I'm concerned PSA .01 jumped to .02 in 4 months

I had to correct my signature, sorry.

4/10 0.01

8/10 0.02

How consistent were you? Diet, activity, time of day? Depending upon the equipment used, the tolerance can be +/- 0.02. So, you are well within the noise limit.

That said, every recurrence started exactly the same way. Take a few more measurements then decide if it is a trend. Watch it like a hawk and you'll get it early.
Jeff

It has been proven time and time again here that fluctuations in PSA at the ultra sensitive level are absolutely meaningless. Many people here have had the ultra sensitive test go up and down all over the place. Stop torturing yourself and move to the standard test. Even Johns Hopkins doesn't use it.

Thanks so much for your responses. I feel calmer now.

Goodlife,

There is absolutely 0 benefit to the ultra sensitive test. Nobody will touch you with any kind of secondary treatment until your PSA is .1 or greater. It fact biochemical recurrence is technically not until .2 anyway. You are just torturing yourself finding fluctuation below .1.

You also need to go back and look at the posts closer, there are a bunch of people using the ultra sensitive test showing fluctuations. Look up a guy called "diagnosed41". He story is a classic example.

Also, show me the data where people using the ultra sensitive test who went on to have secondary treatment that fared better then those using the standard test. If that were true every uro would require the ultra sensitive test.

You are causing yourself unnecessary pain.

Chris,
I'm with Goodlife.
I will continue to have mine checked to 2 decimals and will watch it like a hawk. If my 6 month PSA moves from 0.01 to 0.03 to 0.05 I will be on it so fast it will make my bladder spin.
I want the plan in place and the treatment ready if it rises above my set threshold.
I person receiving a one decimal result will never know until it flips from .1 to .2 and then, maybe, the doc would insist on another 3 month wait to make sure it was not a fluke. That can be 2 years after it has started to rise.
I liken the high resolution test to the advent of digital watches. Before we had them, a minute a day was considered ok. It did not make a difference in the long run. The meeting started anyway, you got to dinner on time. With digital watches now we expect them to be accurate to 1 second a month. It doesn't make a difference except when you are turning on the TV and want to see the first few seconds or are trying to catch the right train in Japan. Given that the mechanical and digital watches are the same price and durability which do you select? It is clear the industry has gone digital.

It is far better for us to have the information and use it wisely rather than not get it because someone else thinks it might confuse us or make us worry. Pushing the example further, why ask for the results at all? Let's have it sent directly to our Uros and PCPs and have them call us if they think we need to do something. That way we won't have to "worry our heads about something we don't know anything about". There is not a guy here who would accept that.
My heat breaks for vam4710 in this thread: Dad's PCa is back
The guy trusted his doc who clearly just put the results in the file without alerting him. Look at his stats. It will make your stomach turn.
I want all the ammunition I can get so that will not happen to me. I'll take 3 decimals if they give it.

Jeff (<0.01ng/ml by Roche Cobas 601 ECLIA)

ChrisR - what you said isn't entirely correct. You said that you wouldn't have biochemical recurranc until a PSA of .2

Many doctors now, consider 3 consecutive rises above .1 as recurrance, that is the standard used in my area. The radiation oncologists locally I spoke with want to see salvage radiation begun before you hit .2. That is their normal "line in the sand". My own uro told me just this week, that .05 is considered the legitimate prescence of PSA after surgery as a primary treatment or radiation as a secondary treatment.

David in SC

Chris,
It is combination of both accuracy and frequency. Most of us here are on a 3 month or 6 month testing schedule. Some are even annual. That decimal point can help me see a trend in values a year or more before my PSA reaches 0.14 - which, by the way, would theoretically still be reading 0.1 . I'll take any advantage I can.

Here's how I use the data:

I am at <0.01 now. If it moves to 0.01 I will consider myself on "storm watch" status: I'm not worried but I will make sure I don't skip the next reading. If it goes to 0.02 I am on "storm warning" status: I might ask the Uro to change my schedule back to 3 months from 6 months. ) And if it goes to 0.05 I am on "storm alert" and will be on the phone with every doc who touched my case. I am a pT3a, (with a pre-RP PSA of 23.
I am not going to wait for it to rise to .2 before starting treatment. I'm making plans at 0.05 so by the time I actually get an appointment I am still, hopefully, well below 0.08.

Despite what the Rolling Stones said: Time is not always on our side.

Jeff (<0.01ng/ml by Roche Cobas 601 ECLIA)

_{I am not expecting disaster but I do like the idea of having a plan in place, just in case. It is like keeping water and food in the basement and 20 gallons of gasoline and a generator in the barn - cheap insurance. The extra digit costs nothing - just an upgrade from the 2002 machine to a 2006 model.}

Post Edited (Worried Guy) : 8/22/2010 10:54:26 AM (GMT-6)

Hey daveshan,
We are together brother. If I get to 0.05 I'm hitting it with both barrels ASAP. There is no honor in fighting a prolonged asymmetric war.

Try to find out what machine they are using for the analysis. I am part of a study comparing the "older" readings, 2006, to the new technology, 2010.
Check out my stats below for the comparison. For me, a 0.04 and 0.03 old, is <0.01 new.
Jeff

4/14 9 months - 0.04 (Siemens Centaur) and <0.01 (Roche ECLIA).
7/12 1 year - 0.03 (Siemens Centaur, direct chemilum); <0.01 (Roche Cobas 601 ECLIA)

Post Edited (Worried Guy) : 8/22/2010 12:22:18 PM (GMT-6)

Chris,
My numbers are not all over the place. They are very stable.
They were always 0.04 or 0.03 with the older 2006 standard and always <0.01 with the new 2010 standard.

Eventually the new one will be the only numbers reported. But for now, both standards are supplied so we can maintain a point of reference. This is part of a huge correlation study now underway.

I'll bet you a couple of bucks that within 2 years, your numbers will likewise be reported via the ECLIA to 2 decimal points.

Time and technology march on.

Jeff (actually a lot less worried with a <0.01 than I would be with a <0.1 )

Listen guys...everyone is going to make their own decision about when - and if - to begin a secondary line of treatment. I am concerned though about anyone jumping the gun too soon with RT. Look at my John's interesting little blip last summer/fall: He was less than 0.1 for 17 months, then his August 2009 test showed 0.1, followed with a 0.3 in September 2009. We met with a radiation oncologist, had CT scan and bone scan, and were all ready to begin RT in October. John's third - and supposedly definitive PSA test - was scheduled for mid October and we were all set to begin RT within a couple of days of that test. Lo and behold, his October PSA reading came back at undetectable and has continued to stay there since then. I often wonder what would have happened if we jumped the gun when it hit 0.3 since we were told by some people not to even bother with the 3rd PSA test. I was ready at PSA test #2 but John and his urologist said "no, we wait for the 3rd blood test." The 'what ifs" make me wince when I think of how close we had come to exposing John to somewhere around 66 gys of radiation when it wasn't necessary.

While John's surgical stats may not indicate as aggressive a disease as others here had, he was a T3a with extraprostectic extension. In his case, the urologist/surgeon said that it was likely benign prostate tissue around the nerve bundles (which were spared) that caused the blip.

I only tell our story to illustrate to those new here how important it is to first verify that there is an upward trend in PSA before pushing the button. Again, each person can and should make their own decision about what steps, if any, to take next, and this decision should be made based on their own history in consult with their medical team.

Jeff:

You know, Jeff, you keep mentioning the importance of being consistent when getting PSA tests. That sounds so logical, but I'm not sure that it carries any validity.

Are there any studies that supports such a contention regarding POST-OP PSA tests?

I know one time I had a probable UTI and my team at Ford Hospital all said it didn't matter in terms of influencing my PSA.

Mel