YOU STOPPED AT: You feel relieved but regret not following precautions → Cost: $1,000-3,000 for unnecessary imaging

COMPLETING: THE REAL-WORLD IMPACT OF FOLLOWING PRE-TEST PRECAUTIONS

Let me finish this important section about why these precautions matter for your specific surveillance situation, and then provide your complete action plan.

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THE REAL-WORLD IMPACT OF FOLLOWING PRE-TEST PRECAUTIONS

Scenario 3 (continued): You Don't Avoid Bicycle Riding
→ PSA rises 0.001-0.002 ng/mL
→ Oncologist sees elevation
→ Orders imaging (MRI/PET scan)
→ You experience significant anxiety
→ Imaging is normal (no recurrence)
→ You feel relieved but regret not following precautions
→ Cost: $1,000-3,000 for unnecessary imaging
→ Emotional cost: Weeks of worry about recurrence
→ Impact on next surveillance: You're now anxious about every test

THE BOTTOM LINE:
Following precautions takes 48 hours of minor lifestyle adjustments.
NOT following precautions can cost you:
  • $1,000-3,000 in unnecessary imaging
  • Weeks of anxiety about cancer recurrence
  • Reduced confidence in your surveillance results
  • Potential cascade of additional testing

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WHAT FOLLOWING PRECAUTIONS GIVES YOU:

✓ ACCURATE PSA RESULTS
  Your PSA reflects your TRUE cancer status, not benign factors

✓ CONFIDENCE IN YOUR SURVEILLANCE
  You know your results are reliable and meaningful

✓ REDUCED ANXIETY
  You don't worry about false elevations

✓ AVOIDED UNNECESSARY TESTING
  No unnecessary repeat PSAs or imaging

✓ COST SAVINGS
  You avoid $1,000-3,000 in unnecessary imaging

✓ PEACE OF MIND
  You know you did everything right to get accurate results

✓ BETTER DOCTOR-PATIENT COMMUNICATION
  Your oncologist can trust your PSA trends over time

✓ EFFICIENT SURVEILLANCE
  Your healthcare team can focus on real changes, not artifacts

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YOUR COMMITMENT TO PRECAUTIONS:

Think of pre-test precautions like this:

Just as you wouldn't eat a big meal right before a blood glucose
test (because it would give a false high reading), you avoid
activities that temporarily elevate PSA before your test.

It's not about being overly cautious—it's about getting ACCURATE
information about your cancer status.

48 hours of precautions = Accurate results for the next 6 months
of surveillance.

That's a worthwhile trade-off.

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YOUR COMPLETE ACTION PLAN FOR [date removed] PSA TEST

PHASE 1: PREPARATION (NOW - [date removed])

Week Before Test:
□ Mark [date removed] on your calendar
□ Schedule your lab appointment if not already done
□ Confirm lab location and hours
□ Plan your route to the lab
□ Write down any questions for your oncologist
□ Review your current medications
□ Note any recent symptoms or activities

Day Before Test ([date removed]):
□ Confirm your lab appointment
□ Prepare comfortable, loose-fitting clothing
□ Gather insurance card and ID
□ Get good sleep (7-9 hours)
□ Avoid alcohol
□ Eat normally
□ Drink normal amount of water
□ Avoid stress if possible

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PHASE 2: 48-HOUR PRECAUTIONS (May 23-25, 2026)

48 Hours Before Test (Starting [date removed] at 10 AM):

AVOID:
✗ Ejaculation (if sexually active)
✗ Vigorous exercise (running, intense cardio, weight lifting)
✗ Bicycle riding (stationary or outdoor)
✗ Any urologic procedures
✗ Strenuous activities that cause pelvic pressure

DO:
✓ Light activity (walking, gentle stretching, yoga)
✓ Normal daily activities (work, household tasks)
✓ Continue all medications as prescribed
✓ Drink normal amount of water
✓ Eat normally
✓ Get normal sleep
✓ Monitor for UTI symptoms (dysuria, frequency, urgency)

IF YOU DEVELOP UTI SYMPTOMS:
→ Contact your doctor IMMEDIATELY
→ Do NOT proceed with PSA test
→ Get urinalysis to confirm infection
→ Treat with antibiotics if confirmed
→ Reschedule PSA for 48 hours after starting antibiotics

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PHASE 3: TEST DAY ([date removed])

Morning of Test:
□ Eat light breakfast (toast, eggs, fruit - all fine)
□ Drink normal amount of water
□ Take all regular medications as prescribed
□ Wear comfortable, loose-fitting clothing
□ Use bathroom before arriving at lab
□ Arrive 10-15 minutes early
□ Bring insurance card and ID
□ Bring list of current medications
□ Bring written questions for your oncologist

At the Lab:
□ Check in at front desk
□ Tell staff: "I'm here for PSA test"
□ Tell phlebotomist: "I had RARP [X years ago]"
□ 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)

After Blood Draw:
□ You can resume normal activities immediately
□ Resume vigorous exercise if desired
□ Resume sexual activity if desired
□ Eat and drink normally
□ No restrictions after test

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PHASE 4: RESULTS & FOLLOW-UP (May 26-28, 2026)

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?"

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PHASE 5: INTERPRETING YOUR RESULTS

When You Get Your Results, You'll See:

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

Your Result Will Fall Into One of These Categories:

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

CATEGORY 2: PSA 0.011-0.020 ng/mL (LIKELY BENIGN - Possible)
✓ 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
✓ No treatment needed

CATEGORY 3: PSA >0.020 ng/mL (UNLIKELY - Rare)