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spike to detectable PSA after 9 years

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Posted 8/13/2015 9:23 PM (GMT -5)
So, I had my radical prostatectomy in July 2006, and have had regular PSA tests since then, all with results that were "undetectable" (officially, the results were < 0.01). Yesterday, I had a PSA test and the result came back as 0.04. I got this result via email from my doctor's office (Dr. Reiter, UCLA), who said simply, "Let’s repeat it again in a few months. Would be quite rare to progress now almost 9 years since his surgery."

So, should I be overly concerned? Is my doctor under-reacting? Should I be trying to repeat this test tomorrow? A few months seems a long time to wait, especially if could increase significantly. Or could these results be a fluke?
Posted 8/13/2015 10:15 PM (GMT -5)
It could be a lab error.
It would be rare for it to be a occurrence. But, you shouldn't be overly concerned. Watchful, yes, but you'd need a rise over a few tests to get to needing to be concerned about needing to do anything.

Waiting three months shouldn't be a problem. Doubt it's suddenly shoot up to aggressive numbers in that time - PC just doesn't grow fast. I don't think your doctor is under reacting. However, if you're concerned, you could get a retest sooner.

Andrew
Posted 8/13/2015 10:25 PM (GMT -5)
Lab error? Yes, it could be....Waiting 3 months to retest won't hurt. But why? It's not like your body is still clearing PSA after your surgery. If it is a "lab error" you should be able to retest immediately. I would at a different lab to rule out the equipment being cause. All waiting 3 months is going to do is make you sweat for that long.....If you are like me I would want to know ASAP if it were a lab error.

Call your Dr. and tell him to send you to a different lab for a re-test.

You could go to the same lab, but I would call them and make sure they have calibrated the equipment between the last time you went and the next....

Wait 3 months....makes no sense at all in your situation.....
Posted 8/14/2015 10:50 AM (GMT -5)
I agree with the others that this is almost certainly a lab error. Ask your doctor's office to have the lab rerun the test on the original sample (lab's usually hang on to these for at least a week), then if it is still high ask for another blood draw with a retest.

Take care and hang in there
Posted 8/14/2015 12:46 PM (GMT -5)
I would go for a retest and not wait 3 months. Are you on an annual cycle for tests. If so, assume the .04 is year after your last one.
Posted 8/14/2015 12:59 PM (GMT -5)
i'd retest now to eliminate lab error. some people are wired differently but I would need to know now.

good luck.

ed
Posted 8/14/2015 1:39 PM (GMT -5)
Yes, I have been on an annual cycle, officially, though i've been early or late due to work schedule. Here is my recent history:


Component PSA,Total
Latest Ref Rng
1/20/2009 <0.01
1/21/2010 <0.01
12/23/2010 <0.01
3/16/2012 <0.01
6/14/2013 <0.01
11/26/2014 <0.01
8/12/2015 0.04
Posted 8/14/2015 1:41 PM (GMT -5)
If it is a real increase, it's slow and small, so there's really no decision to be made yet. So I can see why your doc recommends waiting and establishing a more useful PSADT. On the other hand, blood samples and test kits do get contaminated, and there can be misreads and mislabels.

I think it depends on your anxiety level: if it's making you anxious, get a re-test, using the same lab (readings may differ between labs).
Posted 8/14/2015 2:18 PM (GMT -5)
At this point, I am strongly considering retesting on Monday.
Posted 8/14/2015 2:41 PM (GMT -5)
no harm in that and it help rule out lab error.

Let us know how it goes.

Andrew
Posted 8/14/2015 6:45 PM (GMT -5)
To be honest , .04 I believe is still " undetectable".
Bob
Posted 8/18/2015 2:39 PM (GMT -5)
Well, I went for a retest, and the result came back as < .01! I was pretty much prepared to get another .04, so I was quite surprised. So I guess weird results can happen...
Posted 8/18/2015 3:12 PM (GMT -5)
I have been lurking and following your thread...

Really happy for you! I'll bet it's the best zero you had yet!

Great advice to get the re-test and avoid the 3 months of anxiety.

Jon
Posted 8/18/2015 3:14 PM (GMT -5)
Yes, weird things happen at the lab. One of the reasons I always say, retest and confirm.

Glad to hear it came a zero and congratulations on the great result.

Andrew
Posted 8/18/2015 3:27 PM (GMT -5)
Great news!
Posted 8/18/2015 3:37 PM (GMT -5)
I'm very happy for you with your new results. That's great.
Posted 8/18/2015 3:57 PM (GMT -5)
Congratulations, for being undetectable for 9 years. Gives me hope that I also will be.
Actually your first test result should be seen as undetectable since anything below 0.1 is regarded undetectable according to current standards.
Posted 8/18/2015 4:03 PM (GMT -5)
Terrific news, congrats.
Posted 8/18/2015 4:18 PM (GMT -5)
WAY TO GO!!
Posted 8/18/2015 5:11 PM (GMT -5)
Very good news!! Those machines need regular calibration and this is not the first time this has happened in my five years here on this site.
Posted 8/18/2015 8:09 PM (GMT -5)
This is wonderful news, and exactly what I expected with the retest. If I get an increased PSA level on my next test, I'll do the same thing and retest.
Posted 8/18/2015 8:35 PM (GMT -5)
Nice!
Posted 8/19/2015 4:44 PM (GMT -5)
"let's repeat it in a few months", the doc says. Good for him. He's not the one who can think of nothing else during those few months. I'd bet if it were him, he'd be in the lab at his office every day getting his PSA checked. Good for you, for not waiting. Listen to his advice, but you're in charge.
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