While waiting for my appointment with the doctor this afternoon, I got caught up on reading about the new Datsun 280ZX in the waiting room in the May 1981 edition of Road & Track magazine. Seriously. That thing belonged in the National Archives, not the doctor’s waiting room. Needless to say, it was a fun trip down memory lane, as I had just graduated from college three months earlier and was driving my 1974 Ford Galaxie 500 (my first car).
The discussion with the doctor went about as expected. In a nutshell: Continue to monitor; no action needed at this point given my PSA level and my PSA doubling time of 155 months. (Calculated using the Memorial Sloan-Kettering PSADT nomogram.)
She told me something new, too, concerning the explanation for some of the very minor fluctuations in PSA levels. I knew that physical activity and having orgasms before a blood draw could impact your PSA level, but she said that even variations in your hydration level can cause minor variations in your PSA readings. Interesting.
Just for grins and giggles, I asked her the $64,000 question: How do you define biochemical recurrence?
There was quite a long pregnant pause before she responded, “That’s a difficult question to answer.” She explained the that it’s been defined many ways and, while she never did answer my question directly, my impression was that she was in the “two or more consecutive increases in your PSA level” camp.
One thing the doctor said, too, was that she has seen cases where patients PSAs start increasing and then plateau and sit there for years without much change at all and no need for intervention.
She also suggested that, given where my PSA level was and how slowly it was moving, that we could retest in six months instead of sticking to the four month schedule that I’ve been using for the last three and a half years. I agreed. I return on 22 October 2019.
Again, the meeting went pretty much as I expected it would, and I’m okay with what we discussed.
I had a great trip to Switzerland in the first half of the month despite some dodgy weather (which is to be expected in northern climates in April). If you’re interested in reading about it (or at least just looking at some photos), you can check it out on my other blog, Travelin’ Dan.
Dan's Journey through Prostate Cancer 
Hi, Dan, glad things went well for you at the doctor. I’ve been dealing with this cancer since 2014. I must say your blog has been one of the more enjoyable discoveries I have made on my journey through the Internet looking for information. There’s so much ambiguity involved with this disease that it can be very frustrating at times but I suppose there are a lot of good outcomes hidden in the weeds of that ambiguity. Good luck!
I briefly owned a 1973 Datsun 240Z. Great car with that inline 6 cylinder engine.
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Thanks for your kind words about the blog. I couldn’t agree more about the ambiguity thing. It’s maddening to us patients as we try to sort out the best path for our unique situations.
I had a 1984 Nissan 200SX and a 1987 Nissan Pathfinder and loved both of them. In fact, I held onto the Pathfinder for 15 years.
Wishing you all the best,
Dan
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Hi Dan,
Your mention that physical activity and having an orgasm before getting the blood drawn can have an impact in the PSA reading. Is this the case even after RP?
I knew this is a factor when you still have the prostate but I had assume once RP this would not be the case.
Thank you again for sharing
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I thought the same thing until one of my doctors recommended not to have an orgasm within three days of a PSA test even after prostatectomy. Whether he was right or not, I just decided that I would follow the advice regardless to remove one more variable from the equation. It’s a small sacrifice for consistency.
It would be interesting to hear if your doctor agrees with this advice or not.
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Steve
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