Does Ultra Sensitive PSA have any value after SRT?

good answer, billy, and thanks btw

My uro and RT doc only use the simple test, as what they want to see is simply "Less than 0.1" (<0.1). So for me the issue has never arisen.

How much can PSA fluctuate at these small numbers and not be any sort of BCR? The way my hospital treats the tests suggests that anything that goes on below 0.1 doesn't really matter.

If you keep getting "less than 0.1s" then they can of course be disguising a slowly rising trend such as 0.01, 0.02, 0.03 0.04, 0.05, 0.06 etc, which might indictae a BCR is about to show up, but with tests every 3 months it's going to take a long time (Also the steps are arithmetic which means that the first rise is a fast doubling time whereas later rises are much much slower doubling times.
However if all you have is: 0.05, 0.04, 0.05, 0.03, 0.05, 0.05, 0.06, 0,05 etc, then you might get an attatck of PSA anxiety when it goes up from 0.04 to 0.06 when you don't need to.

As for the side effects of HT, all I know of first hand is a friend's husband my age who had SRT combined with HT after his PSA came back straight after surgery. He (and she) did not have a good time: weight gain, mood swings, man boobs, sweats, loss of concentration etc and he's also got major issues with incontinence and ED. And now, although he's only my age (51) he's decided he has to give up full-time employment and commuting etc and is going to try and work from home as a consultant. Also met two guys in the RT waiting room who were also having HT and they both complained of major problems with weight gain.

Alf

Maybe it is too late to answer since this thread has gone off track a bit but here's how I look at it.
First let define terms. Screening, diagnostic, sensitive, ultrasensitive... I will skip it for now.

I am going to call the tests single decimal digit, double decimal digit, and triple decimal digit and sometime I will drop the word decimal.

1)The test costs are the same. We did a study here an found there was virtually no price difference. Actually one lab we checked the two decimal digit testing cost $15 LESS than single digit!
2) The single digit test has been widely used since the late 1990's and was a big advancement over "your Daddy's PSA test" of zero decimals.
3)The 2 digit test has been widely used since 2006 and there was a recent significant upgrade in 2010. (Roche Cobas 601 ECLIA )
Some guys are even getting reports to 3 decimals but the machine only has a resolution of 0.003.

You wrote "PSA <0.1 for 2 yrs. PSA rose to .2 at 30 months,"
If you had been getting 2 digit readings you would have seen this gradual change. You might still have waited to do something about it but at least there would not be a surprise.

If it were me (and extensive travel was not required) I would go to the lab that is using the newest equipment, with the latest protocols and I would continue going to that same lab for all future testing.

Typically there are two boxes on the blood work form for PSA testing:
"Screening" - Generally single digit and used for screening before treatment or with PSAs normally expected to be above 2.
"Diagnostic" - Generally 2 digit and used for post treatment.
Make sure the correct box is checked before you leave the office.

Good luck to you,
Jeff (a LFPF - 2 digit kind of guy).

my psa result after rp was 0.02 and two months later 0.05. uro got me to the rad. clinic the next week to get started. two consecutive psa's after rt were both <0.1. both uro and radiation onc. agree that using ultra sensitive at this point holds little value.

also, it is my understanding that following rp if rt is needed- to start when psa is 0.05 or lower yields higher success rates.  next psa is tuesday the 8th of feb.

anxiety is not really a problem anymore except for about a week or so before test time. i suppose this is something we all have to deal with.