I was seeing my Primary Care Manager (PCM) about fatigue that I was experiencing. Since I had not been in to see her for two years... got busy... she ordered a series of labs, of which the PSA was one. My previous PSA was 2.5 the last time I had it taken previously 2 years ago.

I had a new PSA of 4.6 and was referred to PHOENIX UROLOGY OF ST JOSEPH INC, MO. My doctor there did the digital examination and could not feel anything and neither had my PCM. He said that my numbers were low and since I had no family history of prostate cancer we could probably wait 6 months and re-test then decide if a biopsy was warranted. I said, I am here now so let's just schedule it now and get it over with. The biopsy came back positive for 2 of 12 samples showing 3% and 10% respectively.

While I was waiting for the results which took a week to come back from the lab I researched what treatment options were available for me. I decided on the robot-assisted laparoscopic prostatectomy with Dr. Brantley Thrasher at KUMED. My urologic surgeon at St Joseph recommended the use of the newer technology which his hospital did not currently have.

My decision for surgery versus radiation was that you can always have radiation therapy after surgery if the cancer returns. I read numerous articles were surgeons were unwilling or recommended against conducting surgery on patients who had undergone radiation therapy first.

The operation went well, and my results were:

-Histologic Type: Adenocarcinoma
-Histologic Grade: Moderately differentiated -Gleason Pattern: 3+3=6 -Proportion of prostate tissue involved by tumor: Less than 10%
-Extraprostatic Extension: Absent -Seminal Vesicle Invasion: Absent
-Margins: Negative
-Lymph-Vascular Invasion: Absent
-Perineural Invasion: Absent
-Pathologic Staging: pT2c,Nx,M

It has been a month since the surgery and I feel fine. It is now a matter of following up with future PSA tests at 3 months and then every 6 months after that to check on any recurrence of the cancer that may have spread outside of the prostate. I am optimistic that they got it all the first time.

Update to some information I forgot to enter the first time: Pathologic Staging: pT2c, Nx, M non-applicable. Due to the low level of my initial biopsy results the decision was not to remove the lymph nodes nor did I have a bone scan for Mets. I did have a CAT scan, from my upper chest to my pelvis, which came back with everything appearing normal.

Dr. Thrasher, whom I would recommend to anyone, has been performing robotic surgery four times a week for approximately the last five years. So by the time he got to me he had at least 750(+) robotic surgeries under his belt in addition to having previously performed over 1,000 of the normal open / manual radical prostatectomies.

New information. Following the removal of the catheter I had a medium level of incontinence varying between two to four pads a day tapering down to one a day at the end of five weeks. By the beginning of week seven I realized that the only leakage I was having was associated with strong coughing or sneezing so I stopped using pads. I no longer consider this a real problem though I will continue with the Kegel exercises every other day for a while longer.

I had a follow-up appointment with Dr. Thrasher on 19 Oct 2010 to discuss the results of my 90 day post surgery PSA test which came back at less than 0.01. He told me that the reading means that my PSA level is undetectable. We will follow-up with further 90 day checkups for the next year.

Several weeks ago he also started me on 50mg of Viagra every three days for penile rehabilitation and I also have an appointment to get training and receive an Osbon ErecAid Vacuum Therapy System in early Nov. I had erections before surgery without any problem and after surgery I have had them but they are not suitable for intercourse. With Viagra there is improvement but still does not result in fully usable erections.

For both the incontinence and erections he told me I am on track on where I should be for recovery. The wife is very understanding. I will be sure to update in one year.

Thanks to both Kerry and Gregg for this website ... really helps me to look at my situation in comparison with others going through the same thing.

Well my one year anniversary from prostate surgery has come and gone with only one hiccup.

I went in for my six month post-surgery PSA test on 5 January 2011. I was expecting approximately the same result as Oct 2010 which was less than 0.01 (undetectable) based upon the results of my post-surgery pathology report. Was I SURPRISED when I stopped by the hospital to pick up my lab results after work? Yes!!! The results were less than 4.0.

As soon as I got home I went online to the YANA website to see if anyone here, with a similar post surgery pathology report etc., had a similar jump in PSA from being undetectable. No one did. I figured/hoped that the test did not work or the lab messed up the results. So I contacted my surgeon in the morning and he said in his 20 plus years this had never happened with him and the test had to be off.

I had another PSA test on January 7, 2011 at the same lab and it came back as less than 0.05 (undetectable). The hospital had changed the assay test since last Oct when they could detect PSA down to 0.01. So I now had two PSA results one indicating a possible chemical recurrence and one not detecting anything. No one in the lab could explain when I called.

So I had a third PSA test at KUMED the morning of my checkup which came out as less than 0.01. again undetectable. During my talk with the surgeon he mentioned that I would be surprised at the number of errors that labs can and do make when they put blood samples in the machine for testing.

After the checkup I went back to work and sent and e-mail to the patient advocate at the hospital where I had the first two PSA tests asking them to determine the reason my first lab results were in error. I received the following response:

"Good morning sir! I forwarded your concerns to the Chief of our Lab department and received the following response:

I looked up the results from Jan 5. It should have been resulted out as less than 0.05 and not less than 4.0. The tech looked at the reference value and not the assay range when he reported it out. I looked at all the lab results from Jan 5, there were no patient results which should have been reported as less than 4.0 or greater than 4.0.

Thank you so much for bringing this to our attention. We apologize for the incorrect information given. The person who made this error was identified and further education and appropriate counseling will be given."

I did my 9 and 12 month PSA tests at KUMED and not the local hospital on the military base here. Not because of the error but because they use different assay methods from time to time and I wanted consistency in the assay method of being able to detect down to 0.01.

My April PSA was less than 0.01

My July PSA was less than 0.01

Incontinence is no longer a problem as even the dribbles that I sometimes had have ceased to occur.

Erections are getting better with 100mg of Viagra when needed. Right now I sometimes need it and sometimes I do not. Sometimes even Viagra does not work. However, there has been continued improvement every month following surgery.

I am now on a 6 month checkup schedule.

Overall my life is pretty much back to normal. Who would have thought that possible a year ago? Not me.

Once again thanks to everyone making this website happen and that includes all of you who update your information. As it was reading your stories that I found most helpful.

Finally, I had my "TWO" year checkup and got a clean bill of health from my surgeon/urologist. Not sure why I have had this check-up as some sort of major milestone in my mind, but I have.

Anyway, I have been getting my PSA checked every six months at KUMED since July 2011. I also had another PSA test as part of a routine physical at the Veterans Affairs Hospital during my yearly check-up with them. The test results are below:

September 2011-PSA 0.00 Undetectable level (VA Medical Center)
January 2012-PSA <0.01 Undetectable level (KUMED)
July 2012-PSA <0.01 Undetectable level (KUMED)

I am still working on the ED front with continued improvement.

Erections are 100% with 100mg of Viagra. The nerves are still healing for me. My doctor said at least 30% of surgery patients take longer than two years to fully recover. I have had other unrelated surgeries that damaged nerves in my foot and shoulder and it took at least 2 to 3 times longer for the nerves to heal then the surgeons said it should take. So for me I think I am on track for the nerves healing.

"No" Incontinence: have not had any problem here since 5 weeks after surgery. Even heavy lifting or strenuous exercise is not a problem.

I will stay on a 6 month check-up schedule for the next year and after that I will have an annual check-up.

Terry, thank you, (and all of your assistants/helpers) for coming back and keeping the site going. The updates that others have posted have been very useful for me to read and I hope mine does the same for others as well.

I had my "Three" year checkup and got a clean bill of health from my surgeon/urologist.

Anyway, I have been getting my PSA checked every six months at KUMED for the last two years. I also have another PSA test as part of a routine annual physical at the Veterans Affairs Hospital during my check-up with them. The test results are below:

November 2012-PSA 0.00 Undetectable level (VA Medical Center)
January 2013-PSA <0.01 Undetectable level (KUMED)
July 2013-PSA <0.01 Undetectable level (KUMED)

Erections: I am still working on the ED front with continued improvement and have started using the injectable treatment with good long lasting results with none of the pain some others have mentioned. Erections with 100mg of Viagra are also good but only for a short durations of 30 to 40 minutes at most.

Incontinence is not a problem at all.

I am now on a annual checkup so I will see you all same time next year for my next update.

First,

I just read Terry's last update .. you are in my thoughts and prayers brother.

As for me ...

I had my "Four" year checkup and got a clean bill of health from my surgeon/urologist.

In July 2013 I started having my PSA checked every 12 months at KUMED. I also have another PSA test as part of a routine annual physical at the Veterans Affairs (VA) Hospital during my check-up with them. The test results for both are below:

October 2013-PSA 0.00 Undetectable level (VA Hospital)

July 2013-PSA <0.01 Undetectable level (KUMED)

Erections: is a work in continued improvement. I am now able to achieve erections without help, after four years, (but not long lasting yet) so I use the the injectable treatment which provides great lasting results with none of the pain some others have mentioned. Erections with 100mg of Viagra also continue to be good but only for short durations of 30 minutes at most.

Incontinence is not a problem at all.

See you all … same time next year … for my next update.

I had my "Five" year PSA checkup and got a clean bill of health from my surgeon/urologist at KUMED. The doctor said I am not out of the woods yet but that I can see light at the end of the tunnel. However, I will still be taking the annual PSA test for the rest of my life ....

I also have another PSA test as part of a routine annual physical at the Veterans Affairs (VA) Hospital during my check-up with them. The test results for both are below:

October 2014-PSA 0.00 Undetectable level (VA Hospital)

July 2015-PSA <0.01 Undetectable level (KUMED)

Erections: I use the the Caverject 40 mcg alprostadil for injection treatment which provides great lasting results with none of the pain some others have mentioned.

Incontinence is not a problem at all.

See you all … same time next year … for my next update.

I had my "Six" year PSA checkup and got a clean bill of health from my surgeon/urologist at KUMED. The doctor said I that I no longer needed to see him. I am just to have an annual PSA test with my normal yearly checkup with my primary health care provider.

I had two PSA tests .. one by my primary health care provider who also did a free PSA test along with a PSA test along with a host of other lab tests since it had been two years since I had any lab tests with them.

My surgeon at KUMED also had one PSA test done.

The test results for both are below:

29 June 2016 -PSA <0.01 Undetectable level (Primary Doctor)

29 June 2016 -PSA <0.018; Results comments for this stated "Unable to Calculate". I assume since they cannot detect any PSA in me they were unable to calculate any useful measurement on this test (Primary Doctor)

15 July 2016 -PSA <0.01 Undetectable level (KUMED)

Erections: I use the the Caverject 20 mcg alprostadil for injection treatment which provides great lasting results with none of the pain some others have mentioned.

Incontinence is not a problem at all.

On a side note ... my older brother (then age 60) had a PSA test and biopsy two years ago that confirmed a 5.6 PSA and a 3+4=7 Gleason score. Surgery pathology report said cancer contained in prostate but was 1mm from the edge. He has since had undetectable PSA.

Even with no family history from my father's family (they mostly died in their mid 50's) we had no idea if this ran in our current generation.

I highly recommend any male siblings get a PSA if a brother develops prostate cancer.

See you all … same time next year … for my next update.

7 years have flown by.

I did my yearly PSA check today and it came back "Undetectable" at <0.03

This is a new test that only measures PSA down to 0.03 that my PCM is using.

Erections: I still use the the Caverject 20 mcg alprostadil for injection treatment which provides great lasting results with none of the pain some others have mentioned.

See you all … same time next year … for my next update.

8 years have flown by.

I did my yearly PSA check 17 July 2018 and it came back as "Undetectable" at <0.13

This is a new test that only measures PSA down to 0.13 that my PCM is using.

It would be nice if Hospitals and or PCM's used the same PSA test year in and year out. However they do not. So I just focus on the interpretation of the results which in this case continues to show that I have no detectable PSA according to my Doctor.

Erections: I still use the the Caverject 20 mcg alprostadil for injection treatment which provides great lasting results with none of the pain some others have mentioned.

See you all same time next year for my next update.

9 years ... time is flying by ....

Current PSA test on 27 June 2019 came back "Undetectable" at <0.00.

Erections: I still use the the Caverject 20 mcg alprostadil for injection treatment which provides great lasting results with none of the pain some others have mentioned.

See you all same time next year for my next update.

10 years ... a mile stone of some type I am sure...

Current PSA test results on 18 Sept 2020 came back "Undetectable" at 0.00.

Note: I normally get my PSA checked during my annual checkup during the month of June at the local Veterans Administration (VA) Hospital just down the road. However, this year they called in May and said they were cancelling all LABS and in person doctor appointments for the foreseeable future. This was due to the coronavirus. The first available appointment for me based upon the VA's planning schedule to reopen was Mid-Sept 2020. So I made my appointment on the first available day of 18 Sept which occurred without any issues.

I still use the Caverject 20 mcg alprostadil for injection treatment which provides lasting results.

See you all in the June 2021 timeframe for my next update.

11 years ... time is flying by ....

Current PSA test on 17 Sep 2021 came back "Undetectable" at <0.01.

Erections: I still use the the Caverject 40 mcg alprostadil for injection treatment which provides great lasting results with none of the pain some others have mentioned.

See you all same time next year for my next update.

12 years have come and gone since my original diagnosis.

PSA test on 5 Aug 22 came back "Undetectable" at <0.1 according to my primary doctor.

So same time next year for me ....

Well I moved to Japan in late 2022 for my final retirement location.

I did a yearly medical checkup in the Japanese Health care system but it does not normally include a PSA test, which I had though it did. Live and learn.

Anyway, I being a retired military member, I also had a yearly physical done at the local US Military hospital nearby which did include a PSA test.

The doctor said the results show no measureable PSA with my test results of < 0.100 ng/mL. Same as in my test of 2022.

So coming up on 14 years in June, post surgery, with no real issues from having the prostrate removed.

So same time (approximately) next year.

Phillip's e-mail address is: phil363 AT hotmail.com (replace "AT" with "@")