PSA Test Result after 5 years of RP

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Walt1956
Walt1956 Member Posts: 4
Hi all this is my first post to this group.

I am 55 years old and have had RP 5 years ago. My PSA results have always been <0.04 and that was considered by my Urologist undetectable.
My Gleeson score was 7 and PSA prior to surgury was 3.2.

My local GP did a general blood test a few weeks ago and included a PSA test from another Company and my PSA came back at 0.03 (not <0.03), obviously using a more accurate instument (measuring to 0.01).

The Doctor wasn't concerned with this reading (but another Doctor wasn't concerned with the 3.2 psa before RP) so I will see my Urologist in a few weeks regarding this.

Im a little concerned about this reading in that its very close to 0.04.

So I would appreciate any comments or thoughts.

Thanks.
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Comments

  • Samsungtech1
    Samsungtech1 Member Posts: 351
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    Confused
    Your Psa went down and you are xoncerned? It was .04 and now is .03? What is your question? When the PSA goes down that is a good thing. What exactly is your question?

    Mike
  • Walt1956
    Walt1956 Member Posts: 4
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    Confused
    Your Psa went down and you are xoncerned? It was .04 and now is .03? What is your question? When the PSA goes down that is a good thing. What exactly is your question?

    Mike

    Hi Sam.
    My PSA has always

    Hi Sam.

    My PSA has always been less than 0.04 (<0.04) and considered undetectable.

    Now my PSA= 0.03 (not less than 0.03) and is considered detectable.

    Hence my question.
  • Old-timer
    Old-timer Member Posts: 196
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    You don't neet to be concerned
    I do not believe the numbers you report mean anything scary. In fact, they look good. It is possible, perhaps even probable, that the cancer can come back after RP. That happened to me after 13 years. At that time, the annual PSA check showed up as .1. In a year it grew to .2. After another six months it was .39, then .69, then 1.16. (I am quoting these from memory). Now after eight more years, radiation, and hormone treatment, the PSA is less than .01 and stable. No change in four years. I am a happy guy approaching age 86. But I don't feel a day older than 80! LOL.

    Don't let this story bother you; in fact I hope it lifts your spirits.

    Best of luck and many happy years ahead for you, Walt.

    Jerry
  • Samsungtech1
    Samsungtech1 Member Posts: 351
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    Walt1956 said:

    Hi Sam.
    My PSA has always

    Hi Sam.

    My PSA has always been less than 0.04 (<0.04) and considered undetectable.

    Now my PSA= 0.03 (not less than 0.03) and is considered detectable.

    Hence my question.</p>

    PSA
    Walt,
    There are plenty of people here that might be able to answer your question. I guess my question is if less than .04 isundetectable how can .03 be more Most of what you posted seems quite mild. I do not believe it is that much to worry about. Meet with your doc and see what he says.

    Good luck. No sense worrying until you have a reason.
  • hunter49
    hunter49 Member Posts: 246 Member
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    Welcome aboard. We are very
    Welcome aboard. We are very similar only I had my surger in 11/11 at 49. My most recent PSA test came back at .025 when last 2 were <.01. I freaked and called my friend at Hopkins and he said relax that is way low and undetectable. He advised to see if it was a difernet lad and it was so I went to the lab that did the other 2 and it was .01. I wondered why that was and the lab advised they no longer say less than any number on a ultra sensative test so the lowest you can go is .01. See if the test is the same lab but either way the number is down and your doing great.
  • VascodaGama
    VascodaGama Member Posts: 3,689 Member
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    hunter49 said:

    Welcome aboard. We are very
    Welcome aboard. We are very similar only I had my surger in 11/11 at 49. My most recent PSA test came back at .025 when last 2 were <.01. I freaked and called my friend at Hopkins and he said relax that is way low and undetectable. He advised to see if it was a difernet lad and it was so I went to the lab that did the other 2 and it was .01. I wondered why that was and the lab advised they no longer say less than any number on a ultra sensative test so the lowest you can go is .01. See if the test is the same lab but either way the number is down and your doing great.</p>

    Detectable or Undetectable, that is the question .......
    Walt

    Doctors got by experience different threshold values to diagnose the stats of their patients. The wording “undetectable” could include many levels of PSA. Some doctors use a level of 0.1 as their target of success. Results above this marker become detectable. Any value below [less than (<)] is undetectable.

    Laboratories also refer to the PSA according to the LLD of assays meaning that a number lower than their finite limit would be represented with the (<) sign in the assay’s LLD. You are right in saying that <0.04 could be lower than 0.03 but both numbers can be considered as detectable or undetectable if the doctor’s threshold is that low.
    (http://labmed.ascpjournals.org/content/40/2/105.full)
    Mathematically one could say that 0.03 equals to <0.04 or even that the value 0.03 is lower.

    Another fact to consider is that PSA values at such low levels may be erroneous due to many other factors. The above survivors know it well that a PSA of 0.03 is low and such is a reason for celebration not worries.
    You may like to read this link;
    http://www.yananow.org/UltraPSA.htm

    My urologist threshold was PSA=0.06 in RP success judgement but some use a threshold of 0.03. However, both numbers indicate remission.

    As far as I am aware of, the two decimal places (0.XX) ultra sensitive assays, independently of the maker (Abott, Boehringer,Cobas, etc), got tolerances in the LLD of (0.01, 0.02 and 0.05). LLD of <0.04 is new to me.
    You may like to know that newer assays now still go further in distinguishing between aggressive and nonaggressive prostate cancer, using other bio markers. Here you got information if interested;
    http://www.abbott.com/news-media/press-releases/abbott-licenses-biomarkers-for-use-in-differentiating-aggressive-from-nonaggressive-prostate-cancer.htm

    Congratulations on the Zeros.

    Welcome to the board.

    VGama
  • Walt1956
    Walt1956 Member Posts: 4
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    Detectable or Undetectable, that is the question .......
    Walt

    Doctors got by experience different threshold values to diagnose the stats of their patients. The wording “undetectable” could include many levels of PSA. Some doctors use a level of 0.1 as their target of success. Results above this marker become detectable. Any value below [less than (<)] is undetectable.

    Laboratories also refer to the PSA according to the LLD of assays meaning that a number lower than their finite limit would be represented with the (<) sign in the assay’s LLD. You are right in saying that <0.04 could be lower than 0.03 but both numbers can be considered as detectable or undetectable if the doctor’s threshold is that low.
    (http://labmed.ascpjournals.org/content/40/2/105.full)
    Mathematically one could say that 0.03 equals to <0.04 or even that the value 0.03 is lower.

    Another fact to consider is that PSA values at such low levels may be erroneous due to many other factors. The above survivors know it well that a PSA of 0.03 is low and such is a reason for celebration not worries.
    You may like to read this link;
    http://www.yananow.org/UltraPSA.htm

    My urologist threshold was PSA=0.06 in RP success judgement but some use a threshold of 0.03. However, both numbers indicate remission.

    As far as I am aware of, the two decimal places (0.XX) ultra sensitive assays, independently of the maker (Abott, Boehringer,Cobas, etc), got tolerances in the LLD of (0.01, 0.02 and 0.05). LLD of <0.04 is new to me.
    You may like to know that newer assays now still go further in distinguishing between aggressive and nonaggressive prostate cancer, using other bio markers. Here you got information if interested;
    http://www.abbott.com/news-media/press-releases/abbott-licenses-biomarkers-for-use-in-differentiating-aggressive-from-nonaggressive-prostate-cancer.htm

    Congratulations on the Zeros.

    Welcome to the board.

    VGama</p>

    Thanks all.
    I have seen my

    Thanks all.

    I have seen my urologist regarding the result.

    He says not to worry about it as ultra sensitive tests often do this.

    Going back in 6 months with another psa test.

    He says if radiation is ever required it will blast the cancer away since it is very slow growing.

    I will report back in January to let you know how it goes.
  • Walt1956
    Walt1956 Member Posts: 4
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    All good.  Did my PSA test

    All good.  Did my PSA test again and PSA still less than .05 undetectable.

  • ralph.townsend1
    ralph.townsend1 Member Posts: 359 Member
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    Walt1956 said:

    All good.  Did my PSA test

    All good.  Did my PSA test again and PSA still less than .05 undetectable.

    Zero

    That's great. Being a zero is good!!!!

  • VascodaGama
    VascodaGama Member Posts: 3,689 Member
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    Zero

    That's great. Being a zero is good!!!!

    Zerrrrros

    Congratulations.

    Best wishes for continuos remission.

    VG  Wink

  • Bmrguy8
    Bmrguy8 Member Posts: 7
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    2 Post-Op PSA Test result <0.04</b>
    Haven't been on in a while but wanted to report my 2 year Post-Op PSA test result of <0.04.  So happy to be here and still be a member of the "Zero Club."
  • Kongo
    Kongo Member Posts: 1,166 Member
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    Bmrguy8 said:

    2 Post-Op PSA Test result <0.04</b>
    Haven't been on in a while but wanted to report my 2 year Post-Op PSA test result of <0.04.  So happy to be here and still be a member of the "Zero Club."

    Great News!

    Don't you just hate it when it's time for those regular PSA tests?

  • VascodaGama
    VascodaGama Member Posts: 3,689 Member
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    Kongo said:

    Great News!

    Don't you just hate it when it's time for those regular PSA tests?

    A Thriller

    Kongo

    Yes I hate those periods but latter they turn into the thrilling moments of our “tale”.

    Cheers to BMRguy8 for continuing success.

    VG

  • Kinshasa
    Kinshasa Member Posts: 2
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    Bad news, good surprise

    I am 52 years old and had first HIFU, then hormonal trearment and finally last year in September RP. First PSA reading was great: < 0.01. Big celebration after all the different trearments we had tried! However 2 weeks ago, i did another psa testing - same lab as always - and the nurse infromed me over the phone that the PSA was now 0.04!!! Reading all the blogs, it was still clear that it was nothing to worry about. However quadrupling in 2 months time did not feel very comfortable to me either. Today my wife passed by the doctor for a foot injury of my daughter and asked for the official paper to send to my urologist. She phoned me immediately at work with the good news: the result was not 0.04 but < 0.04!!! And the best part was a little line at the bottom of the paper stating that the lab from now no longer considered < 0.01 as undetectable but 0.04! So as a matter of fact, my psa probably was as undetectable as before! Happy to be part of the zero club again!!!!

  • VascodaGama
    VascodaGama Member Posts: 3,689 Member
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    Kinshasa said:

    Bad news, good surprise

    I am 52 years old and had first HIFU, then hormonal trearment and finally last year in September RP. First PSA reading was great: < 0.01. Big celebration after all the different trearments we had tried! However 2 weeks ago, i did another psa testing - same lab as always - and the nurse infromed me over the phone that the PSA was now 0.04!!! Reading all the blogs, it was still clear that it was nothing to worry about. However quadrupling in 2 months time did not feel very comfortable to me either. Today my wife passed by the doctor for a foot injury of my daughter and asked for the official paper to send to my urologist. She phoned me immediately at work with the good news: the result was not 0.04 but < 0.04!!! And the best part was a little line at the bottom of the paper stating that the lab from now no longer considered < 0.01 as undetectable but 0.04! So as a matter of fact, my psa probably was as undetectable as before! Happy to be part of the zero club again!!!!

    Good news

    Congratulations.

    The lab changed its assays allowances. This is typical whern there is a change on the supplyer or type of assay.

    Best wishes for continuing remission.

    VG  Smile

  • thomasmichael
    thomasmichael Member Posts: 2 Member
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    Walt1956 - You are doing Great!

    It is generally accepted that if you can keep your PSA from doubling for 15 months you will be alive after 15 years or more. Your PSA hasn't doubled in 5 years after surgery and more importantly it is veritually undectectable so I would say congratulations!

    I'd be very happy to have a PSA of .03. My PSA three months after RP surgery was 3.1 and three months later is 4.1. If it continues at this rate I won't make it to 15 months before it reaches 6 (which would be doubled thus indicating the cancer is progressing too quickly for me to expect too many years ahead.) The prostate cancer has metastasized to my lymph nodes (stage is T3aN1M0) but from there is likely to go to lungs or hip bones.  I'm now 62. So indeed you should be very happy at .03 five years after surgery.

     

  • VascodaGama
    VascodaGama Member Posts: 3,689 Member
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    Thomas M; Aiming a lower PSA

    Thomas M.

    You have not shared much info on your case but you may aim to have a 0.03 PSA like Walt. RP was not successful in holding the bandit. You probably need further treatment.

    Are you been followed by a physician?

    What about any recommendation regarding a salvage therapy?

    Please let us know your facts so that we may give you some advice.

    What is your Gleason rate?

    Best wishes in your journey.

    VG

  • glh
    glh Member Posts: 1
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    HI and thanks

    HI and thanks

    I am 25 months post radical robotic surgery. I had a PSA of 0.02 or 0.03 for all this time. Now it's

    0.04.  Is this common?  I know the drill about the sensitive tests and being a "zero", but I guess I'm reaching out to hear from others who have had some "activity" in the PSA.  I am one that thinks "something is making it go up."  But, of course, it's  such a small sample at this point. My golf group has a urologist and a guy who works for a testing company.  Uro says. Keep checking.  My other friend who works for the PSA testing company says. It's only noise.  What do you think?  

    glh

     

  • VascodaGama
    VascodaGama Member Posts: 3,689 Member
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    GHL; both opinions are right

    The tiny increase of the PSA could be a cause of misreading by the assay/instrument (named noise) that detects little other proteins and reports those as PSA serum. The amount is very small but it could aggregate a value of 0.02 ng/ml. The limit of detection (LOD) in some laboratories is set for 5% (in a value of 0.1 it would be 0.005) and some have a predefined low limit, typically of LOD<= 0.03 to 0.05. This means that any number that could exist below the low limit of detection (LLD) would be named remission. In some labs they use the term "undetectable" but that could refer to levels up to 1.0 which is not a proper result for reporting in RP cases (no prostate in place).
    Urologists disregard such small differences and prefer to judge the case from three consecutive readings (three tests), done at the same laboratory but independent of the type of assay (ultrasensitive or very ultrasensitive assay).

    Along the years of researching, I found that the majority in RP cases take any PSA below 0.06 ng/ml as in remission. The value of PSA=0.20 refers to biochemical failure and the PSA=0.40 ng/ml is used as the trigger threshold for a salvage treatment. Yours at 0.04 could signify all of the above or even a awaking of the bandit, but you need to keep checking for a real conclusion. When recurrence is guessed, we worry and think to get treated the soonest but there is no practical information indicating that an earlier intervention provides longer periods of living. We know that earlier intervention provides latter biochemical failures.

    Some guys prefer to use very ultrasensitive assays with a sensitivity of three decimal digits (0.XXX ng/ml) which in my opinion has no significance for a clinical PCa reference (please read the below link). I would simply round up the last digit and have peace of mind.

    https://www.beckmancoulter.com/ucm/idc/groups/validatedcustomer/@wsr/@literature/documents/document/glb_bci_155982.pdf

    http://www.pctrf.org/pca-commentary-vol-91-2-your-psa-is-undetectable-what-does-that-mean-how-does-an-undetectable-psa-affect-management/

    Best,

    VG

  • contento
    contento Member Posts: 75
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    Question on PSA

    My doc at MD Anderson doesn't use the ultra sensitive method for measuring PSA  so my measurements  are reported as < .1 ng/ml when your good ( assuming RP ). Also I had always thought that there were other glands in the body that produce PSA , ie adrenal glands ,so that the PSA would not read zero  when using the ultra sensitive test.