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PSA after 10yrs goes from non-detectable to 0.70,

Ag1964
Posts: 3
Joined: Oct 2014

25 Oct 2004: Prostatectomy

PSA=5.4, Gleason=6, cancer close to margin but not in margin

21 Oct 2014: (PSA undetectable until today!)

Annual exam today showed PSA=0.70

Now extremely concerned!

QUESTIONs:

1) Should I expect PSA to continue to rise?

2) What is the praobility that it won't continue to increase?

Thanks,

Very Shook!

 

 

 

VascodaGama's picture
VascodaGama
Posts: 3354
Joined: Nov 2010

I suggest you recheck the last PSA results in another reliable laboratory. Errors are an evident probability.

I wonder if you know what level represents the PSA "undetectable threshold” used by your doctor.

Some doctors use cut-off levels of PSA=>1.00 (ng/ml), to report real values, and some others got thresholds of 0.5, and still some consider values under 0.1 (ng/ml).
In other words, 0.7 is lower than 1.0 so you should have previous values to validate any possibility in increases. Undetectable means nothing in diagnosis but it got a meaning to your doctor.

After prostatectomies, doctors consider RP success when the PSA gets into remission. This value also varies among physicians but almost all of them use the bracket of PSA=< 0.03 to 0.05 (ng/ml). Any increase thereafter is named biochemical failure and surely of concern. A number of doctors do not trust PSA results with values lower than 0.2.
The AUA classifies levels above 0.2 as recurrence. They recommend salvage treatments when the chronology of tests shows constant increases, reaching the 0.4 (ng/ml) threshold mark.

I think you should verify the veracity of the last results and try gathering the values of previous tests along your ten years of survivorship.

Best wishes and peace of mind.

VGama

Ag1964
Posts: 3
Joined: Oct 2014

VGama, thank you so much for your reply & suggestion.

Only 3 days after my PSA was 0.70 I went to a different lab and the PSA reading was <0.1 (N). Does the (N) mean non-detectable? Thank you.

Old-timer's picture
Old-timer
Posts: 196
Joined: Apr 2011

July 1991, at age 65: PSA 4.0, biopsy Gleason 3+4 = 7.0.

September 1991: radical prostatectomy.

December 1991 through 2003: PSA .0.

Early 2004:  PSA 0.2. Then at 3-month intervals my PSA rose: 0.39, 0.61, 1.11.

Feb.-Mar. 2004. Radiation sessions (35).

July 2004: PSA 1.20. (Informed that radiation was not successful.)

October 2004 to June 2008. PSA see-sawed a bit while gradually rising to 20.4.

June 2008. Began hormone therapy.

September 2008 to October 2014. PSA undetectable <0.1.

I am 88, feeling good, remaining relatively active, and enjoying life.

I recognize that no two cases are the same. Hope this record helps keep your spirits high.

Best of luck to you.

Jerry (Old-timer)

Ag1964
Posts: 3
Joined: Oct 2014

Jerry, I really appreciate your responce. So glad to hear that you are cancer free and enjoying life. Your story is inspiring & uplifting to me.

VascodaGama's picture
VascodaGama
Posts: 3354
Joined: Nov 2010

Congratulations for the PSA results. What a relief you may be experiencing.

This result (less than 0.1 ng/ml) from the second laboratory is the low limit detection (LLD) level of the assay they use. Surely that is enough but I think that in your future followup you should move into ultra sensitive type of assays that provide two decimal places (0.0X ng/ml), because you have no prostate gland. The PSA should be read very low.

Best wishes for continuing ZEROS.

VG    

Old Salt
Posts: 802
Joined: Aug 2014

Please note that those ultrasensitive PSA assays may generate a lot of anxiety without clinical benefit.

PS: Here's a link to a thread focussed on just this topic.

http://www.cancerforums.net/threads/10111-Regular-PSA-vs.-Ultra-Sensitive?s=f0454011ad58ee0be2b531dc418009df

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