When should we get first PSA test done post RP?

[piousheart]

The doctor advised to get it after 3 months but I’ve read that 6 weeks is a good time frame. Confused as to when should my father get it done. We’d love to know it sooner but only if it makes sense.

[Tall_Allen]

3 months is standard. Surgery puts a lot of PSA into the blood, so you want it to clear out thoroughly before you start testing. Ask for an ultrasensitive PSA test (lowest value 0.01). If he had a lot of adverse features on his pathology report, he can do it earlier.

[piousheart in reply to Tall_Allen]

Thanks for the helpful reply

[RonnyBaby in reply to piousheart]

I would agree with the standard 3 month time frame. At least at the outset.

A different time frame might be warranted if conditions indicate some warning signs that the PSA number is changing at a rate that triggers more scans / progression of the disease.

Sometimes, it might be advisable to re-test IF an error is suspected in an instrument, prior to making a decision on further treatment(s).

Wishing you well on your journey ....

[Hidden]

There is a way to calculate the first date. Maths are better advisors compared to "one size fits all" practitioners. The half life of PSA is 2.5 to 3.5 days. To be on the safe side we will assume here 3.5 days. In order to ascertain that the PSA measured is new and not the residual of the pre-surgery circulating one, some time must by allowed for the decay of the latter. If the lab goes down to the 0.01 mark the pre-existing one should be left to decay down to 0.005 and less.

Six weeks (42 days) equal 12 half lives or 1/4096 of the pre-surgery PSA value.

Conclusion: If your father had a pre-operative PSA of ~20, 6 weeks are good

If less, you can subtract 3.5 days per halving.

Example: I had 8.6 and took my first PSA at ~5 weeks.

[piousheart in reply to Hidden]

That’s very interesting. His PSA few days before surgery was 2.79

[Hidden in reply to piousheart]

Wait a second! Was he taking any Hormonal therapy? If yes, then it is totally another story. He should wait for it to wear-off, else PSA testing has no meaning.

[piousheart in reply to Hidden]

No he wasn’t taking any hormonal therapy. He was taking Tam-D (1mg.com/drugs/tam-d-0.4mg-0..., Maybe that helped lower his PSA?

[Hidden in reply to piousheart]

What was his Gleason Score and pathology report stage? If these two indices are on the high side his relatively low pre surgery PSA merits more attention.

[piousheart in reply to Hidden]

Gleason: 3+4=7

Pathology stage: pT2N0Mx

[Hidden in reply to piousheart]

Ok fine. Favourable intermediate risk. Have the first PSA test at one month to 5 weeks after surgery and celebrate on undetectable results, Best wishes.

[mja511]

I had RP surgery on 7/28/2020. I had my first post surgery PSA test yesterday - 8/31/2020. My doctor wanted the test around 6 weeks and then every 3 months for the next year.

[piousheart in reply to mja511]

Thank you, that’s what I’ve heard from many others. My fathers doctor asked to wait 3 months but we are leaning on getting one done at around 6 weeks as well

[MNFarmBoy]

In my case, the urologist directed ultra-sensitive PSA tests 6 weeks after RP, and then every 3 months following that. I got the impression that was his standard practice, although in my case there was some moderately adverse pathology. Thus I was really sweating out that first PSA result, and was greatly relieved to receive the <0.014 ng/mL result (below the limit of detection for that laboratory), and fortunately the results have been the same for 1.5 years. PSA before RP was 14.2, so apparently 6 weeks was sufficient time for PSA to decrease from that to less than the limit of detection.

It appears to me that a PSA test at 6 weeks appears meaningful in that, if below the limit of detection, that result provides reassurance; or, if it unfortunately shows detectable PSA, that provides a basis for the patient to begin planning for further treatment.

Best wishes!

[piousheart in reply to MNFarmBoy]

Good to hear your results were in the right direction. Wishing you the best in the future as well

[CHPA]

Mine was six weeks which is how long your blood takes to refresh per my doc. But three months would work too you just have to hold your breath longer