Oncologist or Urologist or both.

Sorry for the wide open discussion here. Have been going to the
Oncologist for 3 years now. Since my PSA has remained less than 0.1
we've not had much to talk about. So this last time I went back to the
Urologist who performed my RP for the first time since the RP with the
intent of having a DRE from someone who knows DRE's. He poo-pooed the
idea of an DRE with my PSA numbers, no pun intended. Another PSA of
>0.1 prompted the Uro to announce my graduation to annual PSA's from
quarterly. Seems like good news but after such close scrutiny of
quarterly PSA's I feel weird about switching to annuals. I know its
sort of moot with everyone having different numbers, etc. but I'm
curious about any other "graduations" to annual PSA checks out there.
For the record my Gleason at RP was 4+4=8. No lymph involvement.
Positive margin. About a 15% tumor size in one quadrant.

Thanks,

Todd <WhiteSoxFan>

My uro onc took smaller steps, from quarterly to 4 months to 6, probably
to 8 or 12 soon unless my recent jump from <0.002 to 0.035 continues.
(It's jumped almost that high before two successive <0.0002s, so that's
not alarming yet.)

I.P.

"WhiteSoxFan" <leicam13@comcast.net> wrote in message
news:8b57553f-a624-481c-9e4b-dfc7ba1803d9@l32g2000vba.googlegroups.com...

: I know its
: sort of moot with everyone having different numbers, etc. but I'm
: curious about any other "graduations" to annual PSA checks out there.
: For the record my Gleason at RP was 4+4=8. No lymph involvement.
: Positive margin. About a 15% tumor size in one quadrant.

My plan with "a scarey aggressive" cancer and a PSA of 3+4=7 was to be
quarterly PSAs for two years, semiannual PSAs for two years, and annual PSAs
thereafter. Based on that, it's a little early to go to annual PSAs.
However, that was MY plan with MY doctor. Others are different.

Having had a few failures, I'm now doing PSA's every eight months and when
next I pass one (if I pass) in February, I'm going to push for annual PSAs.
But that will have been almost four years after my first undetectable
following Casodex.

Based on your Gleason 8, relatively recent surgery, and your uneasiness with
his suggestion, I think you ought to suggest semiannual PSAs for a year or
so.


--
PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA <.1 <.1 <.1 .27 .37 .75 PSAD 0.19 years
EBRT 05-07/2002 @ 47
PSA .34 .22 .15 .21 .32 PSAD .056 years
Lupron 07/03 (1 mo) 8/03 and every 4 months there after
PSA .07 .05 .06 .09 .08 .132 .145 PSAD 1.4 years
Casodex added daily 07/06
PSA undetectable since, < 0.04 on 10/09/08
Illegitimati non carborundum

x-no-archive: yes

In May of 2002, at age 63, with a pre-op Gleason of 3+3 and a post-op
Gleason of 3+4, I had an RP. Pathology discovered cancer cells in adipose
tissue outside of the prostate. My uro said that I could not be declared
"cured" for 10 years. At first I had PSA tests every 3 months. In more
recent years it was every 6 months. My PSA's were always undectable by our
hospital's lab standards (at first >0.1, and in recent years >0.05). About
3 years ago, my uro moved to Chicago, and his partner took over my case. He
looked at my PSA's and suggested I go to every 9 months. Lo and behold,
after 9 months, there was a blip up to 0.07. Four months later it was
checked again and back to >.05. Two 6 month checks followed, and it stayed
there. In my most recent visit, the uro suggested that I go to yearly. I
was glad about this, because now I didnt have to think about prostate cancer
for another year.

This is not putting my head in the sand. Age is an important factor for my
decision making. I am now 71. I recovered erectile function after 5 months
(despite one nerve being taken), and I have been continent from 48 hours
after the surgery. Because of that, and because of a mild proctitis I seem
to have, but most importantly because of my age, I had decided that should
the cancer recur, I will not have radiation. I will only resort to hormones
if the cancer seems extremely aggressive and would take me down quickly. In
other words, my decision is, given my age, that I will seek no further
treatment for prostate cancer. Quality of remaining life is more important
now.

This has been a lengthy explanation of why I was glad to go to the yearly.
I really don't have to think about me and prostate cancer until next May.
That said, I would not recommend this attitude to a younger man who has
potentially many years ahead of him.


"WhiteSoxFan" <leicam13@comcast.net> wrote in message
news:8b57553f-a624-481c-9e4b-dfc7ba1803d9@l32g2000vba.googlegroups.com...
> Sorry for the wide open discussion here. Have been going to the
> Oncologist for 3 years now. Since my PSA has remained less than 0.1
> we've not had much to talk about. So this last time I went back to the
> Urologist who performed my RP for the first time since the RP with the
> intent of having a DRE from someone who knows DRE's. He poo-pooed the
> idea of an DRE with my PSA numbers, no pun intended. Another PSA of
>>0.1 prompted the Uro to announce my graduation to annual PSA's from
> quarterly. Seems like good news but after such close scrutiny of
> quarterly PSA's I feel weird about switching to annuals. I know its
> sort of moot with everyone having different numbers, etc. but I'm
> curious about any other "graduations" to annual PSA checks out there.
> For the record my Gleason at RP was 4+4=8. No lymph involvement.
> Positive margin. About a 15% tumor size in one quadrant.
>
> Thanks,
>
> Todd <WhiteSoxFan>

On Fri, 5 Jun 2009 10:35:23 -0700 (PDT), WhiteSoxFan
<leicam13@comcast.net> wrote:

>Sorry for the wide open discussion here. Have been going to the
>Oncologist for 3 years now. Since my PSA has remained less than 0.1
>we've not had much to talk about. So this last time I went back to the
>Urologist who performed my RP for the first time since the RP with the
>intent of having a DRE from someone who knows DRE's. He poo-pooed the
>idea of an DRE with my PSA numbers, no pun intended. Another PSA of
>>0.1 prompted the Uro to announce my graduation to annual PSA's from
>quarterly. Seems like good news but after such close scrutiny of
>quarterly PSA's I feel weird about switching to annuals. I know its
>sort of moot with everyone having different numbers, etc. but I'm
>curious about any other "graduations" to annual PSA checks out there.
>For the record my Gleason at RP was 4+4=8. No lymph involvement.
>Positive margin. About a 15% tumor size in one quadrant.
>
>Thanks,
>
>Todd <WhiteSoxFan>

I went quarterly during year one, after which I am currently on the
biannual plan for year two. After this coming test, which knock on
wood will return a < 0.1, and I'll be able to go annually until
something should dictate otherwise.

My curiosity lies in what the benefit of a DRE after a prostatectomy
would be. There'd have to be significant growth in there for Dr.
Nikolas Van Helsing to catch anything no?

--
PSA @ 45 yrs. = 4.7 02/06/2007
Biopsy 03/16/2007 G7(3+4),T1c
RLRP 06/12/2007 G7(3+4),T2cN0M0 Neg margins
PSA 07/16/2007 = <0.1
PSA 09/12/2007 = <0.1
PSA 12/18/2007 = <0.1
PSA 03/12/2008 = <0.1
PSA 06/12/2008 = <0.1
PSA 12/12/2008 = <0.1

[LindaC]

I bet that you need to see your oncologist first and tell him/her about what you feel and what have yu been experiencing. Then your oncologist will definitely tell you who's to see/consult next.



___________________________
Linda Costner
Indianapolis Radiation Oncologist