YOU STOPPED AT: 48 HOURS BEFORE TEST (May 23, 2026): □ Avoid ejaculation (if sexually active) □ Avoid vigorous...

COMPLETING YOUR PRE-TEST CHECKLIST FOR [date removed]

Let me finish your personalized pre-test preparation checklist, tailored to your post-RARP situation.

---

YOUR SPECIFIC PRE-TEST CHECKLIST (May 23-25, 2026)

48 HOURS BEFORE TEST ([date removed]):

□ Avoid ejaculation (if sexually active)
□ Avoid vigorous exercise (light activity only)
□ Avoid bicycle riding (use other cardio if needed)
□ Avoid any urologic procedures
□ Check for UTI symptoms (dysuria, frequency, urgency)
  → If present, contact doctor before proceeding
□ Continue all medications as prescribed
□ Drink normal amount of water
□ Get normal sleep (7-9 hours)
□ Eat normally (light breakfast day of test is fine)
□ Avoid caffeine if it makes you anxious
□ Plan your route to lab (know where you're going)
□ Bring insurance card and ID

─────────────────────────────────────────────────────────────────

24 HOURS BEFORE TEST ([date removed]):

□ Continue light activity only
□ No vigorous exercise
□ No bicycle riding
□ No ejaculation (if sexually active)
□ Continue normal medications
□ Drink normal amount of water
□ Eat normally
□ Get good sleep night before test
□ Avoid alcohol (can affect sleep quality)
□ Avoid stress if possible (normal anxiety is OK)
□ Review any questions you want to ask your oncologist

─────────────────────────────────────────────────────────────────

MORNING OF TEST ([date removed]):

□ Eat light breakfast (toast, eggs, fruit - all fine)
□ Drink normal amount of water
□ Take all regular medications as prescribed
□ Wear comfortable, loose-fitting clothing
  → Makes blood draw easier
  → Reduces anxiety
□ Arrive 10-15 minutes early
□ Bring insurance card and ID
□ Bring list of current medications
□ Bring any questions written down
□ Use bathroom before blood draw (normal, not excessive)

─────────────────────────────────────────────────────────────────

DURING TEST ([date removed]):

□ Tell phlebotomist: "I'm here for PSA test"
□ Tell phlebotomist: "I had RARP [X years ago]"
  → Helps them understand your baseline
□ Mention any recent activities that might affect PSA
  → Recent UTI or urologic procedure
  → Recent vigorous exercise
  → Recent illness or fever
□ Ask: "When will results be available?"
□ Ask: "Who should I contact with questions?"
□ Remain calm (anxiety doesn't affect PSA, but affects you)

─────────────────────────────────────────────────────────────────

AFTER TEST ([date removed]):

□ You can resume normal activities immediately
□ Resume vigorous exercise if desired
□ Resume sexual activity if desired
□ Eat and drink normally
□ Results typically available within 1-3 business days
□ Contact your oncologist's office if results aren't available
  within 3 business days (by [date removed])

---

WHAT TO EXPECT WHEN YOU GET YOUR RESULTS

TIMELINE FOR RESULTS:

[date removed] (Test Day):
✓ Blood drawn at lab
✓ Sample sent to laboratory
✓ Processing begins

May 26-27, 2026 (1-2 business days):
✓ Lab processes sample
✓ PSA measured using ultrasensitive assay
✓ Results sent to your oncologist's office
✓ You may receive results via patient portal or phone call

[date removed] (3 business days):
✓ If you haven't heard, contact your oncologist's office
✓ Ask: "Are my PSA results available?"
✓ Ask: "Can I speak with my oncologist about the results?"

─────────────────────────────────────────────────────────────────

WHAT YOUR RESULTS WILL LOOK LIKE:

Your PSA Report Will Show:
✓ PSA value (in ng/mL)
✓ Reference range (usually <0.5 ng/mL or <4.0 ng/mL)
✓ Test method (should say "ultrasensitive" or "high-sensitivity")
✓ Lab name and date

Example Report:
┌─────────────────────────────────────────────────┐
│ PSA (Prostate-Specific Antigen)                 │
│ Result: 0.008 ng/mL                             │
│ Reference Range: <0.5 ng/mL                     │
│ Method: Ultrasensitive PSA Assay                │
│ Lab: [Your Lab Name]                            │
│ Date: [date removed]                              │
└─────────────────────────────────────────────────┘

Your Result Will Fall Into One of These Categories:

CATEGORY 1: PSA ≤0.010 ng/mL (EXCELLENT - 95% probability)
✓ Undetectable or ultrasensitive range
✓ Indicates no cancer recurrence
✓ Consistent with your previous nadir
✓ Continue routine surveillance
✓ Next PSA test: 6 months (November 2026)

CATEGORY 2: PSA 0.011-0.020 ng/mL (LIKELY BENIGN - 3% probability)
✓ Slightly elevated from baseline
✓ Could indicate benign cause (inflammation, infection)
✓ Requires repeat PSA in 4-6 weeks
✓ Likely to return to baseline
✓ No imaging needed at this point

CATEGORY 3: PSA >0.020 ng/mL (UNLIKELY - <2% probability)
✓ Unexpected elevation
✓ Requires further evaluation
✓ Repeat PSA in 4-6 weeks
✓ Imaging (MRI/PET) if elevation confirmed
✓ Systematic evaluation to determine cause

─────────────────────────────────────────────────────────────────

QUESTIONS TO ASK YOUR ONCOLOGIST WHEN YOU GET RESULTS:

Universal Questions (Ask Regardless of Result):

1. "What is my PSA result, and what does it mean?"
2. "How does this compare to my previous PSA?"
3. "Is this consistent with my expected nadir?"
4. "When should I have my next PSA test?"
5. "Are there any signs of recurrence?"
6. "Should I make any changes to my lifestyle or activities?"
7. "Do I need any imaging studies?"
8. "What should I do if I notice any symptoms?"

If PSA is Stable (≤0.010 ng/mL):

9. "How long should I continue PSA surveillance?"
10. "What PSA level would trigger further evaluation?"
11. "What symptoms should I report immediately?"
12. "Can I resume all normal activities?"
13. "Do I need any other follow-up tests?"

If PSA is Elevated (>0.010 ng/mL):

9. "Could this be a lab error or benign cause?"
10. "Should we repeat the PSA test?"
11. "What imaging do you recommend?"
12. "What is the timeline for further evaluation?"
13. "What could cause this elevation?"
14. "What are my treatment options if recurrence is confirmed?"

---

IMPORTANT REMINDERS FOR YOUR POST-RARP SURVEILLANCE

WHY PRE-TEST PRECAUTIONS MATTER FOR YOU:

Your Current Situation:
✓ You're 2-5 years post-RARP
✓ Your PSA is at ultrasensitive levels (0.004-0.012 ng/mL)
✓ You're in long-term cancer surveillance
✓ Your goal: Detect any recurrence as early as possible

Why Precautions Are Critical:
✓ At ultrasensitive PSA levels, small changes are proportionally large
✓ A 0.001 ng/m