What's the Definition of "Zero" or "Undetectable PSA" ?

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K2
Regular Member


Date Joined Feb 2011
Total Posts : 51
   Posted 5/20/2011 2:44 PM (GMT -6)   
HW,
 

I know this topic has probably been addressed numerous times...but I'm seeing multiple definitions from various sources.

 

I had a "sensitive test" from my uro that came in at 0.03 (33 days post RP), then a few weeks later my onc ordered a (non-sensitive) PSA test that came back at 0.1  Having used two different assays - one sensitive and one not I can't draw much of a conclusion...I wasn't too happy having incomparable tests. Like all PC guys I want the lowest number possible. I was disappointed when my sensitive test didn't come back 0.01

 

My uro said my 0.03 vis-à-vis 0.01 was probably due to my single apical PM (focally). Is the 0.02 difference even above the noise level of the test? I'm not sure the data supports his prognosis but clearly it's possible.  I'll get another sensitive test before my rad treatment in a few weeks.

 

Do test ever come back at 0.00? What's "zero"?

 

There seems to be definitions used to support clinical decisions and then there are more empirical-based definitions.

 

K2


Roadracer
New Member


Date Joined Sep 2010
Total Posts : 18
   Posted 5/20/2011 3:11 PM (GMT -6)   
K2, We usually see <0.01 reported when the sensitive test is below the detection limit. Best wishes,
Oct 2007 - PSA 7.0
Nov 2007 - Biopsy Positive in three cores - Gleason 7 (3+4) - Age 64
Jan 2008 - RLRP @ Henry Ford Hospital in Detroit
Post-op, Gleason 7, T3a/N0/M0 Microscopic positive margins
Apr 2008 - PSA <0.01
Aug 2008 - PSA <0.01
Dec 2008 - PSA <0.01
Mar 2009 - PSA <0.01
Sep 2009 - PSA <0.01
Jan 2010 - PSA= 0.09
Apr 2010 - PSA <0.01
Jul 2010 - PSA <0.01
Jan 2011 - PSA <0.01

K2
Regular Member


Date Joined Feb 2011
Total Posts : 51
   Posted 5/20/2011 3:32 PM (GMT -6)   
Roadracer,
 
You had a blip on "Jan 2010 - PSA= 0.09" was that a typo? iven all your tests it's hard to believe that was accurate. Bu I don't know, can SA do that?
 
I have seen HW post celebrating the "zero club" a values a bit higher than 0.01.
 
K2


142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5904
   Posted 5/20/2011 3:58 PM (GMT -6)   
K2,
 
The sensitivity of the actual test process is the culprit here. If a test can measure only to 0.1, and the level measured is somewhere below that (0.00 - 0.099), it will come back to you as < 0.1 (Less Than 0.1). That is undetectable  according to the test.
 
There are others that are good down to 0.03, so again, 0.00-0.029, if it were there, would be undetectable.
 
I get reports from two different labs.
The one my GP uses does ultrasensitive, and has reported me as <0.01, 0.02, and 0.096 over the last year. For that test, I was only "undetectable" for the first test.
My uro/surgeon uses only standard, and from that lab I have always had <0.1, which is true. 0.02 and 0.096 are both less than 0.1. For him, I have been "undetectable" since just after surgery.
I'm betting I will be over 0.1 next month when I go for the next appointment.
 
Can you get absolute 0? Probably not, some will say, because if you can get that test sensitivity down low enough, it is bound to find something. Someone else might better explain it, but there is in theory a tiny bit of PSA produced outside the prostate.
 
The "Zero Club" is for those who get an undetectable from their test, regardless of which lower limit it has. Most of us work under the idea that <0.1 qualifies, since that is what may of our uros consider the minimum value to be significant for deciding further treatment.
DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808

az4peaks
Regular Member


Date Joined Feb 2011
Total Posts : 110
   Posted 5/20/2011 5:15 PM (GMT -6)   
To all interested, - The widely recognized CLINICAL definition of "undetectable" has long been, and remains at most Institutions, LESS THAN 0.1 ng/ml, which is reported as <0.1 ng/ml on Laboratory Reports. In low or medium risk patients, and even in most high risk patients, stable or fluctuating PSA results below this level are rarely of clinical significance and are far more often the cause UNNECESSARY anxiety in many Cancer-free patients. For this reason, unless specifically requested by the patient and/or the ordering Physician, the Standard PSA test (1/10th ng sensitivity) is usually used for ROUTINE post-surgical monitoring at most "centers of excellence". (Mayo Clinic and Johns Hopkins are 2 with which I have personal knowledge)

There is nothing WRONG with using Hyper- or Ultra- sensitive assays, AS LONG AS, the patient is made aware of, and fully understands, the TRUE significance and the increase in non-biological variations that do occur at such extremely low levels of sensitivity. Certainly, Postings on Boards such as this indicate that this, often, is not the case and they are the cause of much needless anxiety in the vast majority of cases.

There MAY be significance in steadily increasing PSA results below this level, but it is highly unlikely that any corrective action will take place before such levels exceed the traditional 0.1 ng/ml "undetectable" threshold, unless there is other supporting clinical data available. - So rather than unnecessary worry, what is gained in most such cases? Below my signature is a copy of a Johns Hopkins article that directly addresses this question and I suggest that you may want to listen to the experts! - John@newPCa.org (aka) az4peaks

A Publication of the James Buchanan Brady Urological Institute Johns Hopkins Medical Institutions
Volume V, Winter 2000

PSA Anxiety:

The Downside of Ultra- Sensitive Tests You've had the radical prostatectomy, but deep down, you're
terrified that it didn't work. So here you are, a grown man, living in fear of a simple blood test, scared to death that the PSA- an enzyme made only by prostate cells, but all of your prostate cells are supposed to be gone -- will come back. Six months ago, the number was 0.01. This time, it was 0.02.
You have PSA anxiety. You are not alone.

This is the bane of the hypersensitive PSA test: Sometimes, there is such a thing as too much information. Daniel W Chan, Ph.D., is professor of pathology, oncology, urology and radiology, and Director of Clinical Chemistry at Hopkins. He is also an internationally recognized authority on biochemical tumor markers such as PSA, and on immunoassay tests such as the PSA test. This is some of what he has to say on the subject of PSA anxiety:

The only thing that really matters, he says, is: "At what PSA levels does the concentration indicate that the patient has had a recurrence of cancer?" For Chan, and the scientists and physicians at Hopkins, the number to take seriously is 0.2 nanograms/milliliter. "That's something we call biochemical recurrence. But even this doesn't mean that a man has symptoms yet. People need to understand that it might take months or even years before there is any clinical physical evidence."

On a technical level, in the laboratory, Chan trusts the sensitivity of assays down to 0. 1, or slightly less than that. "You cannot reliably detect such a small amount as 0.01," he explains. "From day to day, the results could vary -- it could be 0.03, or maybe even 0.05" -- and these "analytical" variations may not mean a thing. "It's important that we don't assume anything or take action on a very low level of PSA. In routine practice, because of these analytical variations from day to day, if it's less than 0. 1, we assume it's the same as nondetectable, or zero."

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24271
   Posted 5/20/2011 9:35 PM (GMT -6)   
I second 142's answer above, that matches my understanding and what I have been told
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06, 2/11 1.24, 4/11 3.81
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, 21 Catheters, Ileal Conduit Surgery 9/10

knotreel
Veteran Member


Date Joined Jan 2006
Total Posts : 589
   Posted 5/22/2011 2:00 PM (GMT -6)   
You might want to see the test results yourself, I had a nurse tell me 0.1 on one test when it was actually <0.1. That is a big difference. If it's less than 0.1 then you could still be at your 0.03 or lower or any number between 0.001 and 0.09. To someone who doesn't have PCa or a second or lower level nurse or office assistant, 0.1 or <0.1 may not be important or they might not even know the difference.
Ron
06-08 1st biopsy neg psa 4
10-09 psa 5.5 2nd biopsy 1/12 pos. 10%, G(4+3) age 65
12-15-09 RRP Tulane NOLA Dr Lee
Path, 1%, clr marg, no EPE, no SVI, nodes cl, G(4+3)
100% incontinent @ 12 months
ED, pre-op severe, post op total
10/10 Dr Boone, Methodist recomended AUS
AUS/ IPP performed 1/11/11 Methodist Houston
post op psa's 0.04,<0.1,<0.1,<0.01@12 mo.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5904
   Posted 5/22/2011 2:31 PM (GMT -6)   
Ron's point is very valid - had that "interpretation" problem myself. ALWAYS ask for a copy of the lab report.
 
But then that should be a given for all of our tests and procedures these days, if for no other reason than not all the docs communicate (mine do, because I asked, but it is not at all a given). I show up for a simple flu shot with a notebook, and with the questions they ask today for the CYA files, sometimes even I need it to remember.

K2
Regular Member


Date Joined Feb 2011
Total Posts : 51
   Posted 5/22/2011 4:47 PM (GMT -6)   
My lab report copy was 0.1 not <0.1 so needless to say I'm concerned. I'm scheduled for ART (maybe SRT at this rate) on June 1st (I'm pT3a +LVI, +EPE, +PM). My RP was 3/17/2011 and a jump from 0.03 to 0.1 so soon isn't what one wants to see. Wednesday I'll get another sensitive PSA test using the same sensitive assay as my previous 0.03 test and things should be clearer - not necessarily better. Feeling a bit depressed.

K2

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5904
   Posted 5/22/2011 5:04 PM (GMT -6)   
K2,
 
The "Adjuvant" or "Salvage" labels are pretty much irrelevant at this point. My surgeon requires that his patients wait at least 18 weeks before any radiation just to be sure that the internals have had a chance to heal. We waited a few more weeks in hopes my incontinence would get better (it did not).
 
I also had EPE & Positive Margins with a G 4+5. There wasn't much to look forward to for me other than IGRT. It wasn't the worst thing I've ever done (or at least if it was, I don't know it yet) eyes
 
Hope that .1 turns out to be a fluke.

B2332
New Member


Date Joined Dec 2013
Total Posts : 2
   Posted 12/21/2013 1:29 PM (GMT -6)   
Hi, I'm new but have been waiting for the blood work to come in post-RP before I check in here. Report came in at 0.04 last week, but when I saw the doctors at UCSF yesterday, one said because of my advanced situation I should prepare for salvage radiation, the other, the senior surgeon who actually did the operation, said, let's do another PSA test then see what that shows. Results Monday. I'm way confused now because everything I've read says that 0.1 and below is undetectable. So am I just placed in a special category of ulta-sensitivity because I had positive margins? The doctors told me they use .015 as their marker for zero presence. Anything you can tell me would really help. Happy Holidays.

Age 64. Pre-op PSA 5.9
All 12 biopsy cores positive
Volume of tumor 8.1 cm3
GS 3+4=7 with tertiary pattern 5
Est Vol Gleason pattern 3: 40%
Capsule and extraprostatic invasion
Margin status: 2 slides: 6mm and <1mm
HGPIN present
LM & SV status: negative
Perineural infltration present
AJCC/UICC stage: pT3aN0

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2818
   Posted 12/21/2013 4:36 PM (GMT -6)   
B2332:
As stated above - zero club - undetectable PSA <0.10 - some doctors approach changes in numbers at different levels ( some bring in more money) with 0.20 as the threshold for post-op decisions for going after SRT - salvage radiation treatment - compared to lower numbers - ie. your doc's 0.015 - for adjunct radiation therapy ( doing stuff before anything really happens)....

wishing you all the best,

Bronson

....
Age:57 -gay with spouse, Steve -Peterborough, Ontario, Canada
PSA:10/06/09 3.86
Biopsy:10/16/09- 2/12 cancerous, 5% -Gleason 7 (3+4)
Radical Prostatectomy:11/18/09
Path:pT3a -Gleason 7 -extraprostatic extension -perineural invasion -34.1 gm
PSA:2010- 0.05/ 0.05 ..2011 -0.02/ 0.02 ..2012- 0.02/ 0.10/ 0.09 ..2013- 0.11/ 0.18/ 0.23/0.35 -SRT-10/1-11/18, 2013 - 12/19/13- post SRT-PSA test -0.038

Post Edited (tatt2man) : 12/21/2013 2:59:15 PM (GMT-7)


B2332
New Member


Date Joined Dec 2013
Total Posts : 2
   Posted 12/21/2013 4:51 PM (GMT -6)   
Thanks Bronson,
But check that number again. It's 0.015 not 0.15 that my doctor is using as a baseline. And mine was 0.04. Big difference.

tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2818
   Posted 12/21/2013 5:03 PM (GMT -6)   
the 0.015 was what I meant to write -

I still think you are undetectable - but it all depends on what the path report was with regards to positive margins and if the docs feel there is a risk involved - hence, the adjunct RT approach .. instead of waiting and seeing IF anything happens...

I had positive margins and the only risk part of my pathology was where the cancer was - right near the edge on one lobe - so after 3 years of being undetectable / in remission .... the cancer decided to grow again very quickly - so we did salvage radiation -

take care,
Bronson
Age:57 -gay with spouse, Steve -Peterborough, Ontario, Canada
PSA:10/06/09 3.86
Biopsy:10/16/09- 2/12 cancerous, 5% -Gleason 7 (3+4)
Radical Prostatectomy:11/18/09
Path:pT3a -Gleason 7 -extraprostatic extension -perineural invasion -34.1 gm
PSA:2010- 0.05/ 0.05 ..2011 -0.02/ 0.02 ..2012- 0.02/ 0.10/ 0.09 ..2013- 0.11/ 0.18/ 0.23/0.35 -SRT-10/1-11/18, 2013 - 12/19/13- post SRT-PSA test -0.038

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2683
   Posted 12/21/2013 6:25 PM (GMT -6)   
Thanks for the post on this issue AZ4peaks. You have posted this before. Your voice of reason hopefully will help one reader of your post. You have helped me! Anxiety is a dis ease., whether triggered by psa testing or getting up to meet the morning.
44 mos post op <.1 Pathology 4+3 tertiary5 pni+organ confine 27nodes disected-svi margin- age 70. Caveat. Any statement, position,etc made in my post heretofore should be considered to have the word "arguably" included. The word should be considered self evident, even when not specifically written. Arguably as in a court of law. Logo

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 24271
   Posted 12/21/2013 11:35 PM (GMT -6)   
You are so indeed the limits of being undetectable, being any thing <.10. Couldn't imagine a doctor pushing for salvage treatment with a reading as incredibly low as yours. Many doctors, wouldn't consider it until you had at least 3 consecutive rises above .10, and even then, other's wouldn't consider a secondary treatment until you reached at least .20 or above. I think I would be slowing that doctor down. Lot of risks associated with salvage radiation, and it has a low success rate on a good day, so I sure wouldn't be wanting it until you had absolute confirmation of BCR. That's my take on it.

My oncologist, who only sees patients with advanced PC or advance BC, feels that way too many doctors and/or patients push for salvage treatment without sufficient evidence of it being needed. Just something to think about.

David in SC
Age: 61, 56 at PC dx, PSA 16.3
3rd Biopsy: 9/8 7 of 7 Positive, 40-90%, 4+3
open RP: 11/8, Catheter in 63 days
Path Rpt: 3+4, pT2c, 42g, 20% tumor, 1 pos margin
Incontinence & ED: None
Surgery Failed, recurrence within 9 months
Salvage Radiation 10/9-11/9, SRT failed within 9 months, PSA: Too High
Spent total of 1 ½ years on 21 catheters, Ileal Conduit Surgery 9/10,
7 other PC-related surgeries

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5904
   Posted 12/22/2013 12:11 AM (GMT -6)   
B2332,

I suspect the motive for pushing additional treatment is the tertiary Gleason 5. My surgeon considers any 5 to be 5, so he would consider you a 4+5=9 for evaluating further treatment.

Yes, you are undetectable based on the < 0.1 scheme, which is what my uro and MO use, but that bit of 5 may be setting the tone for them.
Moderator - Prostate Cancer
(Not a medical professional)

DaVinci 10/2009
My adjuvant IGRT journey (2010) -
www.healingwell.com/community/default.aspx?f=35&m=1756808
HT (Lupron) 6-mo injection 9/12;Prolia 6-mo inj 12/12, 06/13

Tim G
Veteran Member


Date Joined Jul 2006
Total Posts : 1418
   Posted 12/22/2013 10:13 AM (GMT -6)   
az4peaks said...
To all interested, - The widely recognized CLINICAL definition of "undetectable" has long been, and remains at most Institutions, LESS THAN 0.1 ng/ml, which is reported as <0.1 ng/ml on Laboratory Reports. In low or medium risk patients, and even in most high risk patients, stable or fluctuating PSA results below this level are rarely of clinical significance and are far more often the cause UNNECESSARY anxiety in many Cancer-free patients. For this reason, unless specifically requested by the patient and/or the ordering Physician, the Standard PSA test (1/10th ng sensitivity) is usually used for ROUTINE post-surgical monitoring at most "centers of excellence". (Mayo Clinic and Johns Hopkins are 2 with which I have personal knowledge)

There is nothing WRONG with using Hyper- or Ultra- sensitive assays, AS LONG AS, the patient is made aware of, and fully understands, the TRUE significance and the increase in non-biological variations that do occur at such extremely low levels of sensitivity. Certainly, Postings on Boards such as this indicate that this, often, is not the case and they are the cause of much needless anxiety in the vast majority of cases.

There MAY be significance in steadily increasing PSA results below this level, but it is highly unlikely that any corrective action will take place before such levels exceed the traditional 0.1 ng/ml "undetectable" threshold, unless there is other supporting clinical data available. - So rather than unnecessary worry, what is gained in most such cases? Below my signature is a copy of a Johns Hopkins article that directly addresses this question and I suggest that you may want to listen to the experts! - John@newPCa.org (aka) az4peaks

A Publication of the James Buchanan Brady Urological Institute Johns Hopkins Medical Institutions
Volume V, Winter 2000

PSA Anxiety:

The Downside of Ultra- Sensitive Tests You've had the radical prostatectomy, but deep down, you're
terrified that it didn't work. So here you are, a grown man, living in fear of a simple blood test, scared to death that the PSA- an enzyme made only by prostate cells, but all of your prostate cells are supposed to be gone -- will come back. Six months ago, the number was 0.01. This time, it was 0.02.
You have PSA anxiety. You are not alone.

This is the bane of the hypersensitive PSA test: Sometimes, there is such a thing as too much information. Daniel W Chan, Ph.D., is professor of pathology, oncology, urology and radiology, and Director of Clinical Chemistry at Hopkins. He is also an internationally recognized authority on biochemical tumor markers such as PSA, and on immunoassay tests such as the PSA test. This is some of what he has to say on the subject of PSA anxiety:

The only thing that really matters, he says, is: "At what PSA levels does the concentration indicate that the patient has had a recurrence of cancer?" For Chan, and the scientists and physicians at Hopkins, the number to take seriously is 0.2 nanograms/milliliter. "That's something we call biochemical recurrence. But even this doesn't mean that a man has symptoms yet. People need to understand that it might take months or even years before there is any clinical physical evidence."

On a technical level, in the laboratory, Chan trusts the sensitivity of assays down to 0. 1, or slightly less than that. "You cannot reliably detect such a small amount as 0.01," he explains. "From day to day, the results could vary -- it could be 0.03, or maybe even 0.05" -- and these "analytical" variations may not mean a thing. "It's important that we don't assume anything or take action on a very low level of PSA. In routine practice, because of these analytical variations from day to day, if it's less than 0. 1, we assume it's the same as nondetectable, or zero."
+ 1  This explains it fully, with surgical precision.    I have never been undetectable using ultrasensitive testing. 

Age 65 Prostatectomy 2006 Organ-confined
PSAs < 0.05

Buddy Blank
Veteran Member


Date Joined Jan 2013
Total Posts : 1024
   Posted 12/22/2013 11:42 AM (GMT -6)   
Good explanation az4peaks. Thx. Happy Holidays.
PSAs: 4.76 (May '12) 4.23 (August '12) 3.98 (October '12) 4.9 (February '13) 2.9 (June '13) 2.7 (November '13)
Biopsy right prostate: Benign tissue
Biopsy left prostate: Prostatic adencarcinoma, Gleason score 7 (4+3), Tumor involves 2 of 10 cores and 5% of total tissue sampled, Positive for perineural invasion
TRUS measured prostate volume 19.36 cc
Stage T1c
66 Pd-103 seeds implanted (March '13)

Prowler6B
New Member


Date Joined Jul 2013
Total Posts : 11
   Posted 12/23/2013 7:32 PM (GMT -6)   
Seems we all need to think a bit about the math.

If a PSA level of 0.2 is cause for additional treatment then I believe one needs to be getting PSA results to at least two decimal places. With only one decimal place, if ones PSA level is from 0.050 to 0.149 it would be reported as 0.1. Likewise, PSA from 0.150 to 0.249 would report as 0.2. So think about it for a second or two, if one was told his PSA increased from 0.1 to 0.2 there would be great concern. But, with better instrument and reporting accuracy you found out it went from 0.14 to 0.15 then the concern would be much less as 0.14 and 0.15 are essentially identical and maybe within instrumentation accuracy. Likewise, if you knew it went from 0.05 to 0.24, one would have much more cause for concern even though the change for all of the above would have been reported as from 0.1 to 0.2.

I believe we all need to understand the math and the accuracy of the equipment. The read out should indicate the the test result to as many decimal places as its accuracy. ie, PSA = 0.134 accurate to +/- 0.003 or whatever the appropriate accuracy. I don't see how having more information on any subject can hurt you. The more data you have the better informed you are. Also, plot your data on a graph, a picture is worth a thousand words.

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5904
   Posted 12/23/2013 9:31 PM (GMT -6)   
Prowler,

In my opinion / experience, too much information in a medical / insurance system that can not or will not use it simply creates more sleepless nights for the patient. Being that patient, I wish I had not done ultra-sensitive. It caused me over a year of sleepless nights with no viable avenue to do anything to make it better.

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2683
   Posted 12/23/2013 10:14 PM (GMT -6)   
Im not getting prowlers point.Isn't psa reported as one piece of data unless under the lowest dectable point the equipment detects, which simply reports an >, then the lowest detectable value of equipment. Im not familiar with any one getting a reading of this to that. They get a number in either 1 2 03 decimal points. Such as .1. or .05 or .123 etc. I see your math and agree with it. I just don't see how it applies to a single reported psa value, whether 1 2 or 3 decimal points. Unless you are taking about increases or decreases in consecutive or more psa blood draws. Clarify your point please.
44 mos post op <.1 Pathology 4+3 tertiary5 pni+organ confine 27nodes disected-svi margin- age 70. Caveat. Any statement, position,etc made in my post heretofore should be considered to have the word "arguably" included. The word should be considered self evident, even when not specifically written. Arguably as in a court of law. Logo

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 2683
   Posted 12/23/2013 10:30 PM (GMT -6)   
Disregard I think i got your point. I wouldn't attempt to explain it though. If you are right and I think you are, perhaps this is why a cancer center such asMSK use .4 for official BCR. someone and come in on this point with more math knowledge and confirm Prowlers Point. In a single decimal system, does a lab round down @ .149 to .1 and up @ halfway point to .2 . If so,the .2 and 3 consecutive rises means you won't see a rise possibly for a long time. Interesting if true. Doesn't effect me cause I won't' treat, no rad, due to age in pathology, and HT at least in double digits. but for others??
44 mos post op <.1 Pathology 4+3 tertiary5 pni+organ confine 27nodes disected-svi margin- age 70. Caveat. Any statement, position,etc made in my post heretofore should be considered to have the word "arguably" included. The word should be considered self evident, even when not specifically written. Arguably as in a court of law. Logo

STW
Regular Member


Date Joined Jun 2009
Total Posts : 272
   Posted 12/24/2013 1:58 PM (GMT -6)   
I've a doctor friend who is a pathologist at one of our local hospitals. (In fact it was he who checked in my prostate to the lab when I had surgery. "I didn't know you had cancer...") He told me they do not round the numbers on PSA tests, they truncate.

So, everything from 0 to .099 is <0.1 and everything from 0.1 to 0.199 is = 0.1.

When I hit 0.1 it was AT LEAST 0.1 and when I hit 0.2 it was AT LEAST 0.2.

Around here, for one, no one is pulling the trigger on further treatment because of a rounding error.
dx 54
PSA 8.7 Biopsy 1/7/09
4/6 cores +, one 90%
G 3+4=7 Neg scan 1/15/09
1 shot Lupron 1/27/09
RP 4/29/09
- nodes, + vesicles, + margin
G 3+4=7 tertiary 5 T3b
Cath 2 wks no PM leaks Pad free wk 5
PSA 6/09 <0.1; 9/09 <0.1; 3/10 <0.1; 9/10=0.1 12/10=0.1; 3/11=0.2
SRT 05/09/2011 - 07/01/11
PSA 10/11 <0.1; 2/12 <0.1; 6/12 <0.1; 10/12 <0.1; 07/13 <0.1; 12/13 <0.1

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 5904
   Posted 12/24/2013 6:37 PM (GMT -6)   
I don't recall the circumstance, but the "truncate" explanation reminds me that I had been told the same thing. It would make sense, as rounding up would be reporting false, higher than reality results.
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