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psa test

hunter49
Posts: 204
Joined: Oct 2011

Had my psa test results come back 7 months post op. 0.025 on a new ultra sensative test. Last time in March was <.01 but at a differnet lab. Guess this is still good. With bad 7 wach test is a nail biter.

laserlight's picture
laserlight
Posts: 165
Joined: May 2012

I have had my post op psa test ran every 6 to 8 weeks since feb of 2011. My results come back at a 0.02, my doctor has explained this as being undetectable. I also had the bad 7, so this is always a nail biter. I have another doctor visit on Monday and will then see what the psa is. My doctor has had me on a 6 to 8 week rotation for psa checks. He said that this was because of the agressive type of the cancer. Take care and keep us posted

hunter49
Posts: 204
Joined: Oct 2011

Laser thanks for reponding. I was a 3+4 at time of biopsy. PSA went dfrom 2.54 in 4/09 to 4.1 in 8/11 Biopsy had 3 out of 15 posative all in one section on one side of prostate 90-95% involvement. Had another PSA at Hopkins in end of October and was 5.4. Had surgery Novemebrr and final biopsy had me a 4+3 and was on both lobes but not multi focla appeared to be growing inward. I had Perinueral invasion but no vascular invasion. All margins, SV and lymph nodes clean of metastisis and no prostatic extension. All CT and bone scans clear. first PSA one month after surgery <.1 3 months < .01 and this one .025 but all 3 were diferent labs. No matter what I tense up before tests. Not sure what else to do but wait and test

VascodaGama's picture
VascodaGama
Posts: 1676
Joined: Nov 2010

Hunter

You are doing it right. Testing is the way to find on the surgery success. Nevertheless, tests should be done with the same type of assay, independently of the laboratory. Results also may be adopted at different laboratories, so that you need to get a place you trust, for consistency.

Different assays have different LLD and the second-line ultra sensitive assays of three decimal places (0.XXX ng/ml) are in fact disregarded in PCa matters. The lowest limit definition is usually taken as a PSA =<0.01 ng/ml, which is the second result you have gotten.
In any case, some doctors give results based on their thresholds which may be different of the real laboratory report. Many urologists consider that any PSA post op lower than 0.1 is GOOD, so that any number presented by the lab will be passed to the patient as PSA=<0.1, or even given with the word “UNDETECTABLE”.
My surgeon’s threshold PSA indicating Remission after surgery (six month post op) was 0.06 ng/ml.

Some laboratories also report numbers representing a threshold which was adopted in accordance with the LLD of the assay. So that any lower number is not reported.
I think that very low levels (0.XXX values) of PSA cause anxiety and do not alter the course of a case.

Norms adopted by responsible Institutions and Medical Associations consider PSA post op of higher than 0.2 ng/ml as markers of cancer progression. However any constant increase at lower levels above 0.01 may indicate recurrence and that is of significance in aggressive type of cancers.

Your last PSA of 0.025 (0.03) is very low and still in the “remission” levels considered by the majority of doctors. Though the flag is raised because this is a higher number from the PSA result (<0.01) of three months ago, and due to your pattern Gleason grade of 4.
Any conclusion should only be taken in your next test at the three month apart.

Be patient and do not get anxious. After all, the other fidings at the path report are good.

You are not alone and no matter which way your case leads, there are always solutions to follow.

Wishing you the best.
VGama

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