injections hoorah and can throw away the socks although they did keep my feet warm. Unfortunately I am still struggling with abdominal pain. I visited a out of hours doctor on saturday and suggested I get my blood checked. Unfortunately they did not have the facility to carry out this procedure. So here I am having just completed the task with a practice nurse. To my surprise, they are checking my PSA. But after only 4 weeks? this seems a bit soon to m . last week I only just received the histology report on my prostate and they found a negative margin on my prostate which was great news. However I suppose its better to know early if they have found cancer anywhere else.Really hope that the adominal pains are just needing a bit more time to settle things down. I have an appointment to see another GP on monday . So fingers crossed I get the all clear.

Edited by member 14 Jan 2020 at 12:19  | Reason: Not specified

User
Posted 14 Jan 2020 at 12:24
Dave, it can take many months for abdominal pain to entirely disappear. You've had major surgery and all sorts of internal abdominal muscles were cut during that surgery. Even when surface incisions have healed, that doesn't mean that all the internal stuff also has. Four weeks is very early days.

Best wishes,

Chris

User
Posted 14 Jan 2020 at 12:55

Cheers Chris. That's exactly what I wanted to hear and do hope that's all it is. I do think I worry a bit too much. Hope it's good news regarding PSA and not something else to worry about but realise it's better to get to know earlier rather than later.

User
Posted 14 Jan 2020 at 13:20

Dave. I was RP late May 2019. I still get small pains & itches around the 6 incisions, especially the Bellybutton one from where they extracted the prostate. I think it is probably scar tissue. Remember not to overdo it physically too soon. There is a risk of Hernia & your surgeon will not be pleased to see you again.

User
Posted 14 Jan 2020 at 13:33

Cheers Prosixty. Yes I think I may have over done things a couple of times but usually feel a bit better a couple of days later. Just a bit concerned about bloating and being a bit loose as well as the pain. This is a different pain to when I over do things. Prior to the RARP I was being treated for irritable bowl syndrome or at least taking the tablets for this, since having the biopsies taken.Hope this makes sense.

Edited by member 14 Jan 2020 at 13:36  | Reason: Not specified

User
Posted 14 Jan 2020 at 17:29
Your PSA has been taken a little too early to be reliable- generally, they say it takes about 6 weeks for the existing PSA to stop floating around your body. So don't be worried if your result is not yet under the magic 0.1 ... it may have fallen further by the time you get your proper post-op PSA test
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 14 Jan 2020 at 17:36

Thanks Lynn. That's what I thought. Can, t understand why the doctor has asked for one. She must have her reasons. I am not due to have a follow until three months post op so a good while to go yet. I have already received confirmation that they have a negative margin so no point in worrying until then I suppose.

Edited by member 14 Jan 2020 at 17:37  | Reason: Not specified

User
Posted 17 Jan 2020 at 10:54

Reading a bit more on the PSA and seemingly there are a couple of types. One more accurately than the other. I am assuming the one taking post RARPis more accurate that the one taken when this all kicked off. Although could be wrong as 8.74 initially seems pretty accurate to me. My results of my PSA are probably through by now, however I am reluctant to ask the GP receptionist what it is as she may not know which PSA it is and fear it maybe misleading.Hope this makes sense. I would much rather wait and discuss this with the GP on monday when I have an appointment with him.

User
Posted 17 Jan 2020 at 16:25
Hi Dave, your post doesn't make any sense - you have possibly read something and misinterpreted it? There aren't different types of PSA test, just different ways of reporting the result. What do you mean about the receptionist? She will just tell you the result - she won't be interpreting it.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Jan 2020 at 16:45

 I thought one PSA test was more accurate than the other, so thanks for clearing that up. As the receptionist would just give me the result and as the PSA was taken at only 4 weeks. It would be difficult to interpret. May as well wait until Monday when I have an appointment to see the GP. Hope that has cleared it up and sorry for any confusion.

User
Posted 17 Jan 2020 at 19:17
Ah, okay. It is the same test and when the reading is over 0.1 it is reported precisely so 13, 13.5, 8.74.

When the PSA is below 0.1 different hospitals/ labs have opposing views. Some will only report the result as less than 0.1 (<0.1) while others will report it to 2 or even 3 decimal places. So the blood is tested and the result is 0.045 ... in one region the man will be told it is 0.045, in another it will be reported as <0.05, in another it will be reported as <0.1.

It is the same test regardless of the way it is reported - the important thing is that it is less than 0.1.

Because your test was done a little earlier than usual, it might not have quite got down to 0.1 yet but may still drop in the couple of weeks after that.

There is a completely different test called a free PSA test but that wouldn't be used for someone in your situation - it is occasionally used pre-diagnosis but is pointless for someone already diagnosed - and it is reported as a % rather than a score.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Jan 2020 at 19:30

Thanks for explaining it to me. Much easier to understand when explained in one place rather than getting little bits from different threads. As I am not due to see the specialist until the 3 month post op. Can I assume they will still need another PSA just prior to this appointment?

User
Posted 17 Jan 2020 at 20:24
Yes, you would normally be told whether to get that PSA test at the hospital (so that it goes direct to the surgeon) or from the GP ( in which case you might have to collect the result to take to the appointment with you)
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 17 Jan 2020 at 20:42

Hi Dave

Since my op end of November. My first Post op PSA is due week 10 and I am to take the result to see my consultant at week 12 review meeting. Those timeframes appear to be fairly common from what I understand.

cheers

TG

User
Posted 17 Jan 2020 at 22:05

Tech guy. Thanks for your input. I really Don, t know what to expect at 4 weeks but will try not to be too concerned if its not what I hoped for. I will probably get in touch with the specialists nurse a few weeks before my 3 month appointment and ask if they want another one.

User
Posted 17 Jan 2020 at 23:41

Pleasure 

Three months appears to be the minimal interval to measure potential change. I had my last one July 1st 2019 (5.6). Fingers crossed <0.1 in a few weeks time. GP nurse does mine and they generally have the result in 24hrs. Not sure of the low level accuracy of the lab they use. Guess will find out soon. 

Going forwards for me the prof recommends them three monthly for one year. Six months for following two years then annually although I will probably stick with six monthly for rest of my life assuming GP is cool with it. 

Best

TG

User
Posted 18 Jan 2020 at 01:17
The first is usually 6 - 8 weeks post op and then three monthly after that, going eventually to 6 monthly and then annual tests. You will hardly ever see anyone post their PSA result on the anniversary of their op.

Most surgeons see their patient 6 - 8 weeks post op to check healing and progress is as expected, and to explain the pathology; it makes sense for them to have a PSA result to add to the picture.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 18 Jan 2020 at 05:45
To say again, I have seen one surgeon and two oncologists who concur that what is called ‘super-sensitive assay’, i.e. PSA down to multiple decimal points, is generally a waste of time and causes more worry than it’s worth.

The top PCa oncologist at the Royal Marsden, the leading cancer hospital in Britain, (where they only test to 0.04), conceded that super-sensitive is only of use in a very few cases, which I suppose is the reason my local billion-pound super-hospital only tests to <0.1 = ‘undetectable’.

My advice to you, Baxt, is to stop worrying, dreaming up fantasy PSA testing regimes, and presume your prostatectomy was successful until (if ever) you discover it was not.

Best of luck for the future and your continuing recovery.

Cheers, John.

User
Posted 18 Jan 2020 at 06:56

Cheers John you are probably right and think there is a bit of bored setting in, due to not being active and not feeling too grand. I keep returning on a regular basis in the hope of understanding a bit more. I don,t think I would not be too concerned if I was feeling a bit better. I just feel my recovery is slower than it should be but appreciate there are complications due to chronic lower back pain.

User
Posted 18 Jan 2020 at 07:24

Hard to do. Focus on what u can do each day it will get better.

User
Posted 18 Jan 2020 at 07:26

Thanks again for all the kind words of support.

User
Posted 18 Jan 2020 at 07:29

Hi TechGuy

Thought I would let you know that your PM inbox is full and cannot receive any more PM! Can you delete some stuff as I want to send a message on the topic we were discussing.

Thanks

Grant60

User
Posted 18 Jan 2020 at 07:40

Dear John and DaveBaxt

Sound advice John although I can understand your being worried DaveBaxt when your reading was taken after just 4 weeks.

My first PSA was 6 weeks post op. Reading was given as 0.02. I am pleased to read in thread here that a reading of <0.1 is regarded as undetectable so even more pleased.

My urologist has called for next PSA in 4 months.

Best wishes. Let us know how you get your reading.

Cheers

Grant

User
Posted 18 Jan 2020 at 08:36
Cheers Grant for you input
User
Posted 20 Jan 2020 at 15:41

Just received PSA result and just what I wanted to hear. 0.03. So well below 0.1 therefore undetectable. Hopefully stays thar way.

User
Posted 20 Jan 2020 at 15:57

Fantastic news Dave. You must be chuffed :-)

User
Posted 20 Jan 2020 at 16:28

Brilliant News !!!!!!

User
Posted 20 Jan 2020 at 16:50

Originally Posted by: Online Community Member

Fantastic news Dave. You must be chuffed :-)

Totally cheers

User
Posted 20 Jan 2020 at 16:51

Cheers

 
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