HealingWell
Search Close Search
☰

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 3/26/2009 12:00 PM (GMT -5)
It's been almost a year and a half since my surgery. As shown in some of my previous postings, I have anxiety over follow-up PSA tests. I had tried unsuccessfully to find a urologist in my area (not that I did an exhaustive search) that uses the "standard" PSA assay with sensitivity threshold of 0.1ng/ml. Although my latest result is very low, it is still trending up. The pattern is:

<0.008      <0.008       0.01         0.01          0.02

Based on my final pathology, my odds of having a recurrence are extremely low, but nevertheless I worry about this.

Has anyone else experiences these kinds of fluctuations with their ultra-sensitive testing. I will remain vigilant, but I guess I am looking for reassurance. Thanks

CaPCa

Posted 3/26/2009 12:26 PM (GMT -5)
CaPCa...hmmmm...it really is too bad that you have the anxiety over the PSA ultra-low tests. The 1/100 change is so small of a fluctuation that it is impossible to conclude that it is rising or falling from the base line. Too many factors come into play at that level to assertain that this is anything but lab variances.

Gosh...I wish there was a way for you to not stress over such low amount of change...either up or down at that level. Try just looking at the first digit on the right side of the decimal point...which is zero...which is exactly where you want to be.

Congrats on another ZERO test!
Posted 3/26/2009 1:49 PM (GMT -5)
I don't really see a trend. What I see is a different assay being used or a tad of prostate tissue. Don't forget, use the same assay and lab every time. Don't forget, there are no absolute margins around the whole the prostate. Then there is the cowper's gland. Teenie amounts of PSA will be present.

Swim
Posted 3/26/2009 3:31 PM (GMT -5)
I see you as a guy that it is still pulling real strong Zeros. Don't let the microscopic fluctuactions of the tests throw you off base. There can always be some clinical or even hardware reason why there would be minor variances like you report. I think you are doing well.

David in SC
Posted 3/26/2009 4:52 PM (GMT -5)
When we had the same sort of questions and trends in the ultrasensitive PSA, the advice from Swim and others was reassuring (see signature). Although we did go for one re-test (same lab) my husband is confident he is showing a good post op result of zero thanks to members here and subsequent advice from surgeon. He had a rise from .01 to .02 which has stayed same since but it did worry us a lot at the time (in fact each test itself is a huge stressor). We were reassured by the comments of others about this issue however - I hope you are too. BillyMac also had some good information in back posts about sensitivities (and possible human carelessness) in callibration of highly sensitive machines used,  so maybe you could also have a look at some of these previous posts and compare it to your situation. It might help ease your mind as it did ease ours. Good luck and good health to you. We believe you can celebrate another solid zero!

Posted 3/26/2009 8:46 PM (GMT -5)

Thanks for the words of encouragement - it really, really helps. It is especially helpful to see the PSA numbers of others.

I have posted on this before, but I may again consider searching out a urologist who uses the "conventional" PSA test with a sensitivity threshold of 0.1. While attempting to switch assays earlier, I personally found a general lack of knowledge surrounding PSA tests and statistics in the medical community. I guess the type of information that I and some others are looking for comes from research scientists/doctors and statisticians, more so than the urologist/GP/nurse who is on the "front line", at least in my opinion. As others have experienced, I have had PSA numbers reported to me incorrectly on two occasions, as if there is not enough anxiety and uncertainty already. This time, I may first at least wait until I (hopefully) see a plateau or reduction in an ultrasensitive test result, and then switch doctors to go for the "conventional" test.

Does anyone know of a urologist in Silicon Valley that uses the "conventional" PSA test?

Thanks,

CaPCa

Posted 3/26/2009 9:41 PM (GMT -5)
CaPCa,

My PSA has been jumping around for 2 1/2 years now and I've gotten used to the discrepencies. I went back and looked at all my numbers and this is what I got: 0.01, 0.1 (different lab), 0.02, <0.01, 0.04, 0.02, 0.03, 0.03, 0.03. All four of my doctors say undetectable don't worry about the minor differences.

Ken
Posted 3/27/2009 9:18 AM (GMT -5)
CaCPa,

My six week PSA was taken at a the Fred Flinstone Lab <.1, Doc said get a better lab, then 4 month PSA taken a distance away from home (too far to keep driving) at a John Wayne Lab <.05 and then I found a Lab near home I would use for conveinance sake which was a George Jetson space age Lab for 6,9 and 12 month PSA's that were .01, .01. and <.008. And then I said hey, wait a minute .01 then .01 then <.008 what the heck? Does this mean I had a reading at 6 and 9 ?

I told my concerns to my Doc, and he looked at me long and hard giving a little exhale of his breath, I waited , he paused, and then he spoke... Listen he said, stop watching so much darn television and just go fishin, they have all been zeros as far as I am concerned, be gone.

I am a little behind you in time from surgery and I feel just like you do. Hard to not feel that way. I got to say though being from the Midwest I think a lot more about it when I am stuck inside watching it snow. Taking my mind off of it really does help. I fish spring, summer and fall. I dont Ice Fish in the winter for my wife is not that ugly.

Frank
✚ New Topic ✚ Reply