RobLee said...
I wouldn't sleep well knowing that my PSA was rising. Mixing in a different lab's results becomes a matter of apples vs bananas. My RALP was within weeks of yours and knew right away that I would need SRT in six months, but then that had to be postponed (long story). In the meantime my PSA is being held stable by Lupron. Present target date for SRT is this August. If I were you I'd start laying the groundwork for SRT while getting several consecutive reliable PSA's from the same lab.
Rob, you have your point - yes, if you want to see a trend you better use the same lab. However I am not comparing apples to bananas, I am comparing LESS sensitive test vs MORE sensitive. In medical statistics, sensitivity means the ability of a test to correctly identify those with the disease ( in our case BCR) .
Put another way, if the test is highly sensitive and the test result is negative you can be nearly certain that you don’t have disease.
My understanding that uPSA has a role in case like mine - it helps to decide when to start adjuvant ( or early salvage) radiotherapy after RP. So do I feel better knowing that my uPSA is 0.009? Yes, I do! I am biased? Yes! Sure enough, i'll retest in 3 month to see where it goes.
As we all learned, prostate cancer is not a simple disease - it's a spectrum. Even though you did not include your signature, based on your outlined treatment plan you likely have high risk disease , in this case ADT + ART are standards or care. My case is more in a "grey zone" given intermediate risk ( my main risk factor for BCR is positive focal surgical margin) - so i am trying to avoid RT overtreatment if possible.
In the end, losing sleep is never good idea...