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PSA or uPSA after SRT/ADT?

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Posted 9/12/2019 11:15 PM (GMT -5)
One year past SRT and six months out from ADT. May 2019 uPSA was <0.02 (hurrah). My primary referred me to an MO for regular followup. Saw the MO in August, had blood drawn at his hospital instead of my usual lab, result <0.13. This hospital can't do uPSA on site, the MO says there's no need for uPSA in my situation since I wouldn't be facing further treatment until the PSA is above 0.13 anyway. For my next blood draw in November, I'm going back to my usual lab -- more convenient, great online patient portal, all my records at my fingertips -- which can run either standard PSA or uPSA. My primary, who will write the order, says she'll write it for whichever I want. What the MO told me makes sense and might save me needless anxiety if the uPSA loses the <, but still I feel like I want to know every last decimal point.
Thoughts?
Posted 9/13/2019 6:51 AM (GMT -5)
SP - I have not given it a second thought since ART. No reason to get it prior to PCa either. The lower sensitivity has its place in monitoring but can be a needless stress producer for those who do not need it in my opinion.
Posted 9/13/2019 6:57 AM (GMT -5)
SP, I’m somewhat in the same boat. My GP sends my blood work to a lab that does an ultra sensitive PSA and I had that done last December during my annual physical and it came back < .014. Since then my RO/urologist haven’t coded the scrip for ultra so when I go to quest I get the standard assay and all have been < .1. I would have pushed for the ultra test but I tend to agree with what your MO said-what would we do if we saw an increase above ultra but below the standard PSA level for undetectable? I am fine living with the compromise of getting an ultra during my annual physical every December and standard psa assay all other times.

Mike
Posted 9/13/2019 7:39 AM (GMT -5)
SP, Mayo doesn't do ultrasensitive tests either say there is no need for them.

Larry
Posted 9/13/2019 8:37 AM (GMT -5)
I agree with mumbo. My MO does have me on a uPSA. I could have declared undectable 3 months earlier had I been on a standard test, but otherwise no difference. 😉

At this point in my treatment a uPSA serves no purpose other than potential anxiety. I probably won't ask my MO to change to a standard test. For me it's kind of whatever at this point.
Posted 9/13/2019 11:52 AM (GMT -5)
Rich, another vote for not using the ultra sensitive

I am not in the same boat but my boat is similar. I’ve been testing before SRT at Lab Corp. which tests down to .006. Now I am being treated by MSKCC , and they only test down to .05. I never asked my radiation oncologist why, but I know the answer for me, at least. That is, if I do recurr again, nothing is going to be done about it until I am considerably higher than .05 . So, again, for me at least, I could easily go to Lab Corp. and get tested myself and sometimes I’m tempted, just out of curiosity to know what going on down there or elsewhere, who knows . But it isn’t going to change a thing so Why create additional anxiety for myself.

If My understanding is correct that your situation is more or less the same, I would ask you the same question... why create additional anxiety for yourself. How about we both use the less sensitive tests and just consider ourselves undetectable and cured, until proven otherwise. As a former member and a good friend of mine, Sonny, likes to say, squeeze the juice out of every day and don’t stress too much over tomorrow
Posted 9/13/2019 4:28 PM (GMT -5)

Saipan Paradise said...
I feel like I want to know every last decimal point.
Thoughts?

Nothing wrong with that, assuming you can exhibit the same level of self control you have it the past. I suspect folks prone to PSA anxiety, will have it regardless of the type of test administered. I get the uPSA every two months, and don't obsess before, during or after.....yet ;-)

That advise from Sonny should be followed by more people. What we do, rather than what we say, is the true measure IMHO.

If you're comfortable with uPSA, no logical reason not to get it, Rich.
Posted 9/13/2019 11:02 PM (GMT -5)
Thanks for your input, comrades. Much appreciated. Being a glutton for punishment, I'll probably stay with the uPSA.
Posted 9/18/2019 11:15 PM (GMT -5)
Thought about posting this in Prato's "Finally, T rising" thread. Got a new testosterone result today: T=215. Was still <5 just a few months ago, in May.

Now I really want to do uPSA in November. I was <0.02 throughout ADT post-salvage. Now that T is recovering, I really don't feel satisfied knowing that PSA is <0.13 -- I want to know whether I've stayed ultra-undetectable or am inching upward. That's just my personality, I'm not saying it's everybody's answer.

BTW, libido is definitely recovering. Still the occasional hot flash, though.
Posted 9/19/2019 8:43 AM (GMT -5)
That’s great news Rich. Big rise in a short time.
From what I’ve read, the symptoms, including hot flashes, start to subside more and more as you get deep,into the 200’s.
Posted 9/27/2019 10:14 AM (GMT -5)
Good plan SP. Like Pratoman, I get the MSKCC protocol down to .05. Happy with that because at my age 77+) not clear I would treat a recurrence anyway.
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