Retzius-Sparing Laparoscopic Radical Prostatectomy

Medical Tourism?

https://www.irishexaminer.com/viewpoints/analysis/when-vital-treatment-is-not-medical-tourism-295792.html

First PSA five weeks after my op. Down to <0.1 ug/L, from 18+ ug/L pre-op.

I was told to wait between six and twelve weeks for a follow-up PSA, so hopefully my next test in two or three weeks will be even lower and ‘undetectable’. 🤞

P.S. The hospital have just told me lowest reading possible with their current equipment is <0.1 ug/l which is classed as ‘undetectable’. Good news!

Edited by member 12 Jul 2018 at 11:52  | Reason: Not specified

It won’t be salvage RT at this stage; the outcomes for adjuvant treatment are more relevant to you.

Hi Matron,

I only got a verbal précis of the pathologist’s report which I didn’t totally take in - not because I was in shock - but because of a poor phone line, (thank you EE), and a paper copy is on its way via snail mail. The NHS doesn’t have PDF or email facilities...apparently.

I am just more and more annoyed by my GP surgery’s neglect of my PSA testing for seven years, and the refusal of a “transient” GP at the practice who declined to do a DRE about three years ago, despite me being on his couch in my underpants for something else. He’s buggered off to the sub-continent now.

Did I mention that Her Loveliness has had two invitations for cervical smear tests in the last two years, despite the fact that her entire womb and its ancillaries were destroyed in a medical incinerator three years ago following her total hysterectomy? I did? Sorry to be a bore.

Many thanks for your concern, and no doubt I will be back to you for RT advice, after which I will feel qualified to pontificate about that as well!

Keep smiling, keep breathing.

Best wishes and kind regards, John

Edited by member 24 Jul 2018 at 17:12  | Reason: Not specified

John

Sorry to hear the news, I had an elevated PSA missed for three years and sometimes start doing the "what if" thoughts. Stay positive, there are still plenty of options if needed.

Thanks Chris

Upgraded to T3a, still Gleason 4+3=7. Lymph nodes affected, maybe 1 positive margin (focal). Not sure what that means, but the pathologist seems to have discussed it with a colleague for a second opinion.

Looking forward to seeing the Professor in a few days to thank him for the brilliant job he has done. Not his fault there were seven years between PSA tests. And yes Matron, I am partly to blame because I read on the annual blood test form ‘Full blood count’ assuming that included PSA which evidently it does not. Moreover I had no symptoms, so no reason to suspect prostate disease.

Electron beams here I come (maybe). I wonder if they will let me wear those lead-lined underpants they give you when you have a chest X-ray? 😂😂😂

My first tattoo at 62! All the rage these days I understand.

So many exciting new things to look forward to!

At risk of upsetting Lynn I would insist on a ultrasensetive PSA test, if it comes back as undetectable ie less than 0.001 then you can be reasonably sure you do not need ajuvant  RT.

Of course it may come back as 0.05 and then you have the waiting game or ART  to chose from but at least you will know..

I mentioned that to the oncology nurse and he said they had tried it but it was not worth the trouble.

We have one of the newest and biggest hospitals in Britain here in Coventry, (PFI financed, probably costing over 1bn in the end). I called the biochemist there, because my first post-op PSA came up on my EMIS Patient Access app as 0.1! She said the result was <0.1, the lowest their equipment can measure.

So then I phoned my GP and they said the result on their system was <0.1. So it seems EMIS Patient Access do not have the “<“ in there compute’s fonts!

I’m more than happy with <0.1 ‘undetectable’. We’ll see how long that lasts.

I liked the bit about the breast-feeding and recently orgasmic women’s PSA - not that I know anything about either!

Edited by member 25 Aug 2018 at 11:59  | Reason: Not specified

Thank you again Matron. I already twigged that, and when I see my GP next week armed with the histology report I will request a referral to Warwick Hospital oncology. The multi-million pound ’super hospital’ here in Coventry is so busy it can take 30-45 minutes just to get in there and find somewhere to park. Warwick, you can just drive in and park right outside oncology for free. I would like to get an appointment booked in the bank which can always be cancelled.

The histology report says: lymph node right 1/6 positive for metastatic carcinoma and left 1/8 positive, together with perineural invasion. Circumferential margin involved but very focally at right posterior. No doubt the Prof will translate all this for me next month.

My GP doesn’t seem to know much about PCa, but he is the one out of many doctors in the practice who ticked the PSA box on my annual blood test form last November after seven years since the first one. God bless him! On my sick note he wrote ‘transurethral prostatectomy‘, which is a TURP.

Edited by member 28 Jul 2018 at 12:27  | Reason: Not specified

Not wanting to bleat on about USPSA but this article sums up why it is valuable in cases like Bolinge:

https://www.google.co.uk/amp/s/prostatecancerinfolink.net/2015/01/14/low-detectable-psa-after-prostatectomy-watch-or-treat/amp/

Re Walsgrave I can remember the old place and not only did I go out with a couple of trainee nurses from there in my younger days the oncology unit was excellent. In fact I wish my dad had had all his treatment there rather than the dump that was the George Elliot down the road! !