PSA test only 5 weeks after RALP?

Posted by animate @animate, Nov 28 3:47pm

Hello,

I finally had my RALP procedure 2.5 weeks ago. My recovery so far has been quite good, fortunately, I would say.

I had the catheter removed 1 week after the procedure and my Urologist scheduled me to have my first post-op PSA test 4 weeks after that. So, I will be taking my PSA test 5 weeks after the surgery procedure.

I have always read that this first post-op is usually taken 3 months after surgery and I am concerned that my test will be taken too soon, possibly resulting in misleading values.

Would anyone know if there is a standard waiting time for this and is possible to get unreliable values if taken too soon?

Could there be a specific reason as to why, in my particular case, the Doctor wants to see my PSA value sooner than later?

Thank you.

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shalom7777777 | @shalom7777777 | Nov 28 5:42pm

My Husband had his 6 weeks after the RARP and it was good. By 8 weeks is normal. We thouht maybe the doctor was being proactive...

jeff Marchi | @jeffmarc | Nov 28 5:46pm

Mine was 8 weeks after RALP. This was discussed in this forum a few months ago. More people had it around two months rather than three.

That’s just the first PSA test, You can easily have one a a month later.

It will give you a good idea what’s going on? Nothing to panic about you may be undetectable already, which < .1.

Some other characteristic of your case may be why they wanted it early. If you had any aggressive issues or a high PSA or Gleason they want to see how you’re doing. In some situations they may be planning for early radiation treatment.

brianjarvis | @brianjarvis | Nov 29 7:49am

I wouldn’t consider a PSA test that is given at that time to be misleading or unreliable. The expectation is that PSA won’t yet be undetectable that early, but it should at least be headed in the right direction.

> have you asked your doctor why he wants to see your PSA value sooner than later?

(In my case, I expressed to my medical oncologist that I simply didn’t want to go through the anxiety of waiting 3 months for my first post-radiation/Eligard treatment PSA test. So we scheduled a PSA test for that last day of radiation treatment - not standard for radiation treatment. What was a PSA of 7.976 as treatments started was 0.224 at the end of treatment. That gave me confidence that we were trending in the right direction. Then, 6 weeks later (at my 2nd and final Eligard injection) my PSA was 0.008. Again, more confidence; that 0.008 lasted for two more PSA tests; even more confidence.)

Now, if it’s going to worry you that your PSA is not undetectable that soon, then you might ask to wait. But, if you just want a “confidence check” that your PSA is trending in the right direction, then go for it.

harvey44 | @harvey44 | Nov 29 12:17pm

I would tend to agree with you. Any procedure i have had, it's been at least 3 months before another PSA reading.

animate | @animate | Dec 1 1:04pm

Hi,

Thank you all for your responses. I have not had an opportunity to ask my Doctor why he indicated me to get this PSA test so soon. It was later after the consultation appointment, where he indicated this, when I realized that this might be sooner than usual.

I would think that the PSA value at 5 weeks post-surgery should definitely indicate a downward trend. I would think that there is no possibility of a rising trend. So, I am confident that it should show that it is headed in the right direction. However, my concern is whether by that 5 weeks time the value will reflect if the surgery outcome was successful in a way that no further treatment will be required in the short term.

Anyway, when the time comes I should be discussing all this with my Doctor, clearing up all questions and concerns.

Thank you all again.

neronel | @neronel | Dec 2 10:14am

That’s easy. PSA has a half life of nearly 3 days. So, say your PSA was 6.0 on the day of your prostatectomy, 30 days would be 10 doubling times. That’s 2E10, 1024. 6/1024 is 0.00586< 0.03. Undetectable if the prostatectomy worked.

So, after 30 days, just divide your pre-prostatectomy by about 1000. You really don’t have to wait for 5 weeks.

Lou