The < fell off, am I over reacting with worry? or just wait for the next test?

The < fell off, am I over reacting with worry?

Tuesday 6/13/17 I went for my PSA draw and since I had an appointment a week later with my MO, I asked my URO if he could have his lab perform the additional blood tests for my MO visit and he said yes without an additional fee.

Normally I get the PSA results back in a day or less on line, but after 2 days of no PSA results, I called the URO’s office to find out NO PSA WAS DONE?, only the 2 worthless blood test for the MO were done! So Thursday I drove 220 miles RT back to the URO’s office and had the PSA done. On Friday afternoon the results were not on line, so I called my URO’s office and the doctor’s nurse told me my PSA was undetectable and was the same as the last 2 draws at <0.020.

Monday evening I saw my PSA results on line and the < fell off, it went from <0.020 to 0.020. Yesterday I stated calling the URO’s office to clarify this and the nurse and doctor were both out, but the office staff did state the results were 0.020 and that was good. I told the staff member the PSA result was an increase over the last 2 tests and the staff member said I would have to talk to the doctor’s nurse about it and the doctor and nurse would be in today. The staff member said she would have the nurse call me today.

My MO visit got pushed back till July 7.

I have meetings all day today and tomorrow, so likely my return call will go to voice mail and I will be playing phone tag for days.

I drove back to the URO’s office so that the same lab would be usedfor the PSA. Am I over reacting to this PSA test result? Or should I take a pill and forget about it till the next test?


Final Path after October 13, 2015 surgery:
All 17 lymph nodes were negative.

Prostate size: 4.1 x 3.7 x 4.9 cm

Prostate weight: 53 grams

Total GS 9 (4+5=9)

40% of the prostate involved

Seminal vesicles invasion: Identified

Margins: Minute focus of left posterior margin involved by the tumor. In the right and left apex there is focus approaching the edge, but due to the absence of ink in the portion, it cannot be definitively said that it is a true margin

Perineural invasion: Present, extensive

Path staging: pT3Bno

PSA 7/29/2015 6.76, 11/11/15 0.044, 1/19/16 0.041. Radiation completed Mid May 2016, PSA 5/25/16 0.026, 10/18/16 <0.020, 3/2/17 <0.020, 6/15/17 0.020

ntz,

We have guys here who actually know how the machines work so I have to be careful about making things up since there is a penalty for guessing, but here's what I am fairly sure I know: The machines that measure PSA are more precise than accurate. The machine reads the sample to more decimal points than they report -- four, maybe five, places after the dot. That last digit is pretty meaningless in real-world situations so they round (truncate?) the number to the number of digits that they are sure of. This means that there are two numbers that differ by a single increment in that last unreported digit where one of them gives the less than sign and the other doesn't. For your 0.020 reading, if they truncate then those numbers are 0.02000 and 0.01999 (if they round, 0.01995 and 0.01994). That last digit difference could be a mouse farting in the lab or cosmic rays. So when you lose your less-than sign you don't know that anything has actually changed about your PSA. But you don't know that it hasn't.

If you were a Gleason 6 guy I would tell you, yes, you are overreacting. But you're not and you're not. It's a worry. Not much you can do right now. Wait a bit. Retest and see. This is a good time to fill your Rolodex with radiation oncologists so you are ready but, aside from that, take that pill and worry as little as you can.

I vote for, no worry, retest, and maybe a nice dinner at a good restaurant.

These fears and concerns are entirely normal.
Here's a very similar thread from a few years ago.

www.healingwell.com/community/default.aspx?f=35&m=2115902

Charles

It's really up to you. If you will feel more comfortable getting another 3 month PSA next time, you should. It's about peace of mind.

12/27/2017 - Saw the vampire - PSA was .026 so the less than sign did not return.

At least the rise was very slight from .020 last time in June, I guess?, I just don't know what to think about the latest test and it will six months before I will see the Doctor.

Next PSA draw is in six months from now.

Take care and Happy New Year

These ultra sensitive test can be agonizing. I went to a traditional <0.1 test after
going through what you are. As you can see from my signature below, I'm in the higher
risk category.

I was using a <.01 and I got results from <.01 to .02 and even .03 one time.
Retested after and <.01 again...drove me crazy!

I decided that I won't do anything unless PSA is over 0.1 so, I moved to
non ultra-sensitive about 2 years ago...more Peace for sure.

I know not everyone agrees, but you have to find your own way through this stuff.
Mike