Just what is undectectable psa after surgery.

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torgeir
Regular Member


Date Joined Apr 2008
Total Posts : 33
   Posted 7/13/2008 10:21 AM (GMT -6)   
I notice that there appears to be a lot of variation in psa levels regarding what is undetectable.
Some people are receiving radiation treatment when their psa levels are below .1.
My urologist believes some people will produce psa after the prostate is removed and recommends rt after the psa level reaches .5, is this normal also the doubling time must play an important part in the equation
Dx 10/12/2007 after rise in psa level to 4.7
Biopsy 7 out of 12 cores positive.
Gleason 7 3+4.
Da Vinci 4/02/2008
post op pathology positive margin gleason 7 4+3.
Staged t3a
nerves saved one side
continent from day one can't say the same about ed
still not able to achieve an erection, but close using cialis.
three month post op psa .3 (ouch)
Enrolled in clinical trial for chemotherapy 18/04/2008 using
Taxotere 75mg/m2 every three weeks for six sessions.
Waiting to see results of first psa test after chemo.
18/04/2008 - psa .4 1st chemo
09/05/2008 - psa .3 2nd chemo.
30/05/2008 - psa .3 3rd chemo.
20/06/2008 - psa .2 4th chemo.


DanmanBob
Regular Member


Date Joined Feb 2008
Total Posts : 467
   Posted 7/13/2008 10:51 AM (GMT -6)   
Some measuring devices go no lower than 0.1, others are more precise and can register as low as 0.04, etc.  If you are being tested using one that goes no lower than 0.1, then that would be the lowest number that would show up.
 
For post-op patients, I have seen 0.1 as the threshold above which radiation or some other form of additional treatment is recommended.
 
Others may have seen different reports and if so, will share with you here.
 
DanMan Bob
Danman Bob, Born 1951
Nerve-sparing, open prostate surgery November 13, 2007
Gleason score 9, PSA 14; Biopsy result - 9 of 12 sticks showed cancer
Post-op pathology stated that cancer was confined to the prostate
Unrelated surgery January 2008 delayed incontinence recovery, which is now showing good signs of improvement (fraction of a pad a day as of late April 2008)
100 MG Viagra 3 times a week beginning December 2007
Osbon Erec-Aid Esteem manual pump for therapy beginning mid-February 2008
30 MG papaverine/1 MG phentolamine bimix injections beginning late April 2008
Five week post-op PSA 0.2, five month post-op PSA 0.1, next test August 2008


Tony Crispino
Veteran Member


Date Joined Dec 2006
Total Posts : 7650
   Posted 7/13/2008 12:20 PM (GMT -6)   
I am one of those who had radiation while below .1

My surgery confirmed that I had local mets. There was risidual disease left behind. I had surgery to attack what was on the other side of the knife. My oncologist said he doubted that this would do any good as studies showed I was headed torwards a likely relapse. But it was my cann to hit the area with radiation. Some studies are being done that are showing that we did the right thing.

Tony
Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Stage pT3b (Stage III)
HT began in May, '07 with Lupron and Casodex 50mg
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (May 9 '08): <0.1
I will continue HT until May '09. 
Years in Remission (3/23/07): 1
Visit my Journey at:
And at:
 
STAY POSITIVE!
 
 


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 1398
   Posted 7/13/2008 1:32 PM (GMT -6)   

The standard PSA has a lower detection limit of 0.1 ng/mL, so anything below that is reported as less than 0.1 (<0.1).  Ultra-sensitive tests go lower and usually report to the nearest hundredth rather than the nearest tenth, for example, 0.02.  The detectable limit is lower as well. 

Having written that, I opted to go with the standard PSA test for two reasons (1) I don't plan to consider any salvage radiation unless the PSA is above 0.1 and (2) there is so much noise in the ultra-low test results below 0.1 I don't want to experience undue anxiety by seeing a report that shows a rising PSA, say 0.02 to 0.04 that may in fact be simply test variation and insignificant.

 



Age 59  PSA quadrupled in 1 yr (0.6 to 2.5) 
DRE neg  1 of 12 biopsies pos (< 5%) 
Open surgery June 2006 
Organ confined pT2a  Gleason 5   
Cancer-free for 2 years  PSA's undetectable 


BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1821
   Posted 7/13/2008 6:45 PM (GMT -6)   
This is an interesting article on PSA post-prostatectomy.
www.phoenix5.org/Basics/psaPostSurgery.html
As DanManBob says there are differing generations of equipment now available to measure PSA................Generation 1 reads to 1 decimal place (i.e. 0.1), Generation 2 reads to 2 decimal places (i.e. 0.01) and Generation 3 reads to 3 decimal places (i.e. 0.001).
Bill
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.1 undetectable


Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 1398
   Posted 7/13/2008 7:12 PM (GMT -6)   
BillyMac said...
This is an interesting article on PSA post-prostatectomy.
www.phoenix5.org/Basics/psaPostSurgery.html
As DanManBob says there are differing generations of equipment now available to measure PSA................Generation 1 reads to 1 decimal place (i.e. 0.1), Generation 2 reads to 2 decimal places (i.e. 0.01) and Generation 3 reads to 3 decimal places (i.e. 0.001).
Bill

      Thanks for posting the link to this excellent and concise piece on post-prostatectomy PSAs, Bill.  All the more reason for me to follow baseball hitting statistics to the nearest thousandth and my own PSA statistics to the nearest tenth.

BillyMac
Veteran Member


Date Joined Feb 2008
Total Posts : 1821
   Posted 7/13/2008 9:47 PM (GMT -6)   
Here is another valuable link......................I don't know if it has been posted before. It lays out just what the difference between PSA testing and ultrasensitive PSA testing is, how its done and how it can be of benefit in detecting early possible disease re-occurence.
www.prostate-cancer.org/education/preclin/McDermed_Using_PSA_Intelligently2.html
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07----4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.1 undetectable

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