It is my impression that there is no credible research suggesting that
the particular schedule chosen by the doctor for routine checkups, which
is what I thought the question was about, is cruical.  If the post
surgical pathology report suggests a high likelihood of recurrence, or
similarly if there is a confirmed recurrence at any stage, then of
course the more knowledgeable the doctor, the better off the patient.
Unfortunately, it is hard for a patient to know which doctors are more
knowledgeable in such cases.  This is specially difficult given that
there seem to be honest differences of opinion about when to begin
hormone therapy in case of recurrence.  Ideally, the patient could
examine the research literature, see which approach makes the most
sense, and then choose a doctor accordingly.   But few of us know enough
to be able to do that.  It is probably better to start off with a well
qualified doctor you trust, and try to get answers and explanations
based on what you can find out for yourself.  If you are not satisfied
with the answers, you will have to find another doctor.

I trust my doctor based on both his formal qualifications and my
experience with him. If I have a recurrence some time in the future, I
will decide whether or not to try to find someone who specializes in
treating such cases, but so far at least it hasn't been necessary.

 My surgeon here in NYC is considered one of the best also but it
wasnt cost effective for me to see
 him on a regular basis especially with all the cystoscopys I was
having.  Also I very rarely saw him but
 one of the other doctors in his practice.  The doctor I switched to
is in my medical plan and I think he is
 great.  Very down to earth.
 Are there other doctors in his practice that you could use just for
the PSA testing?
 Well good luck and keep those future PSAs down.

Ooops.  I meant to send this post to Puzzled...as an e-mail...but
there's nothing secret about it.

It's what I know and feel.

Ron B.

Chicago

With the hyper-sensitive PSA assays (and others for that matter) the low
end results are typically measured as "<0.01" or "<0.1" which means that
YOUR PSA is below the detectable range.  It could be "0.009" or it could
be "0.00000000000000000000000000000000001"  They don't know because it
cannot be measured, thus the term undetectable.

 > On Mon, 01 Oct 2007 13:31:47 -0400, "richk" <richk13@yahoo.com> wrote:

When I had my RRP in 2000, they used the hyper-sensitive test that
detected down to "<0.01" and my third test, at eight months post-op,
came in at "0.07" and I damn near had a heart attack since the preceding
two had come in at "<0.01"

Surgeon cautioned me that that was a problem with the hyper-sensitive
tests - minor blips - and to watch for any pattern which might appear.
Fortunately, the only pattern that developed was "<0.01" and, later
(when they changed labs), was "<0.1" results. <g>

FWIW, my surgeon told me he wouldn't formulate any treatment plan for
follow up treatment until he saw a pattern which included a PSA reading
approaching "1.0"

My surgeon and urologist (not the same docs) followed your testing
schedule as well.  At least until December of last year when I was
placed back on annual testing of the PSA.

I'm sorry, Rick.  I just realized your subject was a question.

"Normally" you would like to have a PSA of .004 or less.  Most of us rarely
do.  Without that, you would want to vary somewhere south of 0.10 without
ever going over.