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Medical Forum / Diseases and Disorders / Prostate Cancer / October 2006

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Post-surgery PSA

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RML - 04 Oct 2006 00:08 GMT
It seems as if many here who have had a prostatectomy have their PSA
rechecked within a month or two after the surgery.

My doc has me scheduled for first post surgery PSA 3 months after
surgery. Is this unusual?
Claude - 04 Oct 2006 00:18 GMT
> It seems as if many here who have had a prostatectomy have their PSA
> rechecked within a month or two after the surgery.
>
> My doc has me scheduled for first post surgery PSA 3 months after
> surgery. Is this unusual?

That was what my uro did.
Alan Meyer - 04 Oct 2006 02:30 GMT
> It seems as if many here who have had a prostatectomy have their PSA
> rechecked within a month or two after the surgery.
>
> My doc has me scheduled for first post surgery PSA 3 months after
> surgery. Is this unusual?

I suspect that if your PSA failed to reach zero at one month,
the doc would say, Let's wait at least until month 3 to be sure.

   Alan
ron - 04 Oct 2006 02:44 GMT
> It seems as if many here who have had a prostatectomy have their PSA
> rechecked within a month or two after the surgery.
>
> My doc has me scheduled for first post surgery PSA 3 months after
> surgery. Is this unusual?

One study suggests that PSA decays with a half-life of 2.7 days
(actually the decay prosess is biphasic, but let's keep it simple),
other studies suggest shorter times, but 2.7 days will provide a "worst
case" estimate   After 1 half-life, only 50% of the original PSA is
left, after 2 half-lives, only 25% is left, and so on.  It is typically
assumed that after 10 half-lives whatever is decaying (PSA,
radioisotope, etc.) is gone; only 0.1% of the original amount would
remain.  Now remember that during the operation, a lot of extra PSA was
dumped into the blood stream.  Say going in your PSA was 6.0 ng/ml and
immediately following surgery it was 12 (just a wild guess on my part).
So in the case at hand we could expect the PSA after 10 half-lives or
27 days post surgery, to be 0.001 x 12 = 0.012 ng/ml.  The PSA would be
detectable with some ultrasensitve tests.  So most docs will wait 2-3
months prior to taking the first PSA reading.  No point in rushing
things and getting a detectable reading.  After 20-30 half-lives (2-3
months) the PSA should be as low as it's going to go...Best wishes and
good health, ron
Alan Meyer - 04 Oct 2006 03:41 GMT
> > It seems as if many here who have had a prostatectomy have their PSA
> > rechecked within a month or two after the surgery.
[quoted text clipped - 19 lines]
> months) the PSA should be as low as it's going to go...Best wishes and
> good health, ron

Ron,

A very informative posting, as always from you.  Thanks.

Intrigued by what you posted I searched PubMed.  It turns out
that there is an extensive literature on this subject, including
articles by some famous folks like Dr. Partin.  The numbers
the different articles came up with differ from each other, but
I didn't see any that violated the "conservative" estimate you
give above.

   Alan
Buck - 04 Oct 2006 03:05 GMT
I think 3 months is more of the norm and it is what my doctor did.
Buttercup's Dad - 04 Oct 2006 16:46 GMT
ditto.

> I think 3 months is more of the norm and it is what my doctor did.
Steve Kramer - 05 Oct 2006 01:55 GMT
Mine was 3 months.

Signature

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
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA  .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
Non Illegitimi Carborundum

> It seems as if many here who have had a prostatectomy have their PSA
> rechecked within a month or two after the surgery.
>
> My doc has me scheduled for first post surgery PSA 3 months after
> surgery. Is this unusual?
 
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